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CN-122004798-A - Integrated hemodynamic monitoring sensor and target-oriented liquid treatment method

CN122004798ACN 122004798 ACN122004798 ACN 122004798ACN-122004798-A

Abstract

The application discloses an integrated hemodynamic monitoring sensor and a target-oriented liquid treatment method. The method comprises the steps of obtaining an arterial pressure waveform corresponding to at least one cardiac cycle, identifying a beat-to-beat basic characteristic of each cardiac cycle in real time based on the arterial pressure waveform, wherein the beat-to-beat basic characteristic comprises beat-to-beat systolic pressure and beat-to-beat diastolic pressure, calculating a beat-to-beat pulse pressure difference corresponding to each cardiac cycle, directly calculating to obtain a capacity responsiveness index which does not need to depend on absolute value estimation of each beat output through single analysis operation in a preset time window based on all beat-to-beat pulse pressure differences in the time window, and generating intervention guidance information of target-oriented liquid therapy based on the capacity responsiveness index. By compressing the traditional calculation flow, the application bypasses the complicated stroke volume estimation step, obviously reduces the calculation complexity and the dependence on a physiological model, and improves the monitoring instantaneity, robustness and reliability of clinical guidance.

Inventors

  • JIANG HUIFANG

Assignees

  • 浙江省肿瘤医院

Dates

Publication Date
20260512
Application Date
20260122

Claims (10)

  1. 1. A method of targeted fluid treatment comprising: acquiring a continuous arterial pressure waveform corresponding to at least one respiratory cycle; Identifying a beat-to-beat basis feature for each cardiac cycle within the respiratory cycle based on the continuous arterial pressure waveform, wherein the beat-to-beat basis feature comprises a beat-to-beat systolic pressure and a beat-to-beat diastolic pressure corresponding to each cardiac cycle; calculating a beat-to-beat pulse pressure difference corresponding to each cardiac cycle based on the beat-to-beat systolic pressure and the beat-to-beat diastolic pressure; identifying a maximum beat-to-beat differential pressure and a minimum beat-to-beat differential pressure within an analysis window representing the respiratory cycle; Based on the maximum beat-to-beat pulse pressure difference and the minimum beat-to-beat pulse pressure difference, calculating to obtain a pulse pressure variation degree by performing algebraic analysis operation based on the maximum beat-to-beat pulse pressure difference and the minimum beat-to-beat pulse pressure difference, so as to serve as a core index for evaluating the capacity responsiveness of a patient; Based on the pulse pressure variability, intervention guidance information is generated for guiding a targeted fluid therapy.
  2. 2. The method of claim 1, wherein the step of identifying a beat-to-beat basis feature for each cardiac cycle comprises: performing first derivative calculation on the continuous arterial pressure waveform to identify the moment with the highest pressure rising rate as a starting point of a cardiac cycle; during each identified cardiac cycle, a local maximum of the pressure waveform is determined as the beat-to-beat systolic pressure and a local minimum is determined as the beat-to-beat diastolic pressure.
  3. 3. The method of claim 1, wherein the step of generating intervention guidance information for guiding a targeted fluid therapy comprises: comparing the calculated pulse pressure variation with a preset clinical threshold; And when the pulse pressure variation degree is larger than the preset clinical threshold value, generating intervention guidance information for prompting the patient to possibly be in a capacity deficiency state.
  4. 4. A method according to claim 3, wherein the predetermined clinical threshold is 13%.
  5. 5. The method of claim 3, wherein the step of generating intervention guidance information for guiding a targeted fluid therapy further comprises: simultaneously acquiring the average arterial pressure of the patient; And when the pulse pressure variation degree is larger than the preset clinical threshold value and the average arterial pressure is lower than a preset blood pressure target value, generating intervention guidance information for suggesting the capacity loading test.
  6. 6. The method of claim 1, wherein the duration of the analysis window is set to adaptively cover at least one complete breathing cycle.
  7. 7. The method as recited in claim 1, further comprising: calculating a real-time heart rate of the patient based on the continuous arterial pressure waveform; based on the real-time heart rate and the average beat-to-beat pulse pressure difference over a period of time, a trend of the patient's cardiac output is estimated.
  8. 8. An integrated hemodynamic monitoring sensor, comprising: a signal acquisition module for acquiring a continuous arterial pressure waveform corresponding to at least one respiratory cycle; and the analysis engine is connected with the signal acquisition module and is configured to: Identifying a beat-to-beat basis feature for each cardiac cycle within the respiratory cycle based on the continuous arterial pressure waveform, wherein the beat-to-beat basis feature comprises a beat-to-beat systolic pressure and a beat-to-beat diastolic pressure corresponding to each cardiac cycle; calculating a beat-to-beat pulse pressure difference corresponding to each cardiac cycle based on the beat-to-beat systolic pressure and the beat-to-beat diastolic pressure; identifying a maximum beat-to-beat differential pressure and a minimum beat-to-beat differential pressure within an analysis window representing the respiratory cycle; Calculating a pulse pressure variation degree based on the maximum pulse pressure difference and the minimum pulse pressure difference through an analysis operation directly based on algebraic operation of the maximum pulse pressure difference and the minimum pulse pressure difference to serve as a core index for evaluating the capacity responsiveness of the patient, and Based on the pulse pressure variability, intervention guidance information is generated for guiding a targeted fluid therapy.
  9. 9. The sensor of claim 8, wherein the parsing engine, when generating the intervention guidance information, is specifically configured to: Comparing the calculated variation of the pulse pressure with a preset clinical threshold value, and And when the pulse pressure variation degree is larger than the preset clinical threshold value, generating intervention guidance information for prompting the patient to possibly be in a capacity deficiency state.
  10. 10. The sensor of claim 9, wherein the parsing engine is further configured to: acquiring mean arterial pressure of the patient, and And when the pulse pressure variation degree is larger than the preset clinical threshold value and the average arterial pressure is lower than a preset blood pressure target value, generating intervention guidance information for suggesting the capacity loading test.

Description

Integrated hemodynamic monitoring sensor and target-oriented liquid treatment method Technical Field The invention relates to the technical field of medical monitoring, in particular to an integrated hemodynamic monitoring sensor and a target-oriented liquid treatment method. Background Accurate, continuous monitoring of the hemodynamic status of a patient during critical care and major surgical anesthesia is critical to maintaining organ perfusion, guiding fluid therapy, and the use of vasoactive drugs. Target-directed fluid treatment (GDFT) is a modern fluid management strategy aimed at improving tissue oxygen supply and reducing postoperative complications by optimizing cardiac preload and maximizing Stroke Volume (SV). Pulse pressure variability (Pulse Pressure Variation, PPV) and stroke volume variability (Stroke Volume Variation, SVV) are currently the core dynamic indicators of predicted volume responsiveness in the clinic. In the prior art, acquisition of PPV or SVV typically relies on a monitoring system based on pulse wave contour analysis. These systems first acquire a continuous arterial pressure waveform through an invasive arterial catheter and then transmit the waveform signal to an external host. Complex algorithms within the host process the waveforms, estimate SV through a series of complex, serial dependent computation steps, and compute SVV based thereon. In order to obtain the SVV with relative change, the absolute value of the SV must be estimated first, and the estimation of the SV is seriously dependent on modeling of individual physiological parameters such as aortic compliance and the like, which not only increases the computational complexity, but also introduces a potential error source and reduces the monitoring robustness. Therefore, how to simplify the calculation flow and reduce the dependence on physiological models, and to provide a more direct and more robust capacity reactivity assessment method is a technical problem to be solved in the art. Disclosure of Invention The application aims to provide an integrated hemodynamic monitoring sensor and a target-oriented liquid treatment method, and aims to solve the technical problems of complex flow, computational redundancy and excessive dependence on physiological models of hemodynamic monitoring algorithms in the prior art. To achieve the above object, a first aspect of the present application provides a target-oriented liquid therapy method, including acquiring a continuous arterial pressure waveform corresponding to at least one respiratory cycle, identifying a beat-to-beat basis feature of each cardiac cycle in the respiratory cycle based on the continuous arterial pressure waveform, wherein the beat-to-beat basis feature includes a beat-to-beat systolic pressure and a beat-to-beat diastolic pressure corresponding to each cardiac cycle, calculating a beat-to-beat pressure difference corresponding to each cardiac cycle based on the beat-to-beat systolic pressure and the beat-to-beat diastolic pressure, identifying a maximum beat-to-beat pressure difference and a minimum beat-to-beat pressure difference within an analysis window representing the respiratory cycle, calculating a pulse pressure variation by performing an analysis operation of algebraic operation based on the maximum beat-to-beat pressure difference and the minimum beat-to-beat pressure difference as a core index for evaluating patient capacity responsiveness based on the pulse pressure variation, and generating guide information for guiding the target-oriented liquid therapy based on the pulse pressure variation. Optionally, the analyzing operation specifically calculates the pulse pressure variation degree by the following formula: Wherein, the For the maximum beat-to-beat pulse pressure difference,For the minimum pulse-by-pulse pressure differential. Optionally, the step of identifying the beat-to-beat basis feature of each cardiac cycle comprises performing a first derivative calculation on the continuous arterial pressure waveform to identify the instant at which the pressure rise rate is the fastest as the starting point of the cardiac cycle, and determining a local maximum of the pressure waveform as the beat-to-beat systolic pressure and a local minimum as the beat-to-beat diastolic pressure within each identified cardiac cycle. Optionally, the step of generating intervention guidance information for guiding the targeted fluid therapy includes comparing the computed pulse pressure variability with a preset clinical threshold, and generating intervention guidance information prompting the patient to be likely in an under-capacity state when the pulse pressure variability is greater than the preset clinical threshold. Optionally, the preset clinical threshold is 13%. Optionally, the step of generating intervention guidance information for guiding the targeted fluid therapy further comprises simultaneously acquiring mean arterial pressure of the patient, a