J Clin Monit Comput - Impact of central hypovolemia on photoplethysmographic waveform parameters in healthy volunteers part 2: frequency domain analysis.

Tópicos

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Resumo

JECTIVE: The photoplethysmographic (PPG) waveforms are modulated by the respiratory, cardiac and autonomic nervous system. Lower body negative pressure (LBNP) has been used as an experimental tool to simulate loss of central blood volume in humans. The aim of our research is to understanding PPG waveform changes during progressive hypovolemia.METHODS: With IRB approval, 11 volunteers underwent a LBNP protocol at baseline, 30, 75, and 90 mmHg (or until the subject became symptomatic). Subjects were monitored with finger and ear pulse oximeter probes, ECG, and finger arterial blood pressure monitor (FABP). Heart rate variability (HRV) was analyzed to high frequency (HRV-HF) (0.12-0.4 Hz) and low frequency (HRV-LF) (0.04-0.12 Hz). Frequency analysis of PPG waveforms were computed to low (0.04-0.11 Hz) frequency (PPG-LF), intermediate (0.12-0.18 Hz) frequency (PPG-IF), respiratory (0.19-0.3 Hz) frequency (PPG-Resp.) and cardiac (0.75-2.5 Hz) frequency (PPG-Cardiac)during different phases of LBNP protocolRESULTS: Heart rate increased significantly while systolic, mean and pulse pressure of the FABP declined slowly together with significant reductions in HRV-HF (0.12-0.4 Hz) and HRV-LF (0.04-0.12 Hz) power at LBNP(75). There was significant reduction in finger PPG-Cardiac modulation which is consistent with the reduction in the pulse pressure of the FABP. As the LBNP progress there was shift in the amplitude density of the ear PPG-Cardiac to PPG-Resp. Oscillation as an evidence of progressive hypovolemia with reduction in pulse pressure and increase in the respiratory induced variations. At LBNP(75), there were significant increased (>140% increase from the baseline) in ear PPG-IF (0.12-0.18 Hz) in the meantime HRV-HF showed significant reduction (>89%) from the baseline. At the symptomatic phase; there was a shift in ear PPG-IF to PPG-Resp. With an increase in the ear PPG-Resp. Modulation to =175% from the baselineCONCLUSION: The pulse oximeter waveform contains a complex mixture of the effect of cardiac, venous, autonomic, and respiratory systems on the central and peripheral circulation. The occurrence of autonomic modulation needs to be taken into account when studying signals that have their origins from central sites (e.g. ear and forehead).

Resumo Limpo

jectiv photoplethysmograph ppg waveform modul respiratori cardiac autonom nervous system lower bodi negat pressur lbnp use experiment tool simul loss central blood volum human aim research understand ppg waveform chang progress hypovolemiamethod irb approv volunt underw lbnp protocol baselin mmhg subject becam symptomat subject monitor finger ear puls oximet probe ecg finger arteri blood pressur monitor fabp heart rate variabl hrv analyz high frequenc hrvhf hz low frequenc hrvlf hz frequenc analysi ppg waveform comput low hz frequenc ppglf intermedi hz frequenc ppgif respiratori hz frequenc ppgresp cardiac hz frequenc ppgcardiacdur differ phase lbnp protocolresult heart rate increas signific systol mean puls pressur fabp declin slowli togeth signific reduct hrvhf hz hrvlf hz power lbnp signific reduct finger ppgcardiac modul consist reduct puls pressur fabp lbnp progress shift amplitud densiti ear ppgcardiac ppgresp oscil evid progress hypovolemia reduct puls pressur increas respiratori induc variat lbnp signific increas increas baselin ear ppgif hz meantim hrvhf show signific reduct baselin symptomat phase shift ear ppgif ppgresp increas ear ppgresp modul baselineconclus puls oximet waveform contain complex mixtur effect cardiac venous autonom respiratori system central peripher circul occurr autonom modul need taken account studi signal origin central site eg ear forehead

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