clinmon {clintools} | R Documentation |
Hemodynamic Indices Calculated From Clinical Monitoring (clinmon)
Description
clinmon()
uses a continuous recording and returns a dataframe with hemodynamic indices for every period, epoch or block depending on the input. Calculates COest
, CPPopt
, CVRi
, Dx
, Mx
, PI
, PRx
, PWA
, RI
, and Sx
(see Hemodynamic indices).
Usage
clinmon(df, variables,
trigger = NULL, deleter = NULL,
blocksize = 3, epochsize = 20,
overlapping = FALSE, freq = 1000,
blockmin = 0.5, epochmin = 0.5,
output = "period", fast = FALSE)
Arguments
df |
Raw continuous recording with all numeric data and first column has to be time in seconds. ( |
variables |
Defining the type and order of the recorded variables as a list. Middle cerebral artery blood velocity ( |
trigger |
Trigger with two columns: first is start, and second is end of periods to be analyzed. Every row corresponds to a period. Default is |
deleter |
Deleter with two columns: first is start and second is end of period with artefacts, which need to be deleted. Every row is a period with artefacts. Default is |
blocksize |
Length of a block, in seconds. Default is |
epochsize |
Size of epochs in number of blocks. Default is |
overlapping |
The number of block which should overlap when calculating correlation based indices, and remain blank if overlapping calculations should not be utilized. Default is |
freq |
Frequency of recorded data, in Hz. Default is |
blockmin |
Minimum measurements required to create a block in ratio. Default is |
epochmin |
Minimum number of blocks required to create an epoch in ratio. Default is |
output |
Select what each row should represent in the output. Correlation based indices are not presented when selecting blocks for every row. Currently |
fast |
Select if you want the data to aggregated before analysis resulting in a faster, but perhaps more imprecise run, in Hz. Default is |
Details
Using a continuous raw recording, clinmon()
calculates hemodynamic indices for every period, epoch or block depending on the chosen output.
View(data)
time | abp | mcav |
7.00 | 78 | 45 |
7.01 | 78 | 46 |
... | ... | ... |
301.82 | 82 | 70 |
301.83 | 81 | 69 |
To calculate the indices insert the data and select the relevant variables.
clinmon(df=data, variables=c("abp","mcav"))
See Value for output description.
Value
Returns a dataframe with the results, with either every blocks, epochs or periods as rows, depending on the chosen output.
The columns of the output are:
-
period
- The period number corresponding to the row-number in the trigger file. -
epoch
- The epoch number, or ifperiod
is chosen as output it reflects the number of epochs in the period. -
block
- The block number, or ifperiod
orepoch
is chosen as output it reflects the number of blocks in theperiod
orepoch
. -
time_min
- The minimum time value or theperiod
,epoch
orblock
. -
time_max
- The maximum time value or theperiod
,epoch
orblock
. -
missing_percent
- The percentage of missing data in theperiod
,epoch
orblock
. -
XX_mean
- The mean value of each variable for theperiod
,epoch
orblock
. -
XX_min
- The minimum value of each variable for theperiod
,epoch
orblock
. -
XX_max
- The maximum value of each variable for theperiod
,epoch
orblock
. -
YY
- The indices in each column.
Hemodynamic indices
COest
| Estimated cardiac output
Required variables: abp
, hr
; Required output: -
.
Estimated cardiac output (COest
) is calculated by utilizing the method described by Koenig et al. [1]:
COest = PP / (SBP+DBP) * HR
PP: Pulse pressure; SBP: systolic blood pressure; DBP: diastolic blood pressure; HR: heart rate.
CPPopt
| Optimal cerebral perfusion pressure
Required variables: abp
, icp
; Required output: period
.
Optimal cerebral perfusion pressure (CPPopt
) is calculated utilizing the method described by Steiner et al. [2]. The CPPopt return NA
if CPPopt is the maximum or minimum CPP investigated. CPPopt is recommended to only be calculated after 'several hours' of recording:
CPPopt = The 5 mmHg CPP Interval With Lowest Mean PRx
CPP: cerebral perfusion pressure; PRx: Pressure reactivity index.
CVRi
| Cardiovascular resistance index
Required variables: abp
, mcav
; Required output: -
.
Cardiovascular resistance index (CVRi
) is calculated utilizing the method described by Fan et al. [3]:
CVRi = mean ABP / mean MCAv
ABP: arterial blood pressure; MCAv: middle cerebral artery blood velocity.
Dx
| Diastolic flow index
Required variables: cpp
/abp
, mcav
; Required output: epoch
, period
.
Diastolic flow index (Dx
) is calculated utilizing the method described by Reinhard et al. [4]:
Dxc = cor( mean CPP / min MCAv )
Dxa = cor( mean ABP / min MCAv )
cor: correlation coefficient; CPP: cerebral perfusion pressure; ABP: arterial blood pressure; MCAv: middle cerebral artery blood velocity.
Mx
| Mean flow index
Required variables: cpp
/abp
, mcav
; Required output: epoch
, period
.
Mean flow index (Mx
) is calculated utilizing the method described by Czosnyka et al. [5]:
Mxc = cor( mean CPP / mean MCAv )
Mxa = cor( mean ABP / mean MCAv )
cor: correlation coefficient; CPP: cerebral perfusion pressure; ABP: arterial blood pressure; MCAv: middle cerebral artery blood velocity.
PI
| Gosling index of pulsatility
Required variables: mcav
; Required output: -
.
Gosling index of pulsatility (PI
) is calculated utilizing the method described by Michel et al. [6]:
PI = (systolic MCAv - diastolic MCAv) / mean MCAv
MCAv: middle cerebral artery blood velocity.
PRx
| Pressure reactivity index
Required variables: abp
, icp
; Required output: epoch
, period
.
Pressure reactivity index (PRx
) is calculated utilizing the method described by Czosnyka et al. [7]:
PRx = cor( mean ABP / mean ICP )
cor: correlation coefficient; CPP: cerebral perfusion pressure; ICP: intracranial pressure.
PWA
| Pulse wave amplitude
Required variables: cpp
/icp
/abp
/mcav
; Required output: -
.
Pulse wave amplitude (PWA
) is calculated utilizing the method described by Norager et al. [8]:
PWA = systolic - diastolic
RI
| Pourcelots resistive (resistance) index
Required variables: mcav
; Required output: -
.
Pourcelots resistive (resistance) index (RI
) is calculated utilizing the method described by Forster et al. [9]:
RI = (systolic MCAv - diastolic MCAv) / systolic MCAv
MCAv: middle cerebral artery blood velocity.
Sx
| Systolic flow index
Required variables: cpp
/abp
, mcav
; Required output: epoch
, period
.
Systolic flow index (Sx
) is calculated utilizing the method described by Czosnyka et al. [5]:
Sxc = cor( mean CPP / systolic MCAv )
Sxa = cor( mean ABP / systolic MCAv )
cor: correlation coefficient; CPP: cerebral perfusion pressure; ABP: arterial blood pressure; MCAv: middle cerebral artery blood velocity.
References
Koenig et al. (2015) Biomed Sci Instrum. 2015;51:85-90. (PubMed)
Steiner et al. (2002) Crit Care Med. 2002 Apr;30(4):733-8. (PubMed)
Fan et al. (2018) Front Physiol. 2018 Jul 16;9:869. (PubMed)
Reinhard et al. (2003) Stroke. 2003 Sep;34(9):2138-44. (PubMed)
Czosnyka et al. (1996) Stroke. 1996 Oct;27(10):1829-34. (PubMed)
Michel et al. (1998) Ultrasound Med Biol. 1998 May;24(4):597-9. (PubMed)
Czosnyka et al. (1997) Neurosurgery. 1997 Jul;41(1):11-7; discussion 17-9. (PubMed)
Norager et al. (2020) Acta Neurochir (Wien). 2020 Dec;162(12):2983-2989. (PubMed)
Forster et al. (2017) J Paediatr Child Health. 2018 Jan;54(1):61-68. (PubMed)
Examples
data(testdata)
clinmon(df.data10, variables=c('abp','mcav','hr'), freq=10)