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（由申请人提供）：血流振荡（BFO）是评估微血管功能障碍和压力溃疡风险的新兴生物标志物。研究表明，BFO受内皮代谢，交感神经神经源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生存力和缺血性损伤。需要这种知识来早日检测压力溃疡以及评估预防干预措施的功效。但是，基于BFO的值，没有对良好或差的组织生存能力的定义。我们建议量化与衰老和身体不活跃相关的BFO的变化，以研究微血管功能障碍在发展压溃疡中的作用。这些信息可用于早期检测老年人口的压力溃疡。这项研究的长期目标是基于BFO的线性和非线性特性的分析，开发用于早期检测压力溃疡的方法，然后使用该方法评估预防干预措施增强老年人组织可行性的功效。这项研究的目的是量化BFO的线性和非线性动力学特性的变化，以响应衰老，不活动性和缺血性（第1阶段压力溃疡之前的软组织状态），其压力溃疡风险不同。具体目的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跃对组织生存能力的影响。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HURST指数，下降波动分析，相关维度，样本熵和Lyapunov指数。这项研究将建立对BFO线性和非线性特性及其与压溃疡风险的关系的基本理解。具体目的2是检查BFO的线性和非线性特性的变化是否可用于预测压力溃疡。目前，我们假设BFO线性和非线性特性的下降与压疮的风险有关。我们将在连续的24周期间测量BFO，以捕获正常，1阶段压力溃疡的BFO变化以及压力溃疡阶段的发作。如果成功，我们将能够使用信息来评估软组织是否处于良好的生存力，缺血或阶段1压溃疡相。公共卫生相关性：这项研究将建立基础，以基于血流振荡的线性和非线性特性开发评估工具，这将指导临床医生早期发现身体残疾老年人的压力溃疡。