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Unexpected sawtooth artifact in beat-to-beat pulse transit time measured from patient monitor data.

Publication ,  Journal Article
Lin, Y-T; Lo, Y-L; Lin, C-Y; Frasch, MG; Wu, H-T
Published in: PloS one
January 2019

It is increasingly popular to collect as much data as possible in the hospital setting from clinical monitors for research purposes. However, in this setup the data calibration issue is often not discussed and, rather, implicitly assumed, while the clinical monitors might not be designed for the data analysis purpose. We hypothesize that this calibration issue for a secondary analysis may become an important source of artifacts in patient monitor data. We test an off-the-shelf integrated photoplethysmography (PPG) and electrocardiogram (ECG) monitoring device for its ability to yield a reliable pulse transit time (PTT) signal.This is a retrospective clinical study using two databases: one containing 35 subjects who underwent laparoscopic cholecystectomy, another containing 22 subjects who underwent spontaneous breathing test in the intensive care unit. All data sets include recordings of PPG and ECG using a commonly deployed patient monitor. We calculated the PTT signal offline.We report a novel constant oscillatory pattern in the PTT signal and identify this pattern as a sawtooth artifact. We apply an approach based on the de-shape method to visualize, quantify and validate this sawtooth artifact.The PPG and ECG signals not designed for the PTT evaluation may contain unwanted artifacts. The PTT signal should be calibrated before analysis to avoid erroneous interpretation of its physiological meaning.

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Published In

PloS one

DOI

EISSN

1932-6203

ISSN

1932-6203

Publication Date

January 2019

Volume

14

Issue

9

Start / End Page

e0221319

Related Subject Headings

  • Retrospective Studies
  • Pulse Wave Analysis
  • Photoplethysmography
  • Monitoring, Physiologic
  • Humans
  • General Science & Technology
  • Electrocardiography
  • Artifacts
 

Citation

APA
Chicago
ICMJE
MLA
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Lin, Y.-T., Lo, Y.-L., Lin, C.-Y., Frasch, M. G., & Wu, H.-T. (2019). Unexpected sawtooth artifact in beat-to-beat pulse transit time measured from patient monitor data. PloS One, 14(9), e0221319. https://doi.org/10.1371/journal.pone.0221319
Lin, Yu-Ting, Yu-Lun Lo, Chen-Yun Lin, Martin G. Frasch, and Hau-Tieng Wu. “Unexpected sawtooth artifact in beat-to-beat pulse transit time measured from patient monitor data.PloS One 14, no. 9 (January 2019): e0221319. https://doi.org/10.1371/journal.pone.0221319.
Lin Y-T, Lo Y-L, Lin C-Y, Frasch MG, Wu H-T. Unexpected sawtooth artifact in beat-to-beat pulse transit time measured from patient monitor data. PloS one. 2019 Jan;14(9):e0221319.
Lin, Yu-Ting, et al. “Unexpected sawtooth artifact in beat-to-beat pulse transit time measured from patient monitor data.PloS One, vol. 14, no. 9, Jan. 2019, p. e0221319. Epmc, doi:10.1371/journal.pone.0221319.
Lin Y-T, Lo Y-L, Lin C-Y, Frasch MG, Wu H-T. Unexpected sawtooth artifact in beat-to-beat pulse transit time measured from patient monitor data. PloS one. 2019 Jan;14(9):e0221319.

Published In

PloS one

DOI

EISSN

1932-6203

ISSN

1932-6203

Publication Date

January 2019

Volume

14

Issue

9

Start / End Page

e0221319

Related Subject Headings

  • Retrospective Studies
  • Pulse Wave Analysis
  • Photoplethysmography
  • Monitoring, Physiologic
  • Humans
  • General Science & Technology
  • Electrocardiography
  • Artifacts