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Rapid declines in systolic blood pressure are associated with an increase in pulse transit time

BACKGROUND: The correlation between pulse transit time and blood pressure has been proposed as a route to measure continuous non-invasive blood pressure. We investigated whether pulse transit time trends could model blood pressure trends during episodes of rapid declines in blood pressure. METHODS:...

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Autores principales: Schaanning, Sebastian Grøvdal, Skjaervold, Nils Kristian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7544103/
https://www.ncbi.nlm.nih.gov/pubmed/33031455
http://dx.doi.org/10.1371/journal.pone.0240126
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author Schaanning, Sebastian Grøvdal
Skjaervold, Nils Kristian
author_facet Schaanning, Sebastian Grøvdal
Skjaervold, Nils Kristian
author_sort Schaanning, Sebastian Grøvdal
collection PubMed
description BACKGROUND: The correlation between pulse transit time and blood pressure has been proposed as a route to measure continuous non-invasive blood pressure. We investigated whether pulse transit time trends could model blood pressure trends during episodes of rapid declines in blood pressure. METHODS: From the Medical Information Mart for Intensive Care waveform database we identified substantial blood pressure reductions. Pulse transit time was calculated from the R-peak of the electrocardiogram to the peak of the arterial pulse waveform. The time-series were processed with a moving average filter before comparison. Averaged, continuous heart rate was also analysed as a control. The intra-individual association between variables was assessed per subject using linear regression. RESULTS: In the 511 patients included we found a median correlation coefficient between blood pressure and pulse transit time of -0.93 (IQR -0.98 to -0.76) with regression slopes of -1.23 mmHg/ms (IQR -1.73 to -0.81). The median correlation coefficient between blood pressure and heart rate was 0.46 (IQR -0.16 to 0.83). In supplementary analysis, results did not differ substantially when widening inclusion criteria, but the results were not always consistent within subjects across episodes of hypotension. CONCLUSIONS: In a large cohort of critically ill patients experiencing episodes of rapid declines in systolic blood pressure, there was a moderate-strong intra-individual correlation between averaged systolic blood pressure and averaged pulse transit time. Our findings encourage further investigation into using the pulse transit time for non-invasive real-time detection of hypotension.
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spelling pubmed-75441032020-10-19 Rapid declines in systolic blood pressure are associated with an increase in pulse transit time Schaanning, Sebastian Grøvdal Skjaervold, Nils Kristian PLoS One Research Article BACKGROUND: The correlation between pulse transit time and blood pressure has been proposed as a route to measure continuous non-invasive blood pressure. We investigated whether pulse transit time trends could model blood pressure trends during episodes of rapid declines in blood pressure. METHODS: From the Medical Information Mart for Intensive Care waveform database we identified substantial blood pressure reductions. Pulse transit time was calculated from the R-peak of the electrocardiogram to the peak of the arterial pulse waveform. The time-series were processed with a moving average filter before comparison. Averaged, continuous heart rate was also analysed as a control. The intra-individual association between variables was assessed per subject using linear regression. RESULTS: In the 511 patients included we found a median correlation coefficient between blood pressure and pulse transit time of -0.93 (IQR -0.98 to -0.76) with regression slopes of -1.23 mmHg/ms (IQR -1.73 to -0.81). The median correlation coefficient between blood pressure and heart rate was 0.46 (IQR -0.16 to 0.83). In supplementary analysis, results did not differ substantially when widening inclusion criteria, but the results were not always consistent within subjects across episodes of hypotension. CONCLUSIONS: In a large cohort of critically ill patients experiencing episodes of rapid declines in systolic blood pressure, there was a moderate-strong intra-individual correlation between averaged systolic blood pressure and averaged pulse transit time. Our findings encourage further investigation into using the pulse transit time for non-invasive real-time detection of hypotension. Public Library of Science 2020-10-08 /pmc/articles/PMC7544103/ /pubmed/33031455 http://dx.doi.org/10.1371/journal.pone.0240126 Text en © 2020 Schaanning, Skjaervold http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Schaanning, Sebastian Grøvdal
Skjaervold, Nils Kristian
Rapid declines in systolic blood pressure are associated with an increase in pulse transit time
title Rapid declines in systolic blood pressure are associated with an increase in pulse transit time
title_full Rapid declines in systolic blood pressure are associated with an increase in pulse transit time
title_fullStr Rapid declines in systolic blood pressure are associated with an increase in pulse transit time
title_full_unstemmed Rapid declines in systolic blood pressure are associated with an increase in pulse transit time
title_short Rapid declines in systolic blood pressure are associated with an increase in pulse transit time
title_sort rapid declines in systolic blood pressure are associated with an increase in pulse transit time
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7544103/
https://www.ncbi.nlm.nih.gov/pubmed/33031455
http://dx.doi.org/10.1371/journal.pone.0240126
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