Frederic Michard, Lorenzo Foti, Gianluca Villa, Zaccaria Ricci, Stefano Romagnoli
{"title":"欠阻尼对收缩期径向压力最大上升率（dP/dtMAX）的影响","authors":"Frederic Michard, Lorenzo Foti, Gianluca Villa, Zaccaria Ricci, Stefano Romagnoli","doi":"10.1007/s44254-023-00033-3","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><p>In patients with a radial arterial catheter, underdamping of the pressure signal is common and responsible for an overestimation of systolic arterial pressure (SAP). The maximum rate of the arterial pressure rise during systole (dP/dt<sub>MAX</sub>) has been proposed to assess left ventricular systolic function. The impact of underdamping on dP/dt<sub>MAX</sub> is likely but has never been quantified.</p><h3>Methods</h3><p>We analyzed data from 70 critically ill patients monitored with a radial catheter in whom underdamping of the arterial pressure waveform was confirmed by the Gardner’s method. Invasive SAP and dP/dt<sub>MAX</sub> were recorded at baseline and after the correction of underdamping with a resonance filter.</p><h3>Results</h3><p>With resonance filtering, SAP decreased from 159 ± 25 to 139 ± 22 mmHg (<i>p</i> < 0.001) and dP/dt<sub>MAX</sub> from 2.0 ± 0.6 to 1.1 ± 0.3 mmHg/ms (<i>p</i> < 0.001). The underdamping-induced overestimation of SAP (delta-SAP) ranged from 6 to 41 mmHg (mean 21 ± 9 mmHg or + 15%) and the overestimation of dP/dt<sub>MAX</sub> (delta-dP/dt<sub>MAX</sub>) ranged from 0.2 to 2.0 mmHg/ms (mean 0.9 ± 0.4 mmHg/ms or + 84%). A significant linear relationship (<i>p</i> < 0.001, <i>r</i> = 0.6) was observed between delta-SAP and delta-dP/dt<sub>MAX</sub> such that the higher was delta-SAP, the higher was delta-dP/dt<sub>MAX</sub>.</p><h3>Conclusions</h3><p>Radial arterial pressure underdamping has a major impact on dP/dt<sub>MAX</sub>. In case of underdamping, the overestimation of dP/dt<sub>MAX</sub> is > fivefold higher than SAP overestimation. Therefore, caution should be exercised before using radial dP/dt<sub>MAX</sub> as a marker of left ventricular systolic function.</p><h3>Trial registration</h3><p>Registered at ClinicalTrials.gov on December 22, 2021 (NCT05166993).</p><h3>Graphical Abstract</h3>\n <div><figure><div><div><picture><source><img></source></picture></div></div></figure></div>\n </div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"1 4","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-023-00033-3.pdf","citationCount":"0","resultStr":"{\"title\":\"The impact of underdamping on the maximum rate of the radial pressure rise during systole (dP/dtMAX)\",\"authors\":\"Frederic Michard, Lorenzo Foti, Gianluca Villa, Zaccaria Ricci, Stefano Romagnoli\",\"doi\":\"10.1007/s44254-023-00033-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><p>In patients with a radial arterial catheter, underdamping of the pressure signal is common and responsible for an overestimation of systolic arterial pressure (SAP). The maximum rate of the arterial pressure rise during systole (dP/dt<sub>MAX</sub>) has been proposed to assess left ventricular systolic function. The impact of underdamping on dP/dt<sub>MAX</sub> is likely but has never been quantified.</p><h3>Methods</h3><p>We analyzed data from 70 critically ill patients monitored with a radial catheter in whom underdamping of the arterial pressure waveform was confirmed by the Gardner’s method. Invasive SAP and dP/dt<sub>MAX</sub> were recorded at baseline and after the correction of underdamping with a resonance filter.</p><h3>Results</h3><p>With resonance filtering, SAP decreased from 159 ± 25 to 139 ± 22 mmHg (<i>p</i> < 0.001) and dP/dt<sub>MAX</sub> from 2.0 ± 0.6 to 1.1 ± 0.3 mmHg/ms (<i>p</i> < 0.001). The underdamping-induced overestimation of SAP (delta-SAP) ranged from 6 to 41 mmHg (mean 21 ± 9 mmHg or + 15%) and the overestimation of dP/dt<sub>MAX</sub> (delta-dP/dt<sub>MAX</sub>) ranged from 0.2 to 2.0 mmHg/ms (mean 0.9 ± 0.4 mmHg/ms or + 84%). A significant linear relationship (<i>p</i> < 0.001, <i>r</i> = 0.6) was observed between delta-SAP and delta-dP/dt<sub>MAX</sub> such that the higher was delta-SAP, the higher was delta-dP/dt<sub>MAX</sub>.</p><h3>Conclusions</h3><p>Radial arterial pressure underdamping has a major impact on dP/dt<sub>MAX</sub>. In case of underdamping, the overestimation of dP/dt<sub>MAX</sub> is > fivefold higher than SAP overestimation. Therefore, caution should be exercised before using radial dP/dt<sub>MAX</sub> as a marker of left ventricular systolic function.</p><h3>Trial registration</h3><p>Registered at ClinicalTrials.gov on December 22, 2021 (NCT05166993).</p><h3>Graphical Abstract</h3>\\n <div><figure><div><div><picture><source><img></source></picture></div></div></figure></div>\\n </div>\",\"PeriodicalId\":100082,\"journal\":{\"name\":\"Anesthesiology and Perioperative Science\",\"volume\":\"1 4\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-09-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://link.springer.com/content/pdf/10.1007/s44254-023-00033-3.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Anesthesiology and Perioperative Science\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://link.springer.com/article/10.1007/s44254-023-00033-3\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anesthesiology and Perioperative Science","FirstCategoryId":"1085","ListUrlMain":"https://link.springer.com/article/10.1007/s44254-023-00033-3","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
The impact of underdamping on the maximum rate of the radial pressure rise during systole (dP/dtMAX)
Purpose
In patients with a radial arterial catheter, underdamping of the pressure signal is common and responsible for an overestimation of systolic arterial pressure (SAP). The maximum rate of the arterial pressure rise during systole (dP/dtMAX) has been proposed to assess left ventricular systolic function. The impact of underdamping on dP/dtMAX is likely but has never been quantified.
Methods
We analyzed data from 70 critically ill patients monitored with a radial catheter in whom underdamping of the arterial pressure waveform was confirmed by the Gardner’s method. Invasive SAP and dP/dtMAX were recorded at baseline and after the correction of underdamping with a resonance filter.
Results
With resonance filtering, SAP decreased from 159 ± 25 to 139 ± 22 mmHg (p < 0.001) and dP/dtMAX from 2.0 ± 0.6 to 1.1 ± 0.3 mmHg/ms (p < 0.001). The underdamping-induced overestimation of SAP (delta-SAP) ranged from 6 to 41 mmHg (mean 21 ± 9 mmHg or + 15%) and the overestimation of dP/dtMAX (delta-dP/dtMAX) ranged from 0.2 to 2.0 mmHg/ms (mean 0.9 ± 0.4 mmHg/ms or + 84%). A significant linear relationship (p < 0.001, r = 0.6) was observed between delta-SAP and delta-dP/dtMAX such that the higher was delta-SAP, the higher was delta-dP/dtMAX.
Conclusions
Radial arterial pressure underdamping has a major impact on dP/dtMAX. In case of underdamping, the overestimation of dP/dtMAX is > fivefold higher than SAP overestimation. Therefore, caution should be exercised before using radial dP/dtMAX as a marker of left ventricular systolic function.
Trial registration
Registered at ClinicalTrials.gov on December 22, 2021 (NCT05166993).
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
