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. 2014 Apr;28(2):392-7.
doi: 10.1053/j.jvca.2013.11.014. Epub 2014 Feb 6.

Blood pressure variability: can nonlinear dynamics enhance risk assessment during cardiovascular surgery?

Balachundhar Subramaniam  1 , Kamal R Khabbaz  2 , Thomas Heldt  3 , Adam B Lerner  4 , Murray A Mittleman  5 , Roger B Davis  6 , Ary L Goldberger  7 , Madalena D Costa  7
Affiliations

Blood pressure variability: can nonlinear dynamics enhance risk assessment during cardiovascular surgery?

Balachundhar Subramaniam et al. J Cardiothorac Vasc Anesth. 2014 Apr.

Abstract

We propose that complex (nonlinear) fluctuations of hemodynamic variables (including systemic blood pressure parameters) during cardiovascular surgery contain information relevant to risk assessment and intraoperative management. Preliminary analysis of a pilot study supports the feasibility and potential merits of performing a larger, prospective study to assess the clinical utility of such new dynamical measures and to evaluate their potential role in enhancing contemporary approaches to risk assessment of major adverse events.

Keywords: beat by beat.; blood pressure; blood pressure variability; cardiac surgery; dynamic biomarkers; instability; multiscale entropy; nonlinear analysis; outcomes; perioperative; risk index.

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Figures

Figure 1
Figure 1
Systolic, diastolic, pulse pressure and heart rate fluctuation time series from a control subject. Note: the heart rate time series were not analyzed because most patients had sustained electronic pacing that confounds heart rate variability analyses.
Figure 2
Figure 2
Multiscale entropy (MSE) analysis of the detrended pulse pressure time series from the post-bypass period for the case and control groups. Symbols and error bars represent group means and standard deviation values.
See this image and copyright information in PMC

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