A.V. Chashchin

First Saint-Petersburg State Medical University named after Acad. I.P. Pavlova (Saint-Petersburg, Russia);
North-Western Saint-Petersburg State Medical University named after I.I. Mechnikov (Saint-Petersburg, Russia)

The important in the practical application of medical technology are analyzed: - the problem of uncontrolled influence on the body of occlusive procedures for measuring blood pressure; – questions on their potential danger, reliability and interpretation of the results. The use of occlusion on different segments of the extremities is based on the local effect of intervention into the blood circulation, in order to manifest plethysmographic, oscillometric or auscultatory signals associated with volumetric-dynamic changes in the blood filling of blood vessels. According to informative signs in the signals, blood pressure indices are indirectly determined. However, the occlusion action disturbs the condition of unimpeded blood flow and lymphatic drainage function in the extremity, affects blood circulation in it and in the region of central hemodynamics. In practice are noted the facts of a dangerous change in the state of the body, not provided for by the measurement method. They raise critical questions - about the results correctness, interpretation and valuation of the reliability of measurements. The mechanisms of response, adaptive vascular reaction, manifested in a complex of changes in fluid exchange in different parts of the vascular system basins, different in purpose and level of intravascular pressure are presented. A mathematical model of the superposition of the action of endogenous factors and external influences affecting lympho- and hemocirculation is described. The conclusion is substantiated that by disrupting blood circulation in the vascular system of the extremity, occlusion is potentially dangerous to health, and represents an unaccounted source of methodical error of measurements leading to unreliable results. Solutions are proposed: – together with the results of measurements in the reporting protocols to state the established changes in the body; – additionally measure and interpret the accompanying informative parameters characterizing the change in the state at occlusion; – for diseases in which occlusion poses a danger to the health and life of patients, use alternative non-occlusive measurement methods. The medical and technical requirements and prospects for the development of algorithms are discussed, including: control of changes during measurements; reducing the risk of negative effects on the body; improving the reliability of the results and the functionality of the method.

Purpose of the work is to analyze the factors that initiate the vascular reaction in response to the compression action and represent the source of the methodical error of measurements.

Results are present the mechanisms of the adaptive vascular reaction, manifested in a complex of changes in fluid exchanging in different parts of the circulatory system, different basins in purpose and level of intravascular pressure. A mathematical model of the superposition of the action of endogenous factors and external influences affecting hemolymph circulation is described. The conclusion is substantiated that by disrupting blood circulation in the vascular system of the extremity, occlusion is potentially dangerous to health, and represents an unaccounted source of methodical error of measurements leading to unreliable results. Solutions are proposed: – together with the results of measurements in the reporting protocols to state the changes manifested in the body; – additionally measure and interpret the accompanying informative indices characterizing the change in the state at occlusion; – for diseases in which occlusion poses a danger to the health and life of patients, use alternative non-occlusive measurement methods.

Chashchin A.V. Problematic questions about the effect on the state of the body and the results of measuring blood pressure of procedures with occlusive effects on the vascular system. Biomedicine Radioengineering. 2022. V. 25. № 2–3. Р. 31-45. DOI: https://doi.org/ 10.18127/j15604136-202202-04 (In Russian)

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2. Chashchin A.V. Analiz sosudistoy reaktsii v organizme v okklyuzionnykh protsedurakh izme-reniya arterialnogo davleniya. Sistemnyy analiz i upravleniye v biomeditsinskikh si-stemakh. 2020. T. 19. № 4. S. 108–113. (in Russian).
3. Chashchin A.V. Non-controlled factors of occlusive influence on the processes in the organism. accuracy and reliability of blood pressure measuring results. V sb.: Fundamentalnyye i pri-kladnyye nauki segodnya. Materialy XXV mezhdunar. nauchno-prakt. konf. Morrisville. NC. USA. 2021. S. 154–160.
4. Chashchin A.V. Sistema funktsionalnykh modeley biotekhnicheskoy sistemy krovoobrashche-niya s neinvazivnym vmeshatelstvom i upravleniyem gemodinamicheskimi protsessami: Uchebnoye posobiye. S-Peterburg: «Tekhnolit». 2013. 87 s. (in Russian).
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18. Chashchin A.V. Biotekhnicheskaya sistema dlya funktsionalnykh gemodinamicheskikh prob s kompressionnym deystviyem na sistemu sosudov. Izvestiya YuFU. Ser. Tekhnicheskiye nauki. 2012. № 9 (134). S. 178–184. (in Russian).
19. Patent № 2691932 RU. Sposob prognozirovaniya stepeni tyazhesti ishemicheskogo protsessa serdtsa. golovnogo mozga i nizhnikh konechnostey na osnovanii otsenki tsentralnoy i regionarnoy gemodinamiki organov. A.V. Bykov. N.A. Korenevskiy (in Russian).
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21. Chashchin A.V., Erofeyev N.P., Mokhov D.E., Chyrva N.I. Issledovaniye obyemnometricheskikh izmeneniy sistem krovo- i limfoobrashcheniya verkhney konechnosti pri kompressionnykh vozdeystviyakh. VII Mezhdunarodnyy kongress «Traditsionnaya meditsina» Sb. nauchnykh trudov g. Moskva. 23-25 oktyabrya 2009 g. Prilozheniye k spetsialnomu vypusku zhurnala «Traditsionnaya meditsina». 2009. № 3(18). S. 250–253. (in Russian).
22. Chashchin A.V., Erofeyev N.P., Mokhov D.E., Chyrva N.I. Metod kompressionno-obyemnometricheskogo preobrazovaniya i lazernoy doppler-floumetrii v sravnitelnykh issledovaniyakh obyemnoy dinamiki napolneniya tkaney organizma. VII Mezhdunarodnyy kongress «Traditsionnaya meditsina» Sb. nauchnykh trudov g. Moskva. 23-25 oktyabrya 2009 g. Prilozheniye k spetsialnomu vypusku zhurnala «Traditsionnaya meditsina». 2009. № 3(18). S. 253–257. (in Russian).
23. Chashchin A.V., Popechitelev E.P. Analiz vliyaniya endogennykh faktorov na krovelimfonapolneniye v sosudistoy sisteme organizma. Sistemnyy analiz i upravleniye v biomeditsinskikh sistemakh. 2012. № 1. S. 26–34. (in Russian).
24. Chashchin A.V. Spektralnoye predstavleniye reaktsii organizma v funktsionalnykh probakh s okklyuzionnym vozdeystviyem na tkani. Izvestiya YuFU. Ser. Tekhnicheskiye nauki. 2008. № 5(82). S. 23–26. (in Russian).