Browse > Article
http://dx.doi.org/10.9718/JBER.2015.36.5.183

Estimation of Blood Pressure Diagnostic Methods by using the Four Elements Blood Pressure Model Simulating Aortic Wave Reflection  

Choi, Seong Wook (Department of Mechanical and Biomedical Engineering, Kangwon National University)
Publication Information
Journal of Biomedical Engineering Research / v.36, no.5, 2015 , pp. 183-190 More about this Journal
Abstract
Invasive blood pressure (IBP) is measured for the patient's real time arterial pressure (ABP) to monitor the critical abrupt disorders of the cardiovascular system. It can be used for the estimation of cardiac output and the opening and closing time detection of the aortic valve. Although the unexplained inflections on ABP make it difficult to find the mathematical relations with other cardiovascular parameters, the estimations based on ABP for other data have been accepted as useful methods as they had been verified with the statistical results among vast patient data. Previous windkessel models were composed with systemic resistance and vascular compliance and they were successful at explaining the average systolic and diastolic values of ABP simply. Although it is well-known that the blood pressure reflection from peripheral arteries causes complex inflection on ABP, previous models do not contain any elements of the reflections because of the complexity of peripheral arteries' shapes. In this study, to simulate a reflection wave of blood pressure, a new mathematical model was designed with four elements that were the impedance of aorta, the compliance of aortic arch, the peripheral resistance, and the compliance of peripheral arteries. The parameters of the new model were adjusted to have three types of arterial blood pressure waveform that were measured from a patient. It was used to find the relations between the inflections and other cardiovascular parameters such as the opening-closing time of aortic valve and the cardiac output. It showed that the blood pressure reflection can bring wide range errors to the closing time of aortic valve and cardiac output with the conventional estimation based on ABP and that the changes of one-stroke volumes can be easily detected with previous estimation while the changes of heart rate can bring some error caused by unexpected reflections.
Keywords
four elements blood pressure model; aortic wave reflection; Invasive blood pressure (IBP); arterial pressure (ABP);
Citations & Related Records
연도 인용수 순위
  • Reference
1 Nichols WW, O'Rourke MF, "McDonald's Blood Flow In Arteries", 4th edn London Arnold, 1996.
2 O'Rourke MF, Gallagher DE, "Pulse wave analysis", J Hypertens, vol. 14, pp. 147-157, 1996.   DOI
3 Linton NWF, Linton RAF, "Estimation of changes in cardiac ouput from the arterial blood pressure waveform in the upper limb", Br J Anaesth, vol. 86, no. 4, pp. 486-496, 2001.   DOI
4 Papaioannou TG, Stefanadis C, "Basic Principles of the Intraaortic Balloon Pump and Mechanisms Affecting Its Performance", ASAIO J, vol. 51, pp. 296-300, 2005.   DOI
5 Goedije O, Hoeke K, Lichtwarch-Aschoff M, Faltchauser A, Lamm P, Reichart B, "Continuous cardiac output by femoral arterial thermodilution calibrated pulse contour analysis: comparison with pulmonary arterial thermodilution", Crit Care Med, vol. 27, pp. 2407-2412, 1999.   DOI
6 Rocca GD, Costa MG, Coccia C, Pompei L, Marco PD, Vilardi V, Pietropaloli P, "Cardiac output monitoring: aortic transpulmonary thermodilution and pulse contour analysis agree with standard thermodilution methiods in patients undergoing lung transplantation", Can J Anaesth, vol. 50, pp. 707-711, 2003.   DOI
7 Westerhof N, Lankhaar JW, Westerhof BE, "The arterial Windkessel", Med Biol Eng Comput, vol. 47, pp. 131-141, 2009.   DOI
8 Wesseling KH, Jansen JRC, Settels, JJ, Schreuder JJ, "Computation of aortic flow from pressure in humans using a nonlinear, three-element model", J Appl Physiol, vol. 74, pp. 2566-2573, 1993.   DOI
9 Stergiopulos N, Westerhof BE, Westerhof N, "Total arterial inertance as the fourth element of the windkessel model", Am J Physiol, vol. 276, pp. H81-H88, 1999.
10 Finkelstein SM, Cohn JN, "First- and third-order models for determining arterial compliance", J Hypertens, vol. 10, pp. S11-S14, 1992.   DOI
11 London GM, Guerin AP, "Influence of arterial pulse and refected waves on blood pressure and cardiac function", Am Heart J. vol. 138, pp. 220-224, 1999.   DOI
12 Figueroa CA, Vignon-Clementel IE, Jansen KE, Hughes TJR, Taylor CA, "A coupled momentum method for modeling blood flow in three-dimensional deformable arteries", Comput. Methods Appl. Mech. Engrg., vol. 195, pp. 5685- 706, 2006.   DOI