Physiological measurement
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Physiological measurement · Aug 2002
Comparative StudyInvestigation of oesophageal photoplethysmographic signals and blood oxygen saturation measurements in cardiothoracic surgery patients.
Pulse oximeter probes attached to the finger may fail to estimate blood oxygen saturation (SpO2) in patients with compromised peripheral perfusion (e.g. hypothermic cardiopulmonary bypass surgery). The measurement of SpO2 from a central organ such as the oesophagus is suggested as an alternative to overcome this problem. A reflectance oesophageal pulse oximeter probe and a processing system implemented in LabVIEW were developed. ⋯ Also, the oesophageal pulse oximeter was found to be reliable and accurate in five cases of poor peripheral perfusion when a commercial finger pulse oximeter probe failed to estimate oxygen saturation values for at least 10 min. These results suggest that the arterial blood circulation to the oesophagus is less subject to vasoconstriction and decreased PPG amplitudes than are the peripheral sites used for pulse oximetry such as the finger. It is concluded that oesophageal SPO2 monitoring may be of clinical value.
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Physiological measurement · Aug 2002
Noninvasive quantification of respiratory modulation on left ventricular size and stroke volume.
To noninvasively explore the complex interactions between heart rate, left ventricular (LV) stroke volume (SV) and respiration, different techniques were proposed and applied to the beat-to-beat measurements of end-diastolic (ED), end-systolic (ES) volumes and SV, obtained from echocardiographic acoustic quantification LV volume signal. Data were obtained from eight patients with dilated cardiomyopathy (DCM, age 60 +/- 2, mean +/- SE), and from 11 age-matched healthy volunteers (N, age 63 +/- 2). ⋯ Moreover, the prevalent effect of increased afterload generating SV reduction during inspiration was pointed out in N, while an intersubject dispersion in the relation between respiratory phase and LV dimension changes was found in DCM. Black-box model identification summarized these mechanisms by means of a few quantitative parameters.
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Physiological measurement · Aug 2002
On-line, simultaneous quantification of ethanol, some metabolites and water vapour in breath following the ingestion of alcohol.
Selected ion flow tube mass spectrometry, SIFT-MS, has been used to measure simultaneously the concentrations in exhaled breath of ethanol, acetaldehyde, ammonia, acetone and, routinely, water vapour, following the ingestion of various amounts of ethanol in 500 ml of water. These breath analyses were obtained from only single exhalations, the results being available immediately in real time. The breath ethanol reaches concentrations that are only approximately consistent with its dilution in blood and body water. ⋯ The simultaneous breath acetone concentrations increase somewhat with time as is expected during the fasting state. The water vapour measurements are indicators of the precision and accuracy of the breath analyses, these being sufficient to show the differences between the breath (body) temperatures of the individuals of less than 1 degrees C. This study demonstrates the potential of SIFT-MS for non-invasive physiological measurement.
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Physiological measurement · Feb 2002
Clinical TrialAssessment of dynamic cerebral autoregulation based on spontaneous fluctuations in arterial blood pressure and intracranial pressure.
Assessments of dynamic cerebral autoregulation usually measure the cerebral blood flow velocity (CBFV) response to changes in arterial blood pressure (ABP). We studied the effect of substituting ABP by cerebral perfusion pressure (CPP), expressed as the difference between ABP and intracranial pressure (ICP), in estimates of dynamic autoregulation obtained by transfer function analysis. CBFV, ABP and ICP were recorded during periods of physiological stability in 30 patients with severe head injury. ⋯ An alternative calculation of the CBFV step response to changes in CPP resembled the corresponding responses for the ABP input. For spontaneous fluctuations in ABP, ICP and CBFV, it is not possible to calculate the CPP-CBFV transfer function directly due to the high positive correlation between ICP and CBFV, but an alternative estimate can be obtained by using the CBFV-ICP transfer function. The latter could also be useful as a method to assess intracranial compliance in head injury patients.
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Physiological measurement · Aug 2001
A new mathematical model of dynamic cerebral autoregulation based on a flow dependent feedback mechanism.
A new mathematical model representing dynamic cerebral autoregulation as a flow dependent feedback mechanism is presented. Two modelling parameters are introduced, lambda, the rate of restoration, and tau, a time delay. Velocity profiles are found for a general arterial blood pressure, allowing the model to be applied to any experiment that uses changes in arterial blood pressure to assess dynamic cerebral autoregulation. ⋯ The comparisons yield similar estimates for lambda and tau, suggesting these parameters are independent of the pressure change stimulus and depend only on the main features of the dynamic cerebral autoregulation process. The modelling also indicates that for imposed oscillatory variations in arterial blood pressure a small phase difference between pressure and velocity waveforms does not necessarily imply impaired autoregulation. It is shown that the ratio between the variation in maximum velocity and pressure variation can be used, along with the phase difference, to indicate the nature of the autoregulatory response.