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Real-time, spectral analysis of the arterial pressure waveform using a wirelessly-connected, tablet computer: a pilot
1St. George Private Hospital, 1 South St., Kogarah, NSW, 2217, Australia. dpybus@bigpond.net.au.
Journal of Clinical Monitoring and Computing
|April 30, 2018
Summary
The Spectral Peak Ratio (SPeR) can assess cardiovascular response to fluid changes in cardiac surgery patients. Real-time SPeR calculation is feasible and provides insights into ventricular loading and venous return.
Area of Science:
- Cardiovascular Physiology
- Medical Engineering
- Critical Care Medicine
Background:
- The Spectral Peak Ratio (SPeR) quantifies cardiovascular response to volume loading using arterial pressure waveform analysis.
- Assessing fluid responsiveness is crucial in cardiac surgery patients.
Purpose of the Study:
- To evaluate the feasibility of real-time SPeR calculation using a mobile computer.
- To examine the determinants of SPeR in cardiac-surgical patients.
Main Methods:
- Real-time spectral analysis of arterial waveforms in 60 cardiac-surgical patients.
- Cyclical changes in ventricular loading induced by varying tidal volume (VTI) before and after aortic valve replacement (AVR).
- SPeR analysis during passive leg raising to assess changes in venous return.
Main Results:
- A strong linear correlation between SPeR and VTI was observed.
- The slope of the SPeR-VTI regression line (β) changed significantly after AVR and correlated with vena contracta width.
- Passive leg raising caused a significant fall in β, linearly related to mean arterial pressure changes.
Conclusions:
- Real-time SPeR calculation is feasible and provides a reliable method for assessing cardiovascular dynamics.
- The parameter β reflects the slope of the cardiac response curve at the venous return equilibrium point.
- SPeR measurements are possible at lower VTI compared to traditional time-domain metrics.
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