Very low frequency variability in the peripheral circulation: the possibility of plethysmographic quantification.
Very low frequency variability in the peripheral circulation: the possibility of plethysmographic quantification.
复制标题
外周循环的频率变化非常低：体积描记量化的可能性。
DOI：
10.1097/eja.0b013e3283297539
复制
发表时间：
2009
影响因子：
3.6
通讯作者：
Puyana,JuanCarlos
中科院分区：
文献类型：
--
作者：
Zenker,Sven;Polanco,PatricioM;Torres,Andres;Clermont,Gilles;Kim,HyungKook;Vodovotz,Yoram;Pinsky,MichaelR;Namas,RajaieA;Puyana,JuanCarlos
在他们最近的一篇文章中，Murray et al. [1]除了呼吸相关的振荡（这是他们感兴趣的主要焦点）之外，还报告了频率范围为0.02 - 0.07 Hz的未滤波透射体积描记信号中的振荡分量（注意，这些频率范围在相应的摘要中被错误地报告为0.2-0.7 Hz，但在手稿本身中没有）。作者将这种振荡成分归因于交感神经活动的同步变化，影响通过动静脉栓塞的血流[2，3]，这表明交感神经张力的无创定量可能性，如先前报道的那样（对于脉搏血氧仪以外的光电体积描记术应用的深入综述，参见[4]）。在这种情况下，应该指出，激光多普勒血流仪研究，使用傅立叶和基于小波的频谱分析技术，已经量化了从相对高频呼吸到非常低频范围的外周血流变化的各种振荡分量。他们还提供了有关潜在生理机制的实验证据，并评估了对区域和全身麻醉等干预措施的动态反应[5-7]。因此，通常报告的振荡分量（表1）提供了无创监测各种生理调节机制的活动和功能的机会，包括但不限于与呼吸/通气相关的血液动力学变化和交感传出活动的变化。然而，激光多普勒血流仪还不能作为标准临床环境中的监测工具。
In their recent article in this journal, Murray et al.[1] reported, in addition to the respiration-related oscillations which were the main focus of their interest, an oscillatory component in the unfiltered transmission plethysmographic signal in the frequency ranging from 0.02 to 0.07 Hz (of note, these frequency ranges are reported incorrectly as 0.2–0.7 Hz in the corresponding abstract, but not in the manuscript itself). The authors attribute this oscillatory component to synchronous changes in sympathetic activity affecting flow through arteriovenous anastomoses [2, 3], suggesting a potential for noninvasive quantification of sympathetic tone, as has previously been reported (for an in-depth review of applications of photoplethysmography beyond pulse oximetry, see [4]).In this context, it should be pointed out that laser Doppler flowmetry studies, using both Fourier and wavelet-based spectral analysis techniques, have quantified various oscillatory components of peripheral blood flow variability ranging from the relatively high-frequency respiratory to the very low frequency range. They have also provided experimental evidence regarding the underlying physiological mechanisms and evaluated dynamic responses to interventions such as regional and general anaesthesia [5–7]. The oscillatory components typically reported (Table 1), thus, provide an opportunity to monitor noninvasively the activity and function of various physiological regulatory mechanisms, including, but not limited to, the haemodynamic variability associated with respiration/ventilation and variations of sympathetic efferent activity. However, laser Doppler flowmetry is not yet available as a monitoring tool in standard clinical settings.