Med Biol Eng Comput - Fingertip photoplethysmographic waveform variability and systemic vascular resistance in intensive care unit patients.

Tópicos

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Resumo

Low frequency variability in the fingertip photoplethysmogram (PPG) waveform has been utilized for inferring sympathetic vascular control, but its relationship with a quantitative measure of vascular tone has not been established. In this study, we examined the association between fingertip PPG waveform variability (PPGV) and systemic vascular resistance (SVR) obtained from thermodilution cardiac output (CO) and intra-arterial pressure measurements in 48 post cardiac surgery intensive care unit patients. Among the hemodynamic measurements, both CO (P < 0.05) and SVR (P < 0.0001) had statistically significant relationships with the normalized low frequency power (LF(nu)) of PPGV. The LF(nu) of baseline PPGV had moderate but significant positive correlation with SVR (r = 0.54, P < 0.0001), and a value below 52.5 nu was able to identify SVR < 900 dyn s cm5 with sensitivity of 59% and specificity of 95%. The results have provided quantitative evidence to confirm the link between fingertip PPGV and sympathetic vascular control. Suppression of LF vasomotor waves leading to dominance of respiration-related HF fluctuations in the fingertip circulation was a specific (though not sensitive) marker of systemic vasodilatation, which could be potentially utilized for the assessment of critical care patients.

Resumo Limpo

low frequenc variabl fingertip photoplethysmogram ppg waveform util infer sympathet vascular control relationship quantit measur vascular tone establish studi examin associ fingertip ppg waveform variabl ppgv system vascular resist svr obtain thermodilut cardiac output co intraarteri pressur measur post cardiac surgeri intens care unit patient among hemodynam measur co p svr p statist signific relationship normal low frequenc power lfnu ppgv lfnu baselin ppgv moder signific posit correl svr r p valu nu abl identifi svr dyn s cm sensit specif result provid quantit evid confirm link fingertip ppgv sympathet vascular control suppress lf vasomotor wave lead domin respirationrel hf fluctuat fingertip circul specif though sensit marker system vasodilat potenti util assess critic care patient

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