Effect of the shapes of the oscillometric pulse amplitude envelopes and their characteristic ratios on the differences between auscultatory and oscillometric blood pressure measurements
Effect of the shapes of the oscillometric pulse amplitude envelopes and their characteristic ratios on the differences between auscultatory and oscillometric blood pressure measurements
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DOI：
10.1097/mbp.0b013e32826fb773
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发表时间：
2007-10-01
影响因子：
1.3
通讯作者：
Murray, Alan
中科院分区：
文献类型：
--
作者：
Amoore, John N.;Vacher, Emilie;Murray, Alan
介绍振荡式无创血压（NIBP）设备通过使用经验算法分析血压波形来确定压力。许多算法通过计算收缩和舒张特征比率来分析波形，收缩和舒张特征比率是分别在收缩压和舒张压下袖带中的血压测量脉冲的幅度除以峰值脉冲幅度。方法124例患者在袖带放气速率为2-3 mmHg/s的条件下，记录243个血压测量波形和同步听诊血压。模拟器重新生成波形，并将其提供给两个NIBP设备，Omron HEM-907 [OMRON Europe B. V.（OMCE），Hoofddorp，The Netherlands]和GE ProCare 400（GE Healthcare，坦帕，佛罗里达，美国）。对于每个波形，计算器械测量值和听诊参考压力之间的成对收缩压和成对舒张压差。计算与存储在模拟器中的每个血压计波形的参考听诊压力相对应的收缩和舒张特征比率。结果收缩压和舒张压特征比值的均值和标准差分别为0.49（0.11）和0.72（0.12）。两种器械记录的收缩压均低于（负配对压差）低收缩特征比时的相应听诊压，但高于高收缩压时的相应听诊压。相反，与舒张特征比值高的配对舒张压差相比，舒张特征比值低的配对舒张压差之间的差异更大。对于收缩特征比值在0.4和0.7之间（Omron）和0.3和0.5之间（ProCare）的波形，成对收缩压差在+/- 5 mmHg范围内。成对的舒张压差在5毫米汞柱内的那些波形与舒张特征比率在0.4和0.6之间的欧姆龙和0.5和0.8之间的ProCare.Discussion和conclusion收缩期和舒张期成对的血压计听诊压差随其相应的特征比率而变化。对于具有特定特征比率范围的血压计脉搏幅度包络，血压计和听诊压力之间存在良好的一致性（在5 mmHg内），但两种器械的范围不同。需要进一步的工作来对不同的包络形状进行分类，将它们与患者的情况进行比较，以确定对不同波形形状的更清晰的理解是否会提高脑电测量的准确性。
Introduction Oscillometric noninvasive blood pressure (NIBP) devices determine pressure by analysing the oscillometric waveform using empirical algorithms. Many algorithms analyse the waveform by calculating the systolic and diastolic characteristic ratios, which are the amplitudes of the oscillometric pulses in the cuff at, respectively, the systolic and diastolic pressures, divided by the peak pulse amplitude. A database of oscillometric waveforms was used to study the influences of the characteristic ratios on the differences between auscultatory and oscillometric measurements.Methods Two hundred and forty-three oscillometric waveforms and simultaneous auscultatory blood pressures were recorded from 124 patients at cuff deflation rates of 2-3 mmHg/s. A simulator regenerated the waveforms, which were presented to two NIBP devices, the Omron HEM-907 [OMRON Europe B.V. (OMCE), Hoofddorp, The Netherlands] and the GE ProCare 400 (GE Healthcare, Tampa, Florida, USA). For each waveform, the paired systolic and paired diastolic pressure differences between device measurements and auscultatory reference pressures were calculated. The systolic and diastolic characteristic ratios, corresponding to the reference auscultatory pressures of each oscillometric waveform stored in the simulator, were calculated. The paired differences between NIBP measured and auscultatory reference pressures were compared with the characteristic ratios.Results The mean and standard deviations of the systolic and diastolic characteristic ratios were 0.49 (0.11) and 0.72 (0.12), respectively. The systolic pressures recorded by both devices were lower (negative paired pressure difference) than the corresponding auscultatory pressures at low systolic characteristic ratios, but higher than the corresponding auscultatory pressures at high systolic pressures. Conversely, the differences between the paired diastolic pressure differences were higher at low diastolic characteristic ratios, compared with those at high diastolic characteristic ratios. The paired systolic pressure differences were within +/- 5 mmHg for those waveforms with systolic characteristic ratios between 0.4 and 0.7 for the Omron and between 0.3 and 0.5 for the ProCare. The paired diastolic pressure differences were within 5 mmHg for those waveforms with diastolic characteristic ratios between 0.4 and 0.6 for the Omron and between 0.5 and 0.8 for the ProCare.Discussion and conclusion The systolic and diastolic paired oscillometric-auscultatory pressure differences varied with their corresponding characteristic ratios. Good agreement (within 5 mmHg) between the oscillometric and auscultatory pressures occurred for oscillometric pulse amplitude envelopes with specific ranges of characteristic ratios, but the ranges were different for the two devices. Further work is required to classify the different envelope shapes, comparing them with patient conditions, to determine if a clearer understanding of the different waveform shapes would improve the accuracy of oscillometric measurements.