Unexpected sawtooth artifact in beat-to-beat pulse transit time measured from patient monitor data

English version

Autoři: Yu-Ting Lin ^aff001; Yu-Lun Lo ^aff002; Chen-Yun Lin ^aff003; Martin G. Frasch ^aff004; Hau-Tieng Wu ^aff003
Působiště autorů: Department of Anesthesiology, Taipei Veteran General Hospital, Taipei, Taiwan ^aff001; Department of Thoracic Medicine, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taipei, Taiwan ^aff002; Department of Mathematics, Duke University, Durham, NC, United States of America ^aff003; Department of Obstetrics and Gynecology and Center on Human Development and Disability (CHDD), University of Washington, Seattle, WA, United States of America ^aff004; Department of Statistical Science, Duke University, Durham, NC, United States of America ^aff005; Mathematics Division, National Center for Theoretical Sciences, Taipei, Taiwan ^aff006
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0221319

Souhrn

Object

It is increasingly popular to collect as much data as possible in the hospital setting from clinical monitors for research purposes. However, in this setup the data calibration issue is often not discussed and, rather, implicitly assumed, while the clinical monitors might not be designed for the data analysis purpose. We hypothesize that this calibration issue for a secondary analysis may become an important source of artifacts in patient monitor data. We test an off-the-shelf integrated photoplethysmography (PPG) and electrocardiogram (ECG) monitoring device for its ability to yield a reliable pulse transit time (PTT) signal.

Approach

This is a retrospective clinical study using two databases: one containing 35 subjects who underwent laparoscopic cholecystectomy, another containing 22 subjects who underwent spontaneous breathing test in the intensive care unit. All data sets include recordings of PPG and ECG using a commonly deployed patient monitor. We calculated the PTT signal offline.

Main results

We report a novel constant oscillatory pattern in the PTT signal and identify this pattern as a sawtooth artifact. We apply an approach based on the de-shape method to visualize, quantify and validate this sawtooth artifact.

Significance

The PPG and ECG signals not designed for the PTT evaluation may contain unwanted artifacts. The PTT signal should be calibrated before analysis to avoid erroneous interpretation of its physiological meaning.

Klíčová slova:

Engineering and technology – Research and analysis methods – Computer and information sciences – Medicine and health sciences – Research assessment – Vascular medicine – Equipment – Surgical and invasive medical procedures – Bioassays and physiological analysis – Electrophysiological techniques – Cardiac electrophysiology – Electrocardiography – Equipment preparation – Instrument calibration – Research monitoring – Signal processing – Instrumentation – Blood pressure – Data acquisition

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