Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 949
Filtrar
1.
Adv Exp Med Biol ; 1232: 315-322, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31893426

RESUMO

We present an unobtrusive cuff-less sphygmomanometer based on contact-type and optical pulse sensors for continuous and minimally invasive monitoring of blood pressure (BP). We developed a cuff-less sphygmomanometer that utilizes the pulse arrival time (PAT) to estimate continuous BP. To assess its accuracy, we recruited 10 healthy subjects in whom we carried out BP studies using the cuff-less sphygmomanometer compared with a standard cuff-type device in a stationary sitting patient. Preliminary results showed that the mean difference (MD) of estimated systolic blood pressure and diastolic blood pressure were 0.96 ± 9.6 (mean ± SD) mmHg and 1.14 ± 7.5 mmHg, respectively, compared to the control. The corresponding correlation between the estimated BP values and controls were 0.78 for systolic blood pressure (p < 0.01) and 0.69 for diastolic blood pressure (p < 0.01); thus, there were significant correlations. These results suggest that the developed cuff-less sphygmomanometer has the potential for continuous BP monitoring. Finally, we conducted a preliminary study of simultaneous monitoring of cuff-less BP and near-infrared spectroscopy to evaluate the potential for assessment of autonomic nervous system functions during mental stress tasks.


Assuntos
Determinação da Pressão Arterial , Esfigmomanômetros , Adulto , Sistema Nervoso Autônomo/fisiologia , Pressão Sanguínea , Determinação da Pressão Arterial/instrumentação , Eletrocardiografia , Frequência Cardíaca , Humanos , Masculino , Monitorização Fisiológica/instrumentação , Monitorização Fisiológica/normas , Esfigmomanômetros/normas , Adulto Jovem
2.
Acute Med ; 18(3): 144-147, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31536051

RESUMO

BACKGROUND: heart rates generated by pulse oximeters and electronic sphygmomanometers in acutely ill patients may not be the same as those recorded by ECG. METHODS: heart rates recorded by an oximeter and an electronic sphygmomanometer were compared with electrocardiogram (ECG) heart rates measured on acutely ill medical patients. RESULTS: 1010 ECGs were performed on 217 patients while they were in the hospital. The bias between the oximeter and the ECG measured heart rate was -1.37 beats per minute (limits of agreement -22.6 to 19.9 beats per minute), and the bias between the sphygmomanometer and the ECG measured heart rate was -0.14 beats per minute (limits of agreement -22.2 to 21.9 beats per minute). Both devices failed to identify more than half the ECG recordings that awarded 3 NEWS points for heart rate. CONCLUSION: Heart rates of acutely ill patients are not reliably measured by pulse oximeter or electronic sphygmomanometers.


Assuntos
Frequência Cardíaca , Oximetria , Oxigênio , Esfigmomanômetros , Estado Terminal , Eletrocardiografia , Humanos , Oximetria/normas , Esfigmomanômetros/normas
3.
J Strength Cond Res ; 33(11): 2926-2931, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31469760

RESUMO

Tiernan, C, Lyons, M, Comyns, T, Nevill, AM, and Warrington, G. The relationship between adductor squeeze strength, subjective markers of recovery and training load in elite Rugby players. J Strength Cond Res 33(11): 2926-2931, 2019-The adductor squeeze strength test has become a popular training monitoring marker, particularly in team sports. The aim of this study was to investigate the relationship between adductor squeeze strength scores, subjective markers of recovery and training load in elite Rugby Union players, because of limited research in this area. Nineteen elite male Rugby Union players completed daily monitoring markers (adductor squeeze strength and 5 selected subjective markers of recovery), over a 10-week preseason training period. Rate of perceived exertion (RPE) was collected to determine training load (session RPE; RPE × session duration) and to calculate weekly training load. Spearman's correlation was used to analyze the relationship between adductor squeeze strength scores, subjective markers of recovery, and weekly training load. The results found that where adductor squeeze scores decreased, both perceived fatigue levels (r = -0.335; R = 11.2%; p < 0.001) and muscle soreness (r = -0.277; R = 7.7%; p < 0.001) increased. A weak correlation was found between Monday adductor squeeze strength scores and the previous week's training load (r = -0.235; R = 5.5%; p < 0.001) and Friday adductor squeeze strength scores and the same week's training load (r = -0.211; R = 4.5%; p < 0.05). These results show that adductor squeeze strength may provide coaches with a time-efficient, low-cost objective, player monitoring marker. Additionally, the combination of adductor strength squeeze, with subjective markers, perceived fatigue, and muscle soreness, and appropriately planned training load may help coaches to optimize training adaptations by determining a player's training status.


Assuntos
Futebol Americano/fisiologia , Força Muscular , Músculo Esquelético/fisiologia , Condicionamento Físico Humano , Adolescente , Fadiga , Humanos , Masculino , Mialgia , Esfigmomanômetros , Coxa da Perna , Adulto Jovem
4.
Int J Sports Med ; 40(9): 585-591, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31272111

RESUMO

The aim of this study was to investigate the effects of walking training with and without blood flow restriction (BFR) on heart rate (HR) and heart rate variability (HRV) kinetics and HRV recovery. Twenty-one men (53.5±3.2 years; 82.4±13.5 kg; 168.5±7.2 cm) were randomly assigned to two training groups: walk training group with (BFR-W; n=11) and without (NOR-W; n=10) BFR. Before and after training, all subjects underwent body composition evaluation, incremental test, and one constant load test. Walking training was performed 3 times/week, during 6 weeks. Each session was composed by 5 sets of 3-min walking and 1-min rest between the sets. All parameters of HR on- and off-kinetics and RMSSD15 0 parameter of HRV on-kinetics were improved for BFR-W group after training (p<0.05), with an interaction effect for HR on-kinetics parameters and RMSSD15 0 parameter (p<0.05). Also, parameters of time and frequency domain of HRV recovery were also improved in BFR-W after training (p<0.05), with no interaction effect (p>0.05). Additionally, in BFR-W group, RMSSD60s values were improved in some moments after training (p<0.05). Therefore, this study demonstrates that a 6-week walking training with BFR improved cardiac autonomic responses on the onset and recovery of exercise.


Assuntos
Constrição , Frequência Cardíaca , Caminhada/fisiologia , Teste de Esforço , Humanos , Cinética , Masculino , Pessoa de Meia-Idade , Fluxo Sanguíneo Regional , Esfigmomanômetros , Coxa da Perna
5.
Blood Press Monit ; 24(4): 208-211, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31162148

RESUMO

OBJECTIVE: The devices to be used in clinical practice should be tested for accuracy and should be validated through the validation protocol. The aim of this study was to determine the accuracy of the Meditech-ABPM-06 ambulatory blood pressure monitor. MATERIALS AND METHODS: The test was carried out in accordance with the protocol established by the European Society of Hypertension (ESH-IP), the British Hypertension Society, and the ANSI/AAMI/ISO 81060-2-2013 protocols. RESULTS: In the European Society of Hypertension validation procedure the subjects with two or three of the absolute differences between observer and device SBP/DBP measurements within 5 mmHg were 31/31. The average device-observer difference was -0.4 ± 3.9 mmHg for SBP and -0.4 ± 2.8 mmHg for DBP. In the British Hypertension Society validation procedure the mean differences of the test device and observer readings were -1.0 ± 4.6 (systolic) and -1.1 ± 4.5 (diastolic). In the ANSI/AAMI/ISO 81060-2-2013 validation procedure (criterion 1) the mean ± SD of the differences between the test device and reference BP was -0.5 ± 4.0/-0.3 ± 4.5 mmHg (systolic/diastolic). The two criteria of the ANSI/AAMI/ISO were fulfilled. CONCLUSION: The Meditech ABPM-06 blood pressure measure device met the requirements specified by the British Hypertension Society, the European Society of Hypertension International Protocol and the AAMI, and therefore was considered acceptable to clinical use with a Grade of A/A.


Assuntos
Monitorização Ambulatorial da Pressão Arterial/instrumentação , Diástole , Hipertensão/fisiopatologia , Sístole , Monitorização Ambulatorial da Pressão Arterial/normas , Monitores de Pressão Arterial/normas , Humanos , Sociedades Médicas , Esfigmomanômetros
6.
Fisioter. Pesqui. (Online) ; 26(2): 158-163, abr.-jun. 2019. tab
Artigo em Português | LILACS | ID: biblio-1012139

RESUMO

RESUMO O objetivo do estudo foi verificar se existem diferenças na força muscular dos membros inferiores (MMII) e na habilidade de locomoção de indivíduos pós-acidente vascular encefálico (AVE) crônico, classificados como deambuladores comunitários ou não comunitários. Foi realizado um estudo transversal em 60 indivíduos pós-AVE crônico, divididos em deambuladores comunitários (n=33) e não comunitários (n=27) pela velocidade de marcha. A força muscular de sete grupos musculares bilaterais de MMII foi avaliada por meio do teste do esfigmomanômetro modificado e habilidade de locomoção pelo ABILOCO. Estatísticas descritivas foram utilizadas para caracterizar a amostra, e o teste t de Student para amostras independentes, a fim de comparar os dois grupos de indivíduos pós-AVE. Observou-se que os deambuladores comunitários apresentaram maiores valores de força muscular para a maioria dos grupos musculares de MMII (−0,973≥t≥−3,189; p≤0,04), e na habilidade de locomoção (t=−2,841; p=0,006). Os indivíduos pós-AVE crônico deambuladores comunitários possuem maior força muscular de MMII e mais habilidade de locomoção em comparação aos deambuladores não comunitários. Sugere-se que a avaliação fisioterapêutica de indivíduos pós-AVE inclua, além da mensuração da força muscular de MMII e seu tratamento, a mensuração da percepção da habilidade de locomoção, para análises da evolução do paciente e da eficácia da conduta terapêutica.


RESUMEN El objetivo del estudio fue verificar si existen diferencias en la fuerza muscular de los miembros inferiores (MMII) y en la habilidad de locomoción de individuos post-accidente cerebrovascular encefálico (ACV) crónico, clasificados como deambuladores comunitarios o no comunitarios. Se realizó un estudio transversal en 60 individuos post-ACV crónico, divididos en deambuladores comunitarios (n = 33) y no comunitarios (n = 27) por la velocidad de marcha. La fuerza muscular de siete grupos musculares bilaterales de MMII fue evaluada por medio de la prueba del esfigmomanómetro modificado, y la habilidad de locomoción por el ABILOCO. Las estadísticas descriptivas se utilizaron para caracterizar la muestra, y la prueba t de Student para muestras independientes con el fin de comparar los dos grupos de sujetos post-ACV. Se observó que los deambuladores comunitarios presentaron mayores valores de fuerza muscular para la mayoría de los grupos musculares de MMII (−0,973≥t≥−3,189; p≤0,04), y en la habilidad de locomoción (t=−2,841; p=0,006). Los individuos post-ACV crónico deambuladores comunitarios poseen mayor fuerza muscular de MMII y más habilidad de locomoción en comparación a los deambuladores no comunitarios. Se sugiere que la evaluación fisioterapéutica de individuos post-ACV incluya, además de la medición de la fuerza muscular de MMII y su tratamiento, la medición de la percepción de la habilidad de locomoción, para análisis de la evolución del paciente y de la eficacia de la conducta terapéutica.


ABSTRACT The objective of this study was to verify if there are differences in the lower-limb muscle strength (LL) and in the locomotion ability among post-stroke patients classified as community or non-community ambulators. A cross-sectional study was conducted in 60 post-chronic stroke subjects, divided into community (n=33) and non-community (n=27) ambulators by gait speed. The muscle strength of seven bilateral muscle groups of LL was evaluated through the modified sphygmomanometer test and locomotion ability through ABILOCO. Descriptive statistics were used to characterize the sample, and Student's t-test was used for independent samples to compare the two groups of post-stroke individuals. We observed that community ambulators had higher values of muscle strength for most muscle groups of LL (−0.973≥t≥3.189; p≤0.04), and in the locomotion ability (t=−2.841; p=0.006). Community ambulators showed higher LL muscle strength and better locomotion ability compared with non-community ambulators. Physiotherapeutic evaluation of post-stroke individuals should include, besides the measurement of LL muscle strength and its treatment, the measurement of the perception of locomotion ability to analyze the evolution of the patient and the efficacy of the therapeutic behavior.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Acidente Vascular Cerebral/fisiopatologia , Força Muscular/fisiologia , Locomoção/fisiologia , Estudos Transversais , Caminhada/fisiologia , Esfigmomanômetros , Extremidade Inferior/fisiopatologia , Marcha/fisiologia
8.
Blood Press Monit ; 24(3): 130-136, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30998553

RESUMO

BACKGROUND: In longitudinal research studies with follow-up examinations, the devices used to measure phenotypes may change over time. When a device change occurs, the two devices should be calibrated to each other to ensure that measurements are comparable. This paper details the Jackson Heart Study (JHS) blood pressure (BP) comparability study. PARTICIPANTS AND METHODS: During its second clinic exam (2005-2008), the JHS switched from a random-zero sphygmomanometer (RZS) BP measurement device to an oscillometric device (OD). During this exam, BP measurements from both an RZS and an OD were taken simultaneously in 2117 participants for the purpose of calibration. Five methods for calibrating systolic BP (SBP) and diastolic BP (DBP) were considered: ignoring the change, ordinary least squares regression, adding the average difference, Deming regression, and robust regression. RESULTS: Using the RZS and OD, the mean (SD) SBP was 125.5 (19.2) and 126.5 (19.9), respectively, and the mean (SD) DBP was 76.4 (10.6) and 74.0 (11.0), respectively. The correlation between RZS and the OD was 0.90 for SBP and 0.80 for DBP. The prevalence of high BP and hypertension and associations with albuminuria were similar when applying each of the five calibration methods. Robust regression was chosen for calibration, giving the following equations:(Equation is included in full-text article.)These equations had a higher R statistic than using calibration equations from the Coronary Artery Risk Development in Young Adults Study and the Heinz Nixdorf Recall Study. CONCLUSIONS: The JHS BP data have been calibrated using the above equations for use in future analyses.


Assuntos
Determinação da Pressão Arterial/instrumentação , Determinação da Pressão Arterial/normas , Pressão Sanguínea , Hipertensão/diagnóstico , Oscilometria/instrumentação , Oscilometria/normas , Adulto , Albuminúria/complicações , Calibragem , Feminino , Humanos , Hipertensão/complicações , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Prevalência , Esfigmomanômetros , Adulto Jovem
9.
Blood Press Monit ; 24(3): 146-150, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31026232

RESUMO

AIM: We evaluated the performance of the Omron HEM-9700T, an automatic upper-arm-type device for the self-measurement of blood pressure (BP), in the sitting and supine positions according to the ANSI/AAMI/ISO81060-2:2013 guidelines. PARTICIPANTS AND METHODS: We screened 106 participants for the validation study in both positions. After excluding 21 participants, a total of 85 participants [38 (44.7%) men; 47 (55.3%) women] with mean±SD age of 54.5±12.2 years (range: 21-78 years) were included. Their arm circumference was 27.5±1.4cm (range: 17.9-40.8cm). The arm circumference distribution met the ANSI/AAMI/ISO81060-2:2013 requirement. The participants' BP measurements alternated between the use of a conventional mercury sphygmomanometer and the automatic device according to the ANSI/AAMI/ISO81060-2:2013 guidelines to measure their BP. RESULTS: The mean differences between reference BPs and HEM-9700T readings in the sitting and supine positions were -0.6±6.4/1.3±5.5 and -1.0±6.2/1.9±5.4mmHg for systolic BP/diastolic BP, respectively. CONCLUSION: The Omron HEM-9700T fulfilled the validation criteria of the ANSI/AAMI/ISO81060-2:2013 guidelines for both the sitting and supine positions.


Assuntos
Determinação da Pressão Arterial , Esfigmomanômetros , Adulto , Idoso , Braço , Pressão Sanguínea , Determinação da Pressão Arterial/instrumentação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Postura Sentada , Decúbito Dorsal , Sístole
10.
Vasc Health Risk Manag ; 15: 47-55, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30881007

RESUMO

Objective: The performance of Omron HEM-6232T and Omron HEM-6181 for monitoring blood pressure (BP) at the wrist was validated in accordance with the ANSI/AAMI/ISO 81060-2:2013 protocol (ANSI/AAMI/ISO) and the European Society of Hypertension International Protocol revision 2010 (ESH IP2). Methods: Three trained medical technologists validated the performance of these devices by comparing data obtained from these devices with those obtained using a standard mercury sphygmomanometer. Results: The mean differences between the devices and mercury readings for SBP and DBP were as follows: HEM-6232T, -0.4±6.7 mmHg and 1.6±5.4 mmHg, respectively; HEM-6181, -0.7±6.2 mmHg and -0.7±5.2 mmHg, respectively, satisfying the ANSI/AAMI/ISO protocol. The mean device-observer measurement difference was -0.9±5.7 mm Hg and 0.2±4.6 mm Hg for SBP and 0.5±4.9 mm Hg and 1.4±3.5 mm Hg for DBP, for HEM-6232T and HEM-6181, respectively, satisfying part 1 of the ESH-IP2. All differences for SBP and DBP in both devices satisfied part 2 of the ESH-IP2. The number of absolute differences in the values obtained using the devices and those measured by the observers fulfilled the requirements of the ANSI/AAMI/ISO and the ESH IP2. Conclusion: The Omron HEM-6232T and HEM-6181 devices met all the requirements of the ANSI/AAMI/ISO and the ESH IP2.


Assuntos
Determinação da Pressão Arterial/instrumentação , Pressão Sanguínea , Hipertensão/diagnóstico , Punho/irrigação sanguínea , Adulto , Idoso , Idoso de 80 Anos ou mais , Desenho de Equipamento , Feminino , Humanos , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Esfigmomanômetros , Adulto Jovem
11.
J Med Vasc ; 44(1): 19-27, 2019 Feb.
Artigo em Francês | MEDLINE | ID: mdl-30770081

RESUMO

OBJECTIVES: At the Paris Saint-Joseph Hospital Group neurovascular unit, the therapeutic patient education program "Treatment of high blood pressure after stroke" involved integrating a vascular physician. The objectives were to include a significant number of patients, to integrate learning self-measurement, and to make an initial analysis of the results concerning patient knowledge, self-measurement practices, adherence to treatment, and control of blood pressure. METHODS: Eighty-six patients under 90 years of age admitted to the neurovascular unit were included in the program between January 1 and October 31, 2017, and participated in an in-hospital educational diagnostic interview followed by an initial session. During this period, 30 patients were reviewed within 3 to 6 months after discharge, with a post-session evaluation for 22 of them. Patient satisfaction was assessed with a questionnaire. A questionnaire was also proposed to the staff. RESULTS: The mean blood pressure of the 22 patients reviewed was on target and they had improved their level of knowledge. The number of sphygmomanometers increased from 5 to 20, but the practice of cycles was not yet mastered. Levels of observed compliance changed little. Patients and paramedics appreciated the program and were convinced of its usefulness. These results do not support a direct effect of therapeutic patient education on blood pressure control, but the observed results are positive and encouraging.


Assuntos
Determinação da Pressão Arterial , Pressão Sanguínea , Hipertensão/terapia , Educação de Pacientes como Assunto , Autocuidado/métodos , Reabilitação do Acidente Vascular Cerebral/métodos , Acidente Vascular Cerebral/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Determinação da Pressão Arterial/instrumentação , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente , Satisfação do Paciente , Valor Preditivo dos Testes , Autocuidado/instrumentação , Esfigmomanômetros , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologia
12.
Transplant Proc ; 51(1): 210-214, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30655160

RESUMO

INTRODUCTION: The measurement of blood pressure (BP) and the management of hypertension in patients with continuous-flow ventricular assist devices (CF-VADs) can present unique challenges. Patients with CF-VADs often do not have a palpable pulse, and therefore traditional blood pressure measurement by auscultation or automated cuff is less reliable. We tested the efficacy of blood pressure estimation using sphygmomanometry combined with finger pulse oximetry only after a hemodynamic optimization was effected to make the values estimated approximately similar to mean arterial pressure. METHODS: Fifteen consecutive patients with a mean age of 57.8 ± 11.2 years were implanted with HeartMate 3 between November 2015 and March 2017. All patients underwent pump speed optimization by conducting a ramp test during right heart catheterization. The patients were prospectively studied during the follow-up period and mean arterial pressure was estimated using 3 different methodologies: Doppler ultrasound, pulse oximeter, and automated blood pressure cuff. For each method 3 consecutive evaluations were conducted during 3 follow-up visits. RESULTS: For each patient, 9 different evaluations were obtained (3 for each method). The overall success rate was 100% for blood pressure assessment conducted with Doppler ultrasound and pulse oximeter and 80%-87% for automated monitor evaluations. The first 2 methodologies were 100% successful, while the third was 60% successful. Pearson's correlation analyses for the Doppler ultrasound and pulse oximeter measurements showed a good correlation when evaluations conducted with the same method were compared. A high variability emerged between estimations obtained by using an automated monitor and a poor correlation was found when this method was compared to the Doppler ultrasound and pulse oximeter measurements. CONCLUSION: According to our results, the pulse oximeter method showed a high success rate and a good correlation level with the standard procedure. Our data encourage the use of oximeters for domiciliary blood pressure assessment in patients implanted with a continuous flow device.


Assuntos
Determinação da Pressão Arterial/métodos , Coração Auxiliar , Oximetria/métodos , Ultrassonografia Doppler/métodos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica/métodos , Esfigmomanômetros
13.
J Med Syst ; 43(2): 24, 2019 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-30603777

RESUMO

Blood pressure (BP) is a bio-physiological signal that can provide very useful information regarding human's general health. High or low blood pressure or its rapid fluctuations can be associated to various diseases or conditions. Nowadays, high blood pressure is considered to be an important health risk factor and major cause of various health problems worldwide. High blood pressure may precede serious heart diseases, stroke and kidney failure. Accurate blood pressure measurement and monitoring plays fundamental role in diagnosis, prevention and treatment of these diseases. Blood pressure is usually measured in the hospitals, as a part of a standard medical routine. However, there is an increasing demand for methodologies, systems as well as accurate and unobtrusive devices that will permit continuous blood pressure measurement and monitoring for a wide variety of patients, allowing them to perform their daily activities without any disturbance. Technological advancements in the last decade have created opportunities for using various devices as a part of ambient assisted living for improving quality of life for people in their natural environment. The main goal of this paper is to provide a comprehensive review of various methodologies for continuous cuff-less blood pressure measurement, as well as to evidence recently developed devices and systems for continuous blood pressure measurement that can be used in ambient assisted living applications.


Assuntos
Monitorização Ambulatorial da Pressão Arterial/instrumentação , Monitorização Ambulatorial da Pressão Arterial/métodos , Eletrocardiografia/métodos , Humanos , Oscilometria/métodos , Fotopletismografia/métodos , Esfigmomanômetros , Dispositivos Eletrônicos Vestíveis
14.
Am J Cardiol ; 123(3): 498-506, 2019 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-30477799

RESUMO

Although echocardiography is usually diagnostic of cardiac tamponade, it may not be readily available at the point-of-care. We sought to develop and validate a measurement of respirophasic variation in the amplitude of pulse oximetry plethysmographic waveforms as a diagnostic tool for cardiac tamponade. Pulse oximetry plethysmographic waveforms were recorded, and the ratio of maximum-to-minimum measured amplitude of these waveforms from one respiratory cycle was calculated by blinded observers. Ratios from 3 consecutive respiratory cycles were then averaged to derive an "oximetry paradoxus" ratio. Cardiac tamponade was independently confirmed or excluded according to a "blinded" objective interpretation of echocardiography or right heart catheterization. Seventy four subjects were enrolled (51% men; mean age 54 ± 15 years); 19 of whom had cardiac tamponade. Oximetry paradoxus area under the curve for diagnosis of cardiac tamponade was 0.90 (95% confidence interval, 0.84 to 0.97); its diagnostic performance was superior to sphygmomanometer-measured pulsus paradoxus (area under the curve difference = 0.16, p = 0.022). In a derivation cohort (n = 37; tamponade, 9 cases), 3 diagnostic oximetry paradoxus thresholds were identified and validated in an independent validation cohort (n = 37; tamponade, 10 cases): 1.2 (100% sensitivity, 44% specificity), 1.5 (80% sensitivity, 81% specificity), and 1.7 (80% sensitivity, 89% specificity). Furthermore, oximetry paradoxus was significantly reduced after draining pericardial fluid. In conclusion, we defined and validated oximetry paradoxus as a simple and ubiquitous point-of-care test to diagnose cardiac tamponade using respirophasic changes in pulse plethysmography waveforms. This test can aid in identifying patients with cardiac tamponade, thus expediting confirmatory testing and life-saving treatment.


Assuntos
Tamponamento Cardíaco/diagnóstico , Oximetria , Tamponamento Cardíaco/terapia , Ecocardiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Técnicas de Janela Pericárdica , Pericardiocentese , Pletismografia , Sistemas Automatizados de Assistência Junto ao Leito , Estudos Prospectivos , Respiração , Sensibilidade e Especificidade , Esfigmomanômetros
16.
Conf Proc IEEE Eng Med Biol Soc ; 2018: 1168-1171, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-30440599

RESUMO

The importance of home blood pressure (BP) monitoring has been emphasized for achieving effective hypertension management. Currently, the most popular non-invasive BP monitors for home use are the upper-arm cuff-style oscillometric devices which determine BP from the cuff pressure oscillations during the cuff inflation/deflation induced by the pulsatile blood flow in the compressed arteries. However, the large size of the upper-arm cuff is not favorable for attachment in daily life for ambulatory BP monitoring. Therefore, the miniaturization of home BP monitors is in demand to improve their portability for frequent measurements. This work examined the oscillometric measurement of mean blood pressure(MBP) at upper arm (UA), middle forearm (MA), wrist (WR), finger proximal phalanx (FP) and finger distal phalanx (FD) on 14 young adults. The experimental results showed that the mean and standard deviation of the differences between the oscillometric MBP at UA and the other sites are 8.86±6.28 mm Hg at MA, 14.43±5.52 mm Hg at WR, 9.80±6.57 mm Hg at FP and -0.77±6.37 mm Hg at FD, respectively. Based on hand checking and literature data, the order of the ratios of the bone volume to the surrounding tissue volume from large to small is WR>MA≈FP>FD≈UA. Together with the experimental results, we infer that a larger bone-tissue volume ratio could result in a larger oscillometric MBP reading. Since the applied cuff pressure are supposed to be less effectively absorbed by the soft-tissue surrounding a larger rigid bone, it is more difficult to occlude the arteries buried in the pressure-absorbing tissue at a bonier site by the inflatable cuffs, which leads to a higher measured MBP than the real MBP. In conclusion, it is promising to develop the finger oscillometric BP monitors to be worn on the finger distal phalanx which have a compact size and provide consistent measurement results with the UA measurements.


Assuntos
Determinação da Pressão Arterial , Pressão Sanguínea , Monitores de Pressão Arterial , Oscilometria , Esfigmomanômetros
17.
Conf Proc IEEE Eng Med Biol Soc ; 2018: 3792-3795, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-30441192

RESUMO

Convenient and painless blood pressure measurement can enable increased user adoption of regular monitoring and early intervention for hypertension, which is a significant cause of mortality worldwide. This paper introduces a fingerwearable blood pressure measurement device to enable frequent daytime and nocturnal monitoring. The blood pressure measurement is achieved using a two-dimensional capacitive tactile sensor array that is located next to a digital artery. A pumpdriven pneumatic bladder presses the tactile array and the finger towards each other to obtain a pressure sweep versus time. The digital artery pressure waveform data collected during this sweep are used to estimate arterial blood pressure. A clinical study (N =97) was conducted to obtain training (N =49) and validation (N =19) data for blood pressure algorithm development and test (N =29) data to determine the estimation accuracy compared to brachial dual-observer auscultation. On the test set, the mean and standard deviation of the error in the systolic blood pressure estimate are 0.9 mmHg and 6.9 mmHg, respectively, while the corresponding quantities for diastolic blood pressure are -3.2 mmHg and 7.0 mmHg, respectively. These results compare favorably to blood pressure accuracy requirements specified by international standards.


Assuntos
Monitores de Pressão Arterial , Dispositivos Eletrônicos Vestíveis , Pressão Sanguínea , Determinação da Pressão Arterial , Dedos , Humanos , Esfigmomanômetros
18.
J Dent Hyg ; 92(5): 38-44, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30385600

RESUMO

Purpose: The purpose of this study was to compare three different types of blood pressure (BP) recording devices (an automated arm cuff, an automated wrist cuff, and a manual cuff / stethoscope combination) for accuracy, patient comfort, and ease of operation.Methods: Three types of sphygmomanometers were tested on 150 study participants (n=150) obtained from the patients presenting for dental hygiene services at an urban dental school in the Midwest. Descriptive statistics were calculated for all variables of interest by cuff type. Repeated measures ANOVA using the Greenhouse-Geisser adjustment were used to test for differences in means in BP and rating measure by cuff type. Post-hoc comparisons using Tukey's procedure were calculated to determine pair-wise differences. An association between the cuff type and convenience rating was evaluated using the Chi-square test, and between cuff type and convenience rating using the Fisher's exact test.Results: There was a significant difference in systolic BP recording by cuff type (p<0.001). The automatic wrist cuff recorded an average of 11.30mm and 8.76mm HG higher systolic BP than the standard cuff and the automatic arm cuff respectively (p<0.001 for both). There was no significant difference in the systolic BP readings between the standard and automatic arm cuff (p=0.226) nor was there a significant difference in diastolic BP by cuff type (p=0.137).Conclusion: Blood pressure cuff readings with traditional sphygmomanometer and stethoscope or an automated brachial cuff are comparable while wrist cuff BP readings deviated significantly. For consistency in blood pressure readings, the three different cuff types are not interchangeable.


Assuntos
Determinação da Pressão Arterial/instrumentação , Determinação da Pressão Arterial/normas , Higienistas Dentários/educação , Conforto do Paciente , Esfigmomanômetros/normas , Determinação da Pressão Arterial/métodos , Estudos Transversais , Humanos
19.
Can J Vet Res ; 82(4): 244-248, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30363283

RESUMO

The objective of this study was to characterize arterial blood pressure (BP) measurements obtained by using 2 indirect methods, oscillometry and Doppler ultrasonic sphygmomanometry, in conscious goats. Agreement between systolic BP yielded by these 2 methods was then assessed. Sixty female dairy goats aged from 1.5 to 11.8 y (median: 5.5 y) were examined in a standing position with a cuff placed on the tail. All goats had a severe arthritic form of caprine arthritis-encephalitis. Three to 5 repeated measurements of each BP type were averaged for each goat and considered as a final measurement. With oscillometry, systolic blood pressure (O-SBP), diastolic blood pressure, and mean blood pressure, as well as heart rate (HR) were measured, while only systolic blood pressure was measured with Doppler (D-SBP). The O-SBP did not correlate with D-SBP [correlation coefficient (r) = 0.24, P = 0.067]; the mean difference (± standard deviation) was 24.5 ± 26.3 mmHg and limits of agreement were from -27.2 mmHg [95% confidence interval (CI): -39.0, -15.4 mmHg] to 76.1 mmHg (95% CI: 64.3, 87.9 mmHg). No significant linear correlation was found between any BPs and HR (r: -0.10 to 0.22) or age (r: -0.26 to 0.07) of the goats. The study showed that, while BP could be measured in conscious goats using both oscillometry and Doppler ultrasonic sphygmomanometry, the results obtained were so inconsistent that these methods could not be used interchangeably.


Assuntos
Determinação da Pressão Arterial/veterinária , Pressão Sanguínea/fisiologia , Cabras/fisiologia , Oscilometria/veterinária , Esfigmomanômetros/veterinária , Ultrassonografia Doppler/veterinária , Animais , Determinação da Pressão Arterial/instrumentação , Determinação da Pressão Arterial/métodos , Feminino , Frequência Cardíaca , Oscilometria/instrumentação , Oscilometria/métodos , Ultrassonografia Doppler/instrumentação
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA