Clinical application of an integrated multiparameter system in perioperative body stress assessment

Objective

As an important reaction against nociceptive stimulus, perioperative stress response has important predictable effects during operation. A moderate stress reaction can protect patients from excessive injury and enable them to safely live through the operation. However, to evaluate perioperative stress levels properly and maintain the reaction in a suitable range to decrease postoperative complications remains a problem. In the present study, we applied a novel system that integrated life multiparameters into a composite index to evaluate patients' reactions to body stress, and the stability and accuracy of the system was further estimated by modifying the intensity of body stress with electroacupuncture.

Method

Volunteers were randomly selected. Multiparameters were recorded respectively. The physiological parameters, including heart rate (HR), variety of HR, pulse tracings (PT), variety of PT, blood pressure (BP), variety of BP, high frequency of electroencephalogram (HFECG), electric resistance of skin, bispectral index (BIS) and perfusion index (PI), were recorded continually. In addition, blood samples were collected at different time points (including preoperation, onset time of operation, and every 15 min postoperation) to acquire biochemical indicators, such as adnephrin, noradrenalin, 5-hydroxytryptamine (5-HT) and so on. The aforementioned parameters were analyzed with the algorithms of ambiguity mathematics according to the principle of evidence-based methods of cybernetics, combined with modern intelligence technology, integrating into a physiological and a biochemical stress index, respectively, which tended to reflect the intensity of the body reaction to nociceptive stimulus. Electroacupuncture was then applied to modify the intensity of body stress. Stress indexes were acquired accordingly.

Results

(1) Every parameter in this system contributed to certain weight in the stress index. Changes of stress indexes paralleled with a variety of perioperative stress intensities. A preliminary estimation of the stimulus level can thus be achieved from the stress indexes. (2) The multiparameter system was designed based on modern mathematical methods including fuzzy theory, grey system and neural networks, and bioinformation reflecting the intensity of stress reaction in these parameters was excavated with the algorithms of ambiguity mathematics. (3) Correlation between the physiological index and biochemical stress index was validated in the multiparameter system, with the conclusion that there was positive concordance between them. So the system using integrated physiological multi-indexes can replace the blood sample analysis to estimate body stress more promptly and, feasibly, with less injury. The multiparameter system provided a platform for evaluating stress reaction standardly and optimally. (4) In this study, the effects of electroacupuncture significantly modulated the body reaction to stress, and the effect can be estimated with a multiparameter system timely and accurately.

Conclusion

In this study, a life multiparameter system was explored with a combination of medicine, mathematics and bioengineering. The body reaction to stress was estimated by integrated multi-indexes, including physiological parameters and blood biochemistry parameters. The biochemical analysis can be replaced by an integrated physiological multiparameter system, as the latter can assess stress continuously and promptly. The system provided a platform and an objective reference standard to evaluate the stress reaction. In addition, the effects of electroacupuncture modulating stress were validated and estimated by the multi-parameter system.

Figure 1

(abstract 234)

Figure 2

(abstract 234)