Assessment of Baroreflex Control of Heart Rate During General Anesthesia Using a Point Process Method.
Evaluation of baroreflex control of heart rate (HR) has important implications in clinical practice of anesthesia and postoperative care. In this paper, we present a point process method to assess the dynamic baroreflex gain using a closed-loop model of the cardiovascular system. Specifically, the inverse Gaussian probability distribution is used to model the heartbeat interval, whereas the instantaneous mean is identified by a linear or bilinear bivariate regression on the previous R-R intervals and blood pressure (BP) measures. The instantaneous baroreflex gain is estimated in the feedback loop with a point process filter, while the RR→BP feedforward frequency response is estimated by a Kalman filter. In addition, the instantaneous cross-spectrum and cross-bispectrum (as well as their ratio) can also be estimated. All statistical indices provide a valuable quantitative assessment of the interaction between heartbeat dynamics and hemodynamics during general anesthesia.
Chen
Z
Z
Neuroscience Statistics Research Lab, Massachusetts General Hospital, Harvard Medical School / Harvard-MIT Division of Health Science and Technology, Boston, MA, USA.
Purdon
Pl
P
Pierce
Et
E
Harrell
G
G
Brown
En
E
Barbieri
R
R
Annu Int Conf IEEE Eng Med Biol Soc. 2008;2008:2781-4
19163282
Anesthesiology. 2001 Jul;95(1):51-5
11465583
Cardiovasc Eng. 2008 Mar;8(1):5-13
18080759
IEEE Trans Biomed Eng. 2006 Jan;53(1):4-12
16402597
Ann N Y Acad Sci. 2009 Mar;1157:61-70
19351356
Proc IEEE Int Conf Acoust Speech Signal Process. 2008 Mar 31;:481-484
19593392
Br J Anaesth. 1986 Apr;58(4):415-21
3954922
IEEE Eng Med Biol Mag. 2001 Mar-Apr;20(2):33-42
11321718
J Clin Anesth. 2007 Feb;19(1):30-6
17321924
Am J Physiol Heart Circ Physiol. 2005 Jan;288(1):H424-35
15374824
Physiol Meas. 1995 May;16(2):131-9
7663368
Anesthesiology. 1988 Sep;69(3):348-56
3261954