Quantifying agitation in sedated ICU patients using heart rate and blood pressure

Physiological Measurement
J Geoffrey ChaseGeoffrey M Shaw

Abstract

Agitation is a significant problem in the intensive care unit (ICU), affecting 71% of sedated adult patients during 58% of ICU patient-days (Fraser and Riker 2001 NY Health-Syst. Pharm. 20 17-24). Subjective scale-based assessment methods are currently used to assess the level of patient agitation, but are limited in their accuracy and resolution. This research develops an objective agitation measurement method using heart rate variability (HRV), systolic blood pressure (BP) and blood pressure variability (BPV) data, processed by wavelet transforms and autoregressive signal processing. A fuzzy inference system (FIS) is developed to classify changes in these signals that correlate with observed patient agitation, and combine them into a final agitation level. Proof of concept clinical trials on 13 normal subjects and 5 ICU patients has been performed to verify the validity of this approach in comparison with agitation graded by nursing staff using the Riker sedation-agitation scale (SAS). Results show good correlation with medical staff assessment with no false positive results during calm periods. Clinically, this initial agitation measurement method promises the ability to consistently and objectively quantify patient agitatio...Continue Reading

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Citations

May 5, 2005·Medical Engineering & Physics·A D RudgeD Lee
Jun 19, 2007·Computer Methods and Programs in Biomedicine·Pierrick BecouzeGeoffrey M Shaw
Aug 29, 2006·Computer Methods and Programs in Biomedicine·Andrew D RudgeChristopher E Hann
Sep 17, 2005·Minerva anestesiologica·E MondelloA U Sinardi
Mar 18, 2011·Revista latino-americana de enfermagem·Rodrigo Jensen, Maria Helena Baena de Moraes Lopes
Nov 18, 2005·Computers, Informatics, Nursing : CIN·Michael J Lewis
Jul 29, 2016·Medical Science Monitor : International Medical Journal of Experimental and Clinical Research·Dapeng HouWei Zheng
Jul 7, 2020·Cardiology in the Young·Addison GearhartAnthony C Chang

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