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Assessment of Baroreflex Control of Heart Rate During General Anesthesia Using a Point Process Method.

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1
Neuroscience Statistics Research Lab, Massachusetts General Hospital, Harvard Medical School / Harvard-MIT Division of Health Science and Technology, Boston, MA, USA.

Abstract

Evaluation of baroreflex control of heart rate (HR) has important implications in clinical practice of anesthesia and postoperative care. In this paper, we present a point process method to assess the dynamic baroreflex gain using a closed-loop model of the cardiovascular system. Specifically, the inverse Gaussian probability distribution is used to model the heartbeat interval, whereas the instantaneous mean is identified by a linear or bilinear bivariate regression on the previous R-R intervals and blood pressure (BP) measures. The instantaneous baroreflex gain is estimated in the feedback loop with a point process filter, while the RR→BP feedforward frequency response is estimated by a Kalman filter. In addition, the instantaneous cross-spectrum and cross-bispectrum (as well as their ratio) can also be estimated. All statistical indices provide a valuable quantitative assessment of the interaction between heartbeat dynamics and hemodynamics during general anesthesia.

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