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Schmidt M, Baumert M, Malberg H, Zaunseder S. Iterative two-dimensional signal warping—Towards a generalized approach for adaption of one-dimensional signals. Biomed Signal Process Control 2018. [DOI: 10.1016/j.bspc.2018.03.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Trumpp A, Lohr J, Wedekind D, Schmidt M, Burghardt M, Heller AR, Malberg H, Zaunseder S. Camera-based photoplethysmography in an intraoperative setting. Biomed Eng Online 2018. [PMID: 29540189 PMCID: PMC5853087 DOI: 10.1186/s12938-018-0467-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background Camera-based photoplethysmography (cbPPG) is a measurement technique which enables remote vital sign monitoring by using cameras. To obtain valid plethysmograms, proper regions of interest (ROIs) have to be selected in the video data. Most automated selection methods rely on specific spatial or temporal features limiting a broader application. In this work, we present a new method which overcomes those drawbacks and, therefore, allows cbPPG to be applied in an intraoperative environment. Methods We recorded 41 patients during surgery using an RGB and a near-infrared (NIR) camera. A Bayesian skin classifier was employed to detect suitable regions, and a level set segmentation approach to define and track ROIs based on spatial homogeneity. Results The results show stable and homogeneously illuminated ROIs. We further evaluated their quality with regards to extracted cbPPG signals. The green channel provided the best results where heart rates could be correctly estimated in 95.6% of cases. The NIR channel yielded the highest contribution in compensating false estimations. Conclusions The proposed method proved that cbPPG is applicable in intraoperative environments. It can be easily transferred to other settings regardless of which body site is considered. Electronic supplementary material The online version of this article (10.1186/s12938-018-0467-7) contains supplementary material, which is available to authorized users.
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Schubert M, Schmidt M, Wolter P, Malberg H, Zaunseder S, Bock K. Additively Manufactured Pneumatically Driven Skin Electrodes. MATERIALS (BASEL, SWITZERLAND) 2017; 11:E19. [PMID: 29295508 PMCID: PMC5793517 DOI: 10.3390/ma11010019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 12/04/2017] [Accepted: 12/15/2017] [Indexed: 11/16/2022]
Abstract
Telemedicine focuses on improving the quality of health care, particularly in out-of-hospital settings. One of the most important applications is the continuous remote monitoring of vital parameters. Long-term monitoring of biopotentials requires skin-electrodes. State-of-the-art electrodes such as Ag/AgCl wet electrodes lead, especially during long-term application, to complications, e.g., skin irritations. This paper presents a low-cost, on-demand electrode approach for future long-term applications. The fully printed module comprises a polymeric substrate with electrodes on a flexible membrane, which establishes skin contact only for short time in case of measurement. The membranes that produce airtight seals for pressure chambers can be pneumatically dilated and pressed onto the skin to ensure good contact, and subsequently retracted. The dilatation depends on the pressure and membrane thickness, which has been tested up to 150 kPa. The electrodes were fabricated in screen and inkjet printing technology, and compared during exemplary electrodermal activity measurement (EDA). The results show less amplitude compared to conventional EDA electrodes but similar behavior. Because of the manufacturing process the module enables high individuality for future applications.
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Trumpp A, Rasche S, Wedekind D, Rudolf M, Malberg H, Matschke K, Zaunseder S. Relation between pulse pressure and the pulsation strength in camera-based photoplethysmograms. CURRENT DIRECTIONS IN BIOMEDICAL ENGINEERING 2017. [DOI: 10.1515/cdbme-2017-0184] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AbstractCamera-based photoplethysmography (cbPPG) is an innovative measuring technique that enables the remote extraction of vital signs using video cameras. Most studies in the field focus on heart rate detection while other physiological quantities are often ignored. In this work, we analyzed the relation between the pulse pressure and the pulsation strengths of cbPPG signals for 70 patients after surgery. Our results show a high correlation between the two measures (r = 0.54). Furthermore, the influence of technical and medical factors was tested. The controlled impact of these factors proved to enhance the correlation by between 9 and 27 %.
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Trumpp A, Bauer PL, Rasche S, Malberg H, Zaunseder S. The value of polarization in camera-based photoplethysmography. BIOMEDICAL OPTICS EXPRESS 2017; 8:2822-2834. [PMID: 28663909 PMCID: PMC5480432 DOI: 10.1364/boe.8.002822] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 03/30/2017] [Accepted: 04/02/2017] [Indexed: 05/22/2023]
Abstract
Camera-based photoplethysmography (cbPPG) is a novel measuring technique that permits the remote acquisition of cardiovascular signals using video cameras. Research still lacks in fundamental studies to reach a deeper technical and physiological understanding. This work analyzes the employment of polarization filtration to (i) assess the gain for the signal quality and (ii) draw conclusions about the cbPPG signal's origin. We evaluated various forehead regions of 18 recordings with different color and filter settings. Our results prove that for an optimal illumination, the perpendicular filter setting provides a significant benefit. The outcome supports the theory that signals arise from blood volume changes. For lateral illumination, ballistocardiographic effects dominate the signal as polarization's impact vanishes.
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Hoyer D, Żebrowski J, Cysarz D, Gonçalves H, Pytlik A, Amorim-Costa C, Bernardes J, Ayres-de-Campos D, Witte OW, Schleußner E, Stroux L, Redman C, Georgieva A, Payne S, Clifford G, Signorini MG, Magenes G, Andreotti F, Malberg H, Zaunseder S, Lakhno I, Schneider U. Monitoring fetal maturation-objectives, techniques and indices of autonomic function. Physiol Meas 2017; 38:R61-R88. [PMID: 28186000 PMCID: PMC5628752 DOI: 10.1088/1361-6579/aa5fca] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Monitoring the fetal behavior does not only have implications for acute care but also for identifying developmental disturbances that burden the entire later life. The concept, of 'fetal programming', also known as 'developmental origins of adult disease hypothesis', e.g. applies for cardiovascular, metabolic, hyperkinetic, cognitive disorders. Since the autonomic nervous system is involved in all of those systems, cardiac autonomic control may provide relevant functional diagnostic and prognostic information. The fetal heart rate patterns (HRP) are one of the few functional signals in the prenatal period that relate to autonomic control and, therefore, is predestinated for its evaluation. The development of sensitive markers of fetal maturation and its disturbances requires the consideration of physiological fundamentals, recording technology and HRP parameters of autonomic control. Based on the ESGCO2016 special session on monitoring the fetal maturation we herein report the most recent results on: (i) functional fetal autonomic brain age score (fABAS), Recurrence Quantitative Analysis and Binary Symbolic Dynamics of complex HRP resolve specific maturation periods, (ii) magnetocardiography (MCG) based fABAS was validated for cardiotocography (CTG), (iii) 30 min recordings are sufficient for obtaining episodes of high variability, important for intrauterine growth restriction (IUGR) detection in handheld Doppler, (iv) novel parameters from PRSA to identify Intra IUGR fetuses, (v) evaluation of fetal electrocardiographic (ECG) recordings, (vi) correlation between maternal and fetal HRV is disturbed in pre-eclampsia. The reported novel developments significantly extend the possibilities for the established CTG methodology. Novel HRP indices improve the accuracy of assessment due to their more appropriate consideration of complex autonomic processes across the recording technologies (CTG, handheld Doppler, MCG, ECG). The ultimate objective is their dissemination into routine practice and studies of fetal developmental disturbances with implications for programming of adult diseases.
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Gräßer F, Beckert S, Küster D, Schmitt J, Abraham S, Malberg H, Zaunseder S. Therapy Decision Support Based on Recommender System Methods. JOURNAL OF HEALTHCARE ENGINEERING 2017; 2017:8659460. [PMID: 29065657 PMCID: PMC5387813 DOI: 10.1155/2017/8659460] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 01/23/2017] [Indexed: 11/21/2022]
Abstract
We present a system for data-driven therapy decision support based on techniques from the field of recommender systems. Two methods for therapy recommendation, namely, Collaborative Recommender and Demographic-based Recommender, are proposed. Both algorithms aim to predict the individual response to different therapy options using diverse patient data and recommend the therapy which is assumed to provide the best outcome for a specific patient and time, that is, consultation. The proposed methods are evaluated using a clinical database incorporating patients suffering from the autoimmune skin disease psoriasis. The Collaborative Recommender proves to generate both better outcome predictions and recommendation quality. However, due to sparsity in the data, this approach cannot provide recommendations for the entire database. In contrast, the Demographic-based Recommender performs worse on average but covers more consultations. Consequently, both methods profit from a combination into an overall recommender system.
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Andreotti F, Graser F, Malberg H, Zaunseder S. Non-invasive Fetal ECG Signal Quality Assessment for Multichannel Heart Rate Estimation. IEEE Trans Biomed Eng 2017; 64:2793-2802. [PMID: 28362581 DOI: 10.1109/tbme.2017.2675543] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The noninvasive fetal ECG (NI-FECG) from abdominal recordings offers novel prospects for prenatal monitoring. However, NI-FECG signals are corrupted by various nonstationary noise sources, making the processing of abdominal recordings a challenging task. In this paper, we present an online approach that dynamically assess the quality of NI-FECG to improve fetal heart rate (FHR) estimation. METHODS Using a naive Bayes classifier, state-of-the-art and novel signal quality indices (SQIs), and an existing adaptive Kalman filter, FHR estimation was improved. For the purpose of training and validating the proposed methods, a large annotated private clinical dataset was used. RESULTS The suggested classification scheme demonstrated an accuracy of Krippendorff's alpha in determining the overall quality of NI-FECG signals. The proposed Kalman filter outperformed alternative methods for FHR estimation achieving accuracy. CONCLUSION The proposed algorithm was able to reliably reflect changes of signal quality and can be used in improving FHR estimation. SIGNIFICANCE NI-ECG signal quality estimation and multichannel information fusion are largely unexplored topics. Based on previous works, multichannel FHR estimation is a field that could strongly benefit from such methods. The developed SQI algorithms as well as resulting classifier were made available under a GNU GPL open-source license and contributed to the FECGSYN toolbox.
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Wedekind D, Trumpp A, Gaetjen F, Rasche S, Matschke K, Malberg H, Zaunseder S. Assessment of blind source separation techniques for video-based cardiac pulse extraction. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:35002. [PMID: 28257535 DOI: 10.1117/1.jbo.22.3.035002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 02/10/2017] [Indexed: 06/06/2023]
Abstract
Blind source separation (BSS) aims at separating useful signal content from distortions. In the contactless acquisition of vital signs by means of the camera-based photoplethysmogram (cbPPG), BSS has evolved the most widely used approach to extract the cardiac pulse. Despite its frequent application, there is no consensus about the optimal usage of BSS and its general benefit. This contribution investigates the performance of BSS to enhance the cardiac pulse from cbPPGs in dependency to varying input data characteristics. The BSS input conditions are controlled by an automated spatial preselection routine of regions of interest. Input data of different characteristics (wavelength, dominant frequency, and signal quality) from 18 postoperative cardiovascular patients are processed with standard BSS techniques, namely principal component analysis (PCA) and independent component analysis (ICA). The effect of BSS is assessed by the spectral signal-to-noise ratio (SNR) of the cardiac pulse. The preselection of cbPPGs, appears beneficial providing higher SNR compared to standard cbPPGs. Both, PCA and ICA yielded better outcomes by using monochrome inputs (green wavelength) instead of inputs of different wavelengths. PCA outperforms ICA for more homogeneous input signals. Moreover, for high input SNR, the application of ICA using standard contrast is likely to decrease the SNR.
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Rasche S, Trumpp A, Waldow T, Gaetjen F, Plötze K, Wedekind D, Schmidt M, Malberg H, Matschke K, Zaunseder S. Camera-based photoplethysmography in critical care patients. Clin Hemorheol Microcirc 2017; 64:77-90. [PMID: 26890242 DOI: 10.3233/ch-162048] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Camera-based photoplethysmography (cbPPG) is an optical measurement technique that reveals pulsatile blood flow in cutaneous microcirculation from a distance. cbPPG has been shown to reflect pivotal haemodynamic events like cardiac ejection in healthy subjects. In addition, it provides valuable insight into intrinsic microcirculatory regulation as it yields dynamic, two-dimensional perfusion maps. In this study, we evaluate the feasibility of a clinical cbPPG application in critical care patients. METHODS A mobile camera set-up to record faces of patients at the bed site was constructed. Videos were made during the immediate recovery after cardiac surgery under standard critical care conditions and were processed offline. Major motion artefacts were detected using an optical flow technique and suitable facial regions were manually annotated. cbPPG signals were highpass filtered and Fourier spectra out of consecutive 10s signal segments calculated for heart rate detection. Signal-to-noise ratios (SNR) of the Fourier spectra were derived as a quality measure. Reference data of vital parameters were synchronously acquired from the bed site monitoring system. RESULTS Seventy patient videos of an average time of 28.6±2.8 min were analysed. Heart rate (HR) was detected within a±5 bpm range compared to reference in 83% of total recording time. Low SNR and HR detection failure were mostly, but not exclusively, attributed to non-physiological events like patient motion, interventions or sudden changes of illumination. SNR was reduced by low arterial blood pressure, whereas no impact of other perioperative or disease-related parameters was identified. CONCLUSION Cardiac ejection is detectable by cbPPG under pathophysiologic conditions of cardiovascular disease and perioperative medicine. cbPPG measurements can be seamlessly integrated into the clinical work flow of critical care patients.
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Holmer A, Tetschke F, Marotz J, Malberg H, Markgraf W, Thiele C, Kulcke A. Oxygenation and perfusion monitoring with a hyperspectral camera system for chemical based tissue analysis of skin and organs. Physiol Meas 2016; 37:2064-2078. [DOI: 10.1088/0967-3334/37/11/2064] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Schmidt M, Baumert M, Malberg H, Zaunseder S. T Wave Amplitude Correction of QT Interval Variability for Improved Repolarization Lability Measurement. Front Physiol 2016; 7:216. [PMID: 27375494 PMCID: PMC4895120 DOI: 10.3389/fphys.2016.00216] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 05/23/2016] [Indexed: 11/13/2022] Open
Abstract
Objectives: The inverse relationship between QT interval variability (QTV) and T wave amplitude potentially confounds QT variability assessment. We quantified the influence of the T wave amplitude on QTV in a comprehensive dataset and devised a correction formula. Methods: Three ECG datasets of healthy subjects were analyzed to model the relationship between T wave amplitude and QTV. To derive a generally valid correction formula, linear regression analysis was used. The proposed correction formula was applied to patients enrolled in the Evaluation of Defibrillator in Non-Ischemic Cardiomyopathy Treatment Evaluation trial (DEFINITE) to assess the prognostic significance of QTV for all-cause mortality in patients with non-ischemic dilated cardiomyopathy. Results: A strong inverse relationship between T wave amplitude and QTV was demonstrated, both in healthy subjects (R2 = 0.68, p < 0.001) and DEFINITE patients (R2 = 0.20, p < 0.001). Applying the T wave amplitude correction to QTV achieved 2.5-times better group discrimination between patients enrolled in the DEFINITE study and healthy subjects. Kaplan-Meier estimator analysis showed that T wave amplitude corrected QTVi is inversely related to survival (p < 0.01) and a significant predictor of all-cause mortality. Conclusion: We have proposed a simple correction formula for improved QTV assessment. Using this correction, predictive value of QTV for all-cause mortality in patients with non-ischemic cardiomyopathy has been demonstrated.
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Śliwiński G, Zeckay R, Malberg H, Diers H, Śliwiński Z, Werner M, Rietze J. Universal brace simulation platform. SCOLIOSIS 2014. [PMCID: PMC4290478 DOI: 10.1186/1748-7161-9-s1-o55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Andreotti F, Riedl M, Himmelsbach T, Wedekind D, Wessel N, Stepan H, Schmieder C, Jank A, Malberg H, Zaunseder S. Robust fetal ECG extraction and detection from abdominal leads. Physiol Meas 2014; 35:1551-67. [DOI: 10.1088/0967-3334/35/8/1551] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Muehlhan M, Marxen M, Landsiedel J, Malberg H, Zaunseder S. The effect of body posture on cognitive performance: a question of sleep quality. Front Hum Neurosci 2014; 8:171. [PMID: 24723874 PMCID: PMC3973903 DOI: 10.3389/fnhum.2014.00171] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 03/08/2014] [Indexed: 11/25/2022] Open
Abstract
Nearly all functional magnetic resonance imaging (fMRI) studies are conducted in the supine body posture, which has been discussed as a potential confounder of such examinations. The literature suggests that cognitive functions, such as problem solving or perception, differ between supine and upright postures. However, the effect of posture on many cognitive functions is still unknown. Therefore, the aim of the present study was to investigate the effects of body posture (supine vs. sitting) on one of the most frequently used paradigms in the cognitive sciences: the N-back working memory paradigm. Twenty-two subjects were investigated in a randomized within-subject design. Subjects performed the N-back task on two consecutive days in either the supine or the upright posture. Subjective sleep quality and chronic stress were recorded as covariates. Furthermore, changes in mood dimensions and heart rate variability (HRV) were assessed during the experiment. Results indicate that the quality of sleep strongly affects reaction times when subjects performed a working memory task in a supine posture. These effects, however, could not be observed in the sitting position. The findings can be explained by HRV parameters that indicated differences in autonomic regulation in the upright vs. the supine posture. The finding is of particular relevance for fMRI group comparisons when group differences in sleep quality cannot be ruled out.
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Morgenstern U, Sobottka SB, Meyer T, Kirsch M, Malberg H, Schackert G. Intraoperative optical imaging in neurosurgery. ACTA ACUST UNITED AC 2014; 58:213-5. [PMID: 23740652 DOI: 10.1515/bmt-2013-0201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Zeckay R, Sliwinski G, Thiele C, Kufel W, Halat B, Michalak B, Kaczmar G, Sliwinski Z, Malberg H. Identification of relevant clinical symptoms for the development of a machine-aided screening method of postural deformities. BIOMED ENG-BIOMED TE 2013; 58 Suppl 1:/j/bmte.2013.58.issue-s1-P/bmt-2013-4389/bmt-2013-4389.xml. [DOI: 10.1515/bmt-2013-4389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Henning A, Hahnel R, Hetzel T, Zaunseder S, Malberg H. Microwave Doppler Radar for Cardiac and Respiratory Activity Measurement – Preliminary Results. BIOMED ENG-BIOMED TE 2013; 58 Suppl 1:/j/bmte.2013.58.issue-s1-E/bmt-2013-4132/bmt-2013-4132.xml. [DOI: 10.1515/bmt-2013-4132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Penzel T, Riedl M, Gapelyuk A, Suhrbier A, Bretthauer G, Malberg H, Schöbel C, Fietze I, Heitmann J, Kurths J, Wessel N. Effect of CPAP therapy on daytime cardiovascular regulations in patients with obstructive sleep apnea. Comput Biol Med 2012; 42:328-34. [DOI: 10.1016/j.compbiomed.2011.09.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Revised: 08/10/2011] [Accepted: 09/07/2011] [Indexed: 01/01/2023]
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Wessel N, Kurths J, Malberg H, Penzel T. Biosignal 2010: Advanced technologies in intensive care and sleep medicine. Physiol Meas 2012; 32:2 p preceding 1715. [PMID: 22141150 DOI: 10.1088/0967-3334/32/11/e01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Malberg H, Ziaziulchyk L, Braer M, Hoffmann M, Mittag A, Huhle R, Zaunseder S, Bonnemeier H, Heinig A, Fischer WJ. Anti Stress App. BIOMED ENG-BIOMED TE 2012. [DOI: 10.1515/bmt-2012-4470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Huhle R, Burghardt M, Zaunseder S, Wessel N, Koch T, Malberg H, Heller AR. Effects of awareness and nociception on heart rate variability during general anaesthesia. Physiol Meas 2012; 33:207-17. [PMID: 22260880 DOI: 10.1088/0967-3334/33/2/207] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
During anaesthesia awareness and nociception are serious complications that may further lead to haemodynamic instability. Specific monitoring of depth of hypnosis and depth of analgesia based on heart rate variability (HRV) analysis is eligible to improve patient safety and reduce efforts in post-operative care. Consequently, in this analysis we assess the applicability of HRV parameters during surgical interventions with standardized intravenous propofol-remifentanil-anaesthesia. Peri-operative electrocardiograms were recorded from cardiovascular stable patients (ASA Score I/II, N = 32, age: 36.4 ± 11.23 a, BMI: 25.2 ± 3.16) scheduled for trauma and dentofacial surgery. HRV time- and frequency-domain parameters, measures of complexity and nonlinear dynamics were compared by analysing longitudinally distributed 300 s intervals preceding/following induction of anaesthesia (BL-I1), intubation (I1-I2) and extubation (E1-E2). Mean value (meanNN) and standard deviation (sdNN) of the heart rate are influenced in BL-I1 (p < 0.001), I1-I2 (p < 0.05) and E1-E2 (p < 0.001). The number of forbidden words of symbolic dynamics changes significantly for BL-I1 (p < 0.001) and not for I1-I2 and E1-E2 (p > 0.05). Probability of low-variability POLVAR10 is significantly altered in all comparisons (BL-I1: Δ = 0.032, p < 0.01, I1-I2: Δ = 0.12, p < 0.05, E1-E2: Δ = 0.169, p < 0.01) but especially during nociception. While standard time-domain parameters lacked selectivity, parameters of symbolic dynamics appear to be specifically influenced by changes in depth of hypnosis and nociception, respectively. However, the lack of steady-state ventilation/breathing in this study needs to be considered in future research. To be used for clinical anaesthesia monitoring our results have to be prospectively validated in clinical studies.
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Zaunseder S, Wirthgen T, Lempe G, Malberg H, Zipser S. Multivariate biosignal acquisition to assess the potential of remote photoplethysmography. BIOMED ENG-BIOMED TE 2012; 57 Suppl 1:/j/bmte.2012.57.issue-s1-O/bmt-2012-4114/bmt-2012-4114.xml. [DOI: 10.1515/bmt-2012-4114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Koch S, Arnold S, Zeckay R, Sliwinski G, Thiele C, Kufel W, Sliwinski Z, Malberg H. Analysis of the distribution of pressure patterns in children with postural deformities. BIOMED ENG-BIOMED TE 2012. [DOI: 10.1515/bmt-2012-4462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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