Non-invasive hemodynamic state monitoring using ultrasound.
Non-invasive hemodynamic state monitoring using ultrasound.
复制标题
使用超声波进行无创血流动力学状态监测。
DOI：
10.1109/iembs.2010.5626322
复制
发表时间：
2010
期刊：
影响因子：
--
通讯作者：
Hoctor,RalphT
中科院分区：
文献类型：
--
作者：
Dentinger,AaronM;Hoctor,RalphT
血流动力学监测为急诊患者的诊断和治疗提供了重要信息。研究了一种非侵入性监测血流动力学状态变化的方法。该方法利用短轴超声彩色血流成像和处理方法来产生动脉区域和血流的同步波形。提取平均面积、峰值体积流速和心率的逐跳测量，并使用这些参数的分布来定义血流动力学状态。通过计算新测量和当前血流动力学状态之间的距离，然后将该距离与自适应阈值进行比较，来检测血流动力学状态的变化。该分布被建模为由均值向量和协方差矩阵表征的多元正态分布，并以马氏距离作为距离度量。阈值水平被调整为基于当前分布产生恒定的假阳性概率。在活体动物实验中，通过观察药物引起的血流动力学状态的变化来评估该方法。基于超声的测量提供了足够的准确性来区分输注血管扩张剂之前、期间和之后的血流动力学状态。在输液开始时的短暂时间内，检测血液动力学状态的急性变化的能力被证明。
Hemodynamic monitoring provides vital information for diagnosing and treating patients in acute clinical settings. A method is investigated to non-invasively monitor changes in the hemodynamic state. The approach utilizes short-axis ultrasound color flow imaging and processing methods to produce simultaneous waveforms for the arterial area and flow. Beat-to-beat measurements of the mean area, peak volumetric flow rate, and heart rate are extracted, and the distribution of these parameters is used to define the hemodynamic state. Changes in the hemodynamic state are detected by calculating a distance between new measurements and the current hemodynamic state, and then comparing this distance to an adaptive threshold. The distribution was modeled as a multivariate normal distribution characterized by a mean vector and a covariance matrix, and the Mahalanobis distance was used as the distance metric. The threshold level was adapted to produce a constant probability of false positives based on the current distribution. The method was evaluated by observing pharmacologically induced changes in the hemodynamic state during an in vivo animal experiment. The ultrasound-based measurements provided sufficient accuracy to discriminate between the hemodynamic states before, during and after infusion of a vasodilator. The ability to detect an acute change in the hemodynamic state was demonstrated in the transient period at the start of the infusion.