Validation of a New Method for Stroke Volume Variation Assessment: a Comparaison with the PiCCO Technique

TL;DR

This study introduces a minimally invasive method using arterial blood pressure signals to assess stroke volume variation, showing high correlation and agreement with the PiCCO technique in ICU patients.

Contribution

The paper presents a novel semi-classical signal analysis approach to estimate stroke volume variation, validated against the PiCCO method in a clinical setting.

Findings

Strong correlation (mean coefficient=0.9) between INVS1 and PiCCO stroke volume.

High agreement and interchangeability demonstrated by Bland-Altman analysis.

Discrepancies linked to physiological parameters like pressure and vascular resistance.

Abstract

This paper proposes a novel, simple and minimally invasive method for stroke volume variation assessment using arterial blood pressure measurements. The arterial blood pressure signal is reconstructed using a semi-classical signal analysis method allowing the computation of a parameter, called the first systolic invariant INVS1. We show that INVS1 is linearly related to stroke volume. To validate this approach, a statistical comparaison between INVS1 and stroke volume measured with the PiCCO technique was performed during a 15-mn recording in 21 mechanically ventilated patients in intensive care. In 94% of the whole recordings, a strong correlation was estimated by cross-correlation analysis (mean coefficient=0.9) and linear regression (mean coefficient=0.89). Once the linear relation had been verified, a Bland-Altman test showed the very good agreement between the two approaches and their interchangeability. For the remaining 6%, INVS1 and the PiCCO stroke volume were not correlated at all, and this discrepancy, interpreted with the help of mean pressure, heart rate and peripheral vascular resistances, was in favor of INVS1.