Intraoperative haemodynamic monitoring: A pilot study on integrated data collection, processing and modelling for extracting vital signs and beyond

In this paper we illustrate an ongoing project focused on intraoperative monitoring of haemodynamic stability and cardiorespiratory interactions, and present an example analysis of vital signs recorded synchronously from multiple monitoring devices through a LabView©-based acquisition software termed “Global Collect”. We present two moving average models for the black box estimation of the gains of the cardiopulmonary baroreflex control of arterial resistance and of ventricular contractility, based on invasive, continuous measurements of arterial blood pressure and central venous pressure. As a proof-of-concept, we analyze the effects of a fluid-challenge maneuver performed during major surgery, quantifying the mechanisms through which such maneuvers are able to increase cardiac performance and hence enhance venous return. These preliminary results of a pilot case study demonstrate the potential of investigating autonomic nervous system control of circulation under general anesthesia in advancing intraoperative patient monitoring and aiding maintenance of haemodynamic stability in patients undergoing major surgery.