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Blood flow oscillations and early detection of pressure ulcers in older adults

老年人的血流振荡和压疮的早期发现

基本信息

批准号：
7872714
负责人：
Yih-Kuen Jan
金额：
$ 20.52万
依托单位：
UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-09-07 至 2012-08-31
项目状态：
已结题

项目摘要

DESCRIPTION (provided by applicant): Blood flow oscillations (BFO) is an emergent biomarker to assess micro vascular dysfunction and risk for pressure ulcers. Research studies have demonstrated that BFO is regulated by endothelial metabolic, sympathovagal neurogenic, and vascular myogenic control mechanisms. By assessing the changes of BFO, tissue viability and ischemic injury can be further quantified. Such knowledge is needed to early detect pressure ulcers as well as to assess efficacy of preventive interventions. However, there is no definition of good or poor tissue viability based on the values of BFO. We propose to quantify the changes of BFO associated with aging and physical inactivity to investigate the role of micro vascular dysfunction in developing pressure ulcers. Such information can be used to early detect pressure ulcers in the elderly population. The long-term goal of this study is to develop methods for early detection of pressure ulcers based on the analysis of linear and nonlinear properties of BFO and then to use the methods to assess the efficacy of preventive interventions on enhancing tissue viability in older adults. The objectives of this study are to quantify the changes of linear and nonlinear dynamical properties of BFO in response to aging, inactivity, and ischemia (soft tissue status before stage 1 pressure ulcers) in older people with various levels of risk for pressure ulcers. Specific aim 1 is to investigate the effects of aging and physical inactivity on tissue viability through analysis of linear and nonlinear properties of BFO. Linear analyses include wavelet and Hilbert transforms and empirical mode decomposition. Nonlinear analyses include Hurst exponent, detrended fluctuation analysis, correlation dimension, sample entropy, and Lyapunov exponent. This study will establish the basic understanding of linear and nonlinear properties of BFO and their relationships with risk for pressure ulcers. Specific aim 2 is to examine whether the changes of linear and nonlinear properties of BFO can be used to predict pressure ulcers. Currently we hypothesize that a decline of linear and nonlinear properties of BFO is associated with the risk for pressure ulcers. We will measure BFO in a consecutive 24-week period to capture the changes of BFO from normal, declined, pre stage 1 pressure ulcers, and onset of pressure ulcers stages. If successful, we will be able to use the information to assess whether soft tissue is under good viability, ischemia, or pre-stage 1 pressure ulcer phases. PUBLIC HEALTH RELEVANCE: This study will establish the foundation to develop assessment tools based on linear and nonlinear properties of blood flow oscillations that will guide clinicians for the early detection of pressure ulcers in older people with physical disabilities.

描述（由申请方提供）：血流振荡（BFO）是一种评估微血管功能障碍和压疮风险的紧急生物标志物。研究表明，BFO受到内皮代谢、交感迷走神经神经和血管肌源性控制机制的调节。通过评估BFO的变化，可以进一步量化组织活力和缺血性损伤。需要这些知识来早期发现压疮以及评估预防干预措施的有效性。然而，没有基于BFO值的良好或不良组织活力的定义。我们建议量化与衰老和缺乏体力活动相关的BFO变化，以研究微血管功能障碍在压疮发生中的作用。这些信息可用于早期检测老年人群中的压疮。本研究的长期目标是根据对BFO线性和非线性特性的分析，开发早期检测压疮的方法，然后使用这些方法评估预防性干预措施对提高老年人组织活力的有效性。本研究的目的是量化BFO的线性和非线性动力学特性的变化，以应对老年人的老化，不活动和缺血（软组织状态1级压疮前）与不同程度的压疮风险。具体目标1是通过分析BFO的线性和非线性特性来研究衰老和身体不活动对组织活力的影响。线性分析包括小波和希尔伯特变换和经验模式分解。非线性分析包括赫斯特指数、去趋势波动分析、关联维、样本熵和李雅普诺夫指数。本研究将建立对BFO的线性和非线性特性及其与压疮风险关系的基本理解。具体目标2是检查BFO的线性和非线性性质的变化是否可以用于预测压疮。目前，我们假设BFO的线性和非线性特性的下降与压疮的风险相关。我们将在连续24周内测量BFO，以捕获BFO从正常、下降、1期前压疮和压疮发作阶段的变化。如果成功，我们将能够使用这些信息来评估软组织是否处于良好的生存能力、缺血或1期前压疮阶段。公共卫生关系：这项研究将为开发基于血流振荡的线性和非线性特性的评估工具奠定基础，这些工具将指导临床医生早期检测有身体残疾的老年人的压疮。