Prediction of Intradialytic Hypotension Using Photoplethysmography

Research output: Contribution to journalArticle

Abstract

Intradialytic hypotension is the most common acute complication during conventional hemodialysis treatment. Prediction of such events is highly desirable in clinical routine for prevention. This paper presents a novel prediction method of acute symptomatic hypotension in which the photoplethysmographic signal is analyzed with respect to changes in amplitude, reflecting vasoconstriction, and cardiac output. The method is based on a statistical model in which the noise is assumed to have Laplacian amplitude distribution. The performance is evaluated on 11 hypotension-prone patients who underwent hemodialysis treatment, resulting in seven events with acute symptomatic hypotension and 17 without. The photoplethysmographic signal was continuously acquired during treatment as was information on blood pressure and oxygen saturation. Using leave-one-out cross validation, the proposed method predicted six out of seven hypotensive events, while producing 1 false prediction out of 17 possible. The performance was achieved when the prediction threshold was chosen to be in the range 57%-65% of the photoplethysmographic envelope at treatment onset.

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Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Medical Engineering

Keywords

  • signal, pulse oximetry, Hemodialysis, intradialytic hypotension, vasoconstriction, processing
Original languageEnglish
Pages (from-to)1611-1619
JournalIEEE Transactions on Biomedical Engineering
Volume57
Issue number7
Publication statusPublished - 2010
Publication categoryResearch
Peer-reviewedYes