A Novel Approach to Pulse Pressure Variation Estimation

We describe a novel algorithm to estimate the pulse pressure variation index (PPV) from arterial blood pressure signals (ABP). PPV has been shown to be one of the best predictors of fluid responsiveness in mechanically ventilated subjects. Our PPV algorithm uses a non-linear technique for envelope estimation, eliminating the need for automatic beat detection. Additionally, the algorithm makes use of nonparametric spectral techniques to extract the respiratory rate, and a median filter for artifact removal. The algorithm was validated against the continuous PPV output obtained from the commercially available PiCCOreg system and gold standard expert PPV manual annotations. The data consists of ABP taken from subjects who experienced rapid changes in hemodynamics. This data comprised over six hours of continuous ABP monitoring

[1]  James McNames,et al.  A novel algorithm to estimate the pulse pressure variation index deltaPP. , 2004, IEEE transactions on bio-medical engineering.

[2]  F. Michard,et al.  Changes in Arterial Pressure during Mechanical Ventilation , 2005, Anesthesiology.

[3]  Andreas Zollinger,et al.  Stroke volume and pulse pressure variation for prediction of fluid responsiveness in patients undergoing off-pump coronary artery bypass grafting. , 2005, Chest.

[4]  F. Michard,et al.  Volume Management Using Dynamic Parameters , 2005 .

[5]  James McNames,et al.  An automatic beat detection algorithm for pressure signals , 2005, IEEE Transactions on Biomedical Engineering.

[6]  C. Richard,et al.  Global end-diastolic volume as an indicator of cardiac preload in patients with septic shock. , 2003, Chest.

[7]  Andre Ferland,et al.  Pulse pressure variation predicts fluid responsiveness following coronary artery bypass surgery. , 2004, Chest.

[8]  C. Richard,et al.  Influence of tidal volume on stroke volume variation. Does it really matter? , 2003, Intensive Care Medicine.

[9]  J. Teboul,et al.  Predicting fluid responsiveness in ICU patients: a critical analysis of the evidence. , 2002, Chest.

[10]  D. Chemla,et al.  Relation between respiratory changes in arterial pulse pressure and fluid responsiveness in septic patients with acute circulatory failure. , 2000, American journal of respiratory and critical care medicine.

[11]  F. Michard,et al.  Prediction of fluid responsiveness: searching for the Holy Grail. , 2004, Journal of applied physiology.

[12]  F. Michard Volume management using dynamic parameters: the good, the bad, and the ugly. , 2005, Chest.

[13]  A. Schachtrupp,et al.  Factors influencing the estimation of extravascular lung water by transpulmonary thermodilution in critically ill patients* , 2005, Critical care medicine.

[14]  M. Aboy,et al.  A novel algorithm to estimate the pulse pressure variation index /spl Delta/PP , 2004, IEEE Transactions on Biomedical Engineering.

[15]  D. Chemla,et al.  More respect for respiratory variation in arterial pressure. , 2004, American journal of respiratory and critical care medicine.