OBJECTIVE: Optimizing peri-operative fluid management has been shown to improve patient outcomes and the use of stroke volume (SV) measurement has become an accepted tool to guide fluid therapy. The Transesophageal Doppler (TED) is a validated, minimally invasive device that allows clinical assessment of SV. Unfortunately, the use of the TED is restricted to the intra-operative setting in anesthetized patients and requires constant supervision and periodic adjustment for accurate signal quality. However, post-operative fluid management is also vital for improved outcomes. Currently, there is no device regularly used in clinics that can track patient's SV continuously and non-invasively both during and after surgery. METHODS: In this paper, we propose the use of a wearable patch mounted on the mid-sternum, which captures the seismocardiogram (SCG) and electrocardiogram (ECG) signals continuously to predict SV in patients undergoing major surgery. In a study of 12 patients, hemodynamic data was recorded simultaneously using the TED and wearable patch. Signal processing and regression techniques were used to derive SV from the signals (SCG and ECG) captured by the wearable patch and compare it to values obtained by the TED. RESULTS: The results showed that the combination of SCG and ECG contains substantial information regarding SV, resulting in a correlation and median absolute error between the predicted and reference SV values of 0.81 and 7.56 mL, respectively. SIGNIFICANCE: This work shows promise for the proposed wearable-based methodology to be used as an alternative to TED for continuous patient monitoring and guiding peri-operative fluid management.
OBJECTIVE: Optimizing peri-operative fluid management has been shown to improve patient outcomes and the use of stroke volume (SV) measurement has become an accepted tool to guide fluid therapy. The Transesophageal Doppler (TED) is a validated, minimally invasive device that allows clinical assessment of SV. Unfortunately, the use of the TED is restricted to the intra-operative setting in anesthetized patients and requires constant supervision and periodic adjustment for accurate signal quality. However, post-operative fluid management is also vital for improved outcomes. Currently, there is no device regularly used in clinics that can track patient's SV continuously and non-invasively both during and after surgery. METHODS: In this paper, we propose the use of a wearable patch mounted on the mid-sternum, which captures the seismocardiogram (SCG) and electrocardiogram (ECG) signals continuously to predict SV in patients undergoing major surgery. In a study of 12 patients, hemodynamic data was recorded simultaneously using the TED and wearable patch. Signal processing and regression techniques were used to derive SV from the signals (SCG and ECG) captured by the wearable patch and compare it to values obtained by the TED. RESULTS: The results showed that the combination of SCG and ECG contains substantial information regarding SV, resulting in a correlation and median absolute error between the predicted and reference SV values of 0.81 and 7.56 mL, respectively. SIGNIFICANCE: This work shows promise for the proposed wearable-based methodology to be used as an alternative to TED for continuous patient monitoring and guiding peri-operative fluid management.
Authors: H G Wakeling; M R McFall; C S Jenkins; W G A Woods; W F A Miles; G R Barclay; S C Fleming Journal: Br J Anaesth Date: 2005-09-09 Impact factor: 9.166
Authors: Jean-Louis Teboul; Bernd Saugel; Maurizio Cecconi; Daniel De Backer; Christoph K Hofer; Xavier Monnet; Azriel Perel; Michael R Pinsky; Daniel A Reuter; Andrew Rhodes; Pierre Squara; Jean-Louis Vincent; Thomas W Scheeren Journal: Intensive Care Med Date: 2016-05-07 Impact factor: 17.440