Correction for respiration artifact in pulmonary blood pressure signals of ventilated patients

Abstract

Objective. To develop an algorithm that corrects pulmonary artery pressure signals of ventilated patients for the respiration artifact. The algorithm should test the validity of the pulmonary pressure signal and differentiate between the cyclic respiration artifact and true measurement artifacts.Methods. The shape of each pulmonary pressure beat is described by eight characteristic features, including mean pressure value and the systolic and diastolic timing and pressure values. The features are corrected for the respiration artifact by fitting them in a least-squares sense on the first and second harmonica of the ventilator frequency. The corrected features are used by a signal validation algorithm, which adds a validity flag to each pressure beat. The validation algorithm rejects pressure beats with sudden changes in their shape but adapts itself when the changes persist.Results. The performance of the correction and validation technique was evaluated using pulmonary artery pressure signals of 30 patients who were scheduled for open heart surgery. The algorithm correctly recognized as invalid data those pressure signals disturbed by coagulation, surgical manipulations, or flushes of the pressure line. The algorithm marked on average 77 ± 11 % of the pulmonary pressure beats as valid.Conclusions. The validation algorithm marked sufficient pressure beats as valid to update a trend display every 5 sec. The correction algorithm enabled the validation algorithm to differentiate between true measurement artifacts and the respiration artifact.