Non invasive oscillometric assessment of pulse pressure variation - a feasibility study

摘要

Cyclic respiratory change of the arterial pulse pressure (pulse pressure variation, PPV) is a better predictor of cardiovascular response to fluid challenge than traditional hemodynamic parameters like arterial blood pressure, central venous pressure, or pulmonary artery occlusion pressure. The main drawback of PPV monitoring is its dependence on arterial cannulation. We demonstrate that respiratory changes are also present in the oscillometric signal obtained during non invasive blood pressure monitoring (NIBP). Furthermore, we show that this signal can be used to assess non-invasive pulse pressure variation (NIPPV) with a modified NIBP cuff and describe the influence of cuff filling media on signal quality. NIPPV measured with a water-filled cuff in 5 patients undergoing elective abdominal surgery was highly correlated to femoral-arterial PPV (r=0.91, p< 0.0001). This method has potential impact on routine monitoring in perioperative care.