Bilateral photoplethysmography for arterial steal detection in arteriovenous fistula using a fractional-order decision-making quantizer.

As inflow and outflow stenoses worsen, both flow resistance and pressure increase in the stenotic vascular access. During dialysis, when blood flow decreases, it may retrograde from the peripheral artery through the palmar arch to the arterial anastomosis site. Arterial steal syndrome (ASS) causes d...

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Publicado en:Medical & Biological Engineering & Computing Vol. 55; no. 2; pp. 257 - 271
Autores principales: Wu, Jian-Xing, Chen, Guan-Chun, Wu, Ming-Jui, Lin, Chia-Hung, Chen, Tainsong
Formato: Journal Article
Publicado: Springer Nature Feb2017
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2017
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      pub: Springer Nature
      place: New York, New York
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        atl: Bilateral photoplethysmography for arterial steal detection in arteriovenous fistula using a fractional-order decision-making quantizer.
      aug:
        au:
          Wu, Jian-Xing
          Chen, Guan-Chun
          Wu, Ming-Jui
          Lin, Chia-Hung
          Chen, Tainsong
        affil: National Synchrotron Radiation Research Center , Hsinchu Science Park , Hsinchu Taiwan
      sug:
        subj:
          Arteriovenous Fistula Physiopathology
          Signal Processing, Computer Assisted Equipment and Supplies
          Plethysmography Methods
          Decision Making, Computer Assisted
          Hemodialysis Adverse Effects
          Female
          Models, Theoretical
          Plethysmography Equipment and Supplies
          Male
          Vascular Diseases Etiology
          Aged
          Models, Biological
          Equipment Design
          Vascular Diseases Diagnosis
          Aged, 80 and Over
          Constriction, Pathologic Physiopathology
          Aged: 65+ years
          Aged, 80 & over
          Female
          Male
      ab: As inflow and outflow stenoses worsen, both flow resistance and pressure increase in the stenotic vascular access. During dialysis, when blood flow decreases, it may retrograde from the peripheral artery through the palmar arch to the arterial anastomosis site. Arterial steal syndrome (ASS) causes distal hypoperfusion, resulting in hand ischemia or extremity pain and edema. Hence, this study proposes the bilateral photoplethysmography (PPG) for ASS detection in arteriovenous fistulas. The decision-making quantizer utilizes the fractional-order feature extraction method and a non-cooperative game (NCG) framework to evaluate the ASS risk level. Bilateral asynchronous PPG signals have significant differences in the rise time and amplitude in relation to the degree of stenosis. The fractional-order self-synchronization error formulation is a feature extraction method used to quantify bilateral differences in blood flow changes between the dexter and sinister PPG signals. The NCG model as a method of decision-making is then employed to evaluate the ASS risk level. Using an acoustic Doppler measurement, the resistive (Res) index is also used to evaluate the vascular access stenosis at the arterial anastomosis site. In contrast with alternative methods including the high-sensitivity C-reactive protein level or Res index, our experimental results indicate that the proposed decision-making quantizer is more efficient in preventing ASS during hemodialysis treatment.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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