Key result
Beat-by-beat blood pressure sampling yielded significantly lower values for area under the curve outside systolic thresholds compared to 15-second sampling (median 625.99 vs 1082.25, P < 0.001).
Why the study?
Does beat-by-beat blood pressure sampling yield different time fraction and AUC beyond systolic BP thresholds compared to 15-second sampling in patients undergoing cardiac surgery?
Observational (n=193)
No
Does beat-by-beat blood pressure sampling yield different time fraction and AUC beyond systolic BP thresholds compared to 15-second sampling in patients undergoing cardiac surgery?
Absolute Event Rate: 625.99% vs 1082.25%
p-value: p=<0.001
Intra-operative blood pressure descriptors such as AUC and time fraction outside target ranges differ significantly when calculated using beat-by-beat versus 15-second sampling resolutions.
<ns4:p> <ns4:bold>Background:</ns4:bold> With evolving techniques for analysis of blood pressure (BP) variability, the importance of sampling resolution for intra-operative BP still remains to be examined. This study aims at comparing BP data with beat-by-beat vs. 15 second resolution. </ns4:p> <ns4:p> <ns4:bold>Methods:</ns4:bold> This is a retrospective analysis of intra-arterial BP data obtained from cardiac surgical patients from the intra-operative period. Data was collected from two sources for each patient, one with beat-by-beat frequency, other at a frequency of once every 15 seconds. The fraction of time and area under the curve beyond systolic BP thresholds of 95 – 135 mmHg were calculated using data from both sources, for each patient. These were compared using Wilcoxon ranked sum test for paired samples using R-statistics version 3.4.3. </ns4:p> <ns4:p> <ns4:bold>Results:</ns4:bold> There was a statistically significant difference (P < 0.001) between the parameters from the two sources. This was especially true for parameters below and outside the thresholds. Only time fraction showed significant difference above the 135 mmHg threshold. </ns4:p> <ns4:p> <ns4:bold>Conclusion:</ns4:bold> Our preliminary analysis shows a definitive difference between BP descriptors, depending on sampling resolution. But the impact of this difference on the outcome predicting models of the parameters stands to be ascertained. Future larger studies, powered to examine the impact of sampling resolution on outcome predictive ability of BP descriptors, with special emphasis on dynamic markers of complexity are warranted. </ns4:p>
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Packiasabapathy et al. (2018) conducted an observational in Cardiac surgery (n=193). Beat-by-beat blood pressure sampling vs. 15-second resolution blood pressure sampling was evaluated on Area under the curve (AUC) of systolic blood pressure outside the 95-135 mmHg range (p=<0.001). Beat-by-beat blood pressure sampling yielded significantly lower values for area under the curve outside systolic thresholds compared to 15-second sampling (median 625.99 vs 1082.25, P < 0.001).
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