search query: @supervisor Koskelainen, Ari / total: 34
reference: 21 / 34
« previous | next »
Author:Keskinen, Juhani
Title:Photoplethysmographic Waveform as an Indicator of Hypovolemia
Fotopletysmografinen aaltomuoto hypovolemian tunnistuksessa
Publication type:Master's thesis
Publication year:2010
Pages:vii + 57      Language:   eng
Department/School:Informaatio- ja luonnontieteiden tiedekunta
Main subject:Lääketieteellinen tekniikka   (Tfy-99)
Supervisor:Koskelainen, Ari
Instructor:Takala, Panu
OEVS:
Electronic archive copy is available via Aalto Thesis Database.
Instructions

Reading digital theses in the closed network of the Aalto University Harald Herlin Learning Centre

In the closed network of Learning Centre you can read digital and digitized theses not available in the open network.

The Learning Centre contact details and opening hours: https://learningcentre.aalto.fi/en/harald-herlin-learning-centre/

You can read theses on the Learning Centre customer computers, which are available on all floors.

Logging on to the customer computers

  • Aalto University staff members log on to the customer computer using the Aalto username and password.
  • Other customers log on using a shared username and password.

Opening a thesis

  • On the desktop of the customer computers, you will find an icon titled:

    Aalto Thesis Database

  • Click on the icon to search for and open the thesis you are looking for from Aaltodoc database. You can find the thesis file by clicking the link on the OEV or OEVS field.

Reading the thesis

  • You can either print the thesis or read it on the customer computer screen.
  • You cannot save the thesis file on a flash drive or email it.
  • You cannot copy text or images from the file.
  • You cannot edit the file.

Printing the thesis

  • You can print the thesis for your personal study or research use.
  • Aalto University students and staff members may print black-and-white prints on the PrintingPoint devices when using the computer with personal Aalto username and password. Color printing is possible using the printer u90203-psc3, which is located near the customer service. Color printing is subject to a charge to Aalto University students and staff members.
  • Other customers can use the printer u90203-psc3. All printing is subject to a charge to non-University members.
Location:P1 Ark Aalto  177   | Archive
Keywords:photoplethysmography
hypovolemia
intravenous therapy
fotopletysmografia
hypovolemia
nesteinfuusio
Abstract (eng): Ensuring adequate cardiac output is crucial in patient care in intensive care units.
Currently there is no generally accepted direct method for monitoring patient blood volume status, and the care personnel makes the decision about fluid administration based on indirect methods.
Respiratory variation indices, derived from invasive arterial blood pressure waveform, have been found to correlate with blood volume deficiency, or hypovolemia.
Also photoplethysmographic indices have been studied, to lesser extent.

In this thesis the hypovolemia correlation of two photoplethysmographic respiratory variation indices, pulse peak variation (PPV) and stroke volume variation (SVV), are compared with three invasive arterial blood pressure -derived indices, systolic pressure variation (SPV), PPV and SVV.
Commonly monitored parameters mean arteral blood pressure (MABP) and central venous pressure (CVP) are used as reference parameters.

The photoplethysmographic and arterial blood pressure data used in the evalution was recorded from twelve ventilated pig test subjects.
The subjects were drained 450 ml of blood to induce a hypovolemic state, and then administered fluid infusion to bring the blood volume status back to normal.
Of the evaluated hypovolemia indices, the best correlation was found in arterial blood pressure PPV and SVV, with Pearson correlation coefficients (rP) over 0.50 and p-values under 0.01.
The photoplethysmographic indices showed less correlation with hypovolemia, but were not substantially worse than blood pressure-derived ones, with of rP 0.47 (PPV) and 0.39 (SVV), and p-values of 0.03 (PPV) and 0.09 (SVV).
SPV had the least correlation with hypovolemia of the evaluated indices.
MABP had the best correlation values as the reference parameter (rP = -0.71, p < 0.001).

The study also showed, that the ventilator frequency has effect on the hypovolemia indices.
Further, in severe anemic, but non-hypovolemic state, the respiratory variation of the photoplethysmographic and arterial blood pressure waveforms increase.
The value of photoplethysmographic hypovolemia indices in fluid therapy guidance is evident, and the noninvasive nature of the measurement encourages to research photoplethysmography -based hypovolemia detection further.
Abstract (fin): Riittävän sydämen minuuttitilavuuden varmistaminen on tärkeää tehohoitoympäristössä.
Yleisesti hyväksyttyä suoraa menetelmää potilaan veritilavuuden mittaamiseksi ei toistaiseksi ole, ja hoitohenkilökunta tekee päätökset nesteytyshoidosta epäsuoriin menetelmiin perustuen.
Invasiivisesta valtimoverenpaineaaltomuodosta johdettujen hengitysvariaatioindeksien on todettu korreloivan veritilavuuden vajauksen eli hypovolemian kanssa.
Myös fotopletysmografiaan perustuvia hypovolemiaindeksejä on tutkittu jonkin verran.

Tässä diplomityössä verrataan kahta fotopletysmografista hypovolemiaindeksiä, pulssinkorkeusvariaatiota (pulse peak variation, PPV) ja lyöntitilavuusvariaatiota (stroke volume variation, SVV) kolmeen valtimoverenpaineesta johdettuun hypovolemiaindeksiin: systolinen painevaihtelu (systolic pressure variation, SPV), PPV ja SVV.
Keskiarvoistettua valtimoverenpainetta (MABP) ja keskuslaskimopainetta (CVP) käytetään vertailuparametreina.

Vertailussa käytettävä data kerättiin kahdeltatoista koe-eläimenä käytetyltä ventiloidulta sialta.
Hypovoleminen tila aiheutettiin laskemalla koe-eläimistä 450 ml verta, jonka jälkeen verivoluumi palautettiin normaaliksi nesteinfuusiolla.
Tutkituista indekseistä parhaiten hypovolemian kanssa korreloivat valtimoverenpaineesta johdetut PPV ja SVV, joiden Pearsonin korrelaatiokertoimet (rP) olivat yli 0.50 ja p-arvot alle 0.01.
Fotopletysmografisten indeksien korrelaatio oli vähäisempää, (PPV: rP = 0.47, p = 0.03 ja SVV: rP = 0.39, p = 0.09) mutta niiden suorituskyky ei ollut huomattavasti valtimoverenpaineindeksejä huonompi.
SPV korreloi hypovolemian kanssa huonoiten vertailuindekseistä.
MABP:n suorituskyky referenssiparametrina oli paras (rP = -0.71, p < 0.001).

Työssä havaittiin myös, että ventilaatiotaajuus vaikuttaa hypovolemiaindeksien arvoihin merkittävästi.
Lisäksi vakavassa aneemisessa, mutta ei-hypovoleemisessa tilassa valtimoverenpaineen ja fotopletysmografisen aaltomuodon hengitysvariaatio kasvaa.

Diplomityön perusteella fotopletysmografisten hypovolemiaindeksien käyttö nesteytyshoitopäätöksen teossa on ilmeisen hyödyllistä.
Fotopletysmografian ei-invasiivisuus tekee alueen lisätutkimuksesta houkuttelevan.
ED:2010-08-11
INSSI record number: 40084
+ add basket
« previous | next »
INSSI