关于非侵入性血压测量的新视角
概括
使用科罗特科夫声校准的非侵入性血压装置可能不准确地估计静脉血压,可能低估了高达19mmHg的动脉内血压. 这会影响所有非侵入性血压测量的准确性.
科学领域:
- 心血管生理学心血管生理学
- 生物医学工程 生物医学工程
- 医疗器械校准 医疗器械校准
背景情况:
- 非侵入性血压 (NIBP) 设备通常使用可检测科罗特科夫声音的听觉血压计进行校准.
- NIBP设备的准确性依赖于对科罗特科夫声音相对于动脉内血压 (IABP) 值的精确检测.
- 现有的验证标准要求在NIBP设备校准时使用Korotkoff声音.
研究的目的:
- 为了研究科罗特科夫声发生和臂动脉脉冲出现之间的时间关系.
- 为了比较科罗特科夫声音衍生的袖口压力与同时进行的动脉内血压测量.
- 为了量化由于科罗特科夫声音定时而导致的血压读数的潜在差异.
主要方法:
- 对15名接受冠状动脉血管造影的参与者进行的实验.
- 通过导管和袖口压力 (CP) 同时测量动脉内血压 (IABP),使用带有麦克风的常规封闭袖口.
- 用于评估手臂脉冲波速率 (PWV) 和动脉硬度的指纹光聚体成像.
主要成果:
- 臂动脉在袖子压力为132.0 ± 17.1 mmHg时被堵塞.
- 来自第一个科罗特科夫声音的静脉血压 (SBP) 低估了IABP,平均为19.0 ± 8.3 mmHg (范围为2-29 mmHg).
- 从最后一个科罗特科夫声音中得出的透气血压 (DBP) 低估了IABP的平均值为4.0 ± 4.3 mmHg (范围为2-12 mmHg).
结论:
- 科罗特科夫声音的出现可能会导致严重低估系统血压与动脉内测量相比.
- 科罗特科夫声检测中的这些不准确性传播到所有非侵入性血压装置,无论其测量方法如何.
- 这些发现突出了目前NIBP设备验证标准的关键局限性,可能会影响临床准确性.
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