Abstract

Accurate, non-invasive measurements of blood pressure and its continuous monitoring are extremely important for personal health care. Arterial tonometry, a method that is used to provide a detailed image of a patient’s cardiovascular health, shows promise for being a non-invasive alternative to current blood pressure measurement methods. However, its measurement accuracy is sensitive to patient variations such as the stiffness of the skin. Thus, this project intends to investigate the effect of skin properties (i.e., stiffness) on the accuracy of tonometric blood pressure measurements. To this end, a test platform, consisting of a pulsatile system and a tunable skin stiffness apparatus (or MR apparatus), is constructed. The cam-follower pulsatile system built based on in vivo testing of human pulses is used to generate realistic pulse waveforms. The MR apparatus is able to adjust its stiffness using Magneto-Rheological (MR) fluid whose apparent viscosity changes with applied magnetic fields. Placed at the surface of the MR apparatus, a cylinder with a frictionless plunger simulates a variable applanation force or “hold-down pressure” of tonometry by adjusting the added weights atop the cylinder. Using this test setup, a series of tests were performed by varying the input magnetic field and the weights, which effectively adjusts the skin stiffness and the hold-down pressure, respectively. The vertical displacement of the plunger caused by the internal pulse pressure was measured using a laser displacement sensor. The output displacement waveforms were analyzed with the focus on the peak amplitude difference of the waveforms, which is related to the augmentation index (a surrogate measure of arterial stiffness). The results show that there exists an “optimal” plunger weight or “hold-down pressure” that provides the most distinct output pulse waveforms. The results further show that the difference in the first two peak values decreases as the skin stiffness increases, indicating that the stiffer the skin property, the less the “hold-down pressure” effects on the accuracy of the tonometry measurements.

Highlights

  • Human skin is a very complex organ that can be separated into three different layers; the epidermis, the dermis, and the hypodermis or subcutaneous tissue (Geerligs, 2006)

  • The displacement waveform results are compared with the reference pulse waveform

  • The distance between the first and second peak of the displacement response was analyzed for different weights and magnetic fields to assess the effect of stiffness

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Summary

Introduction

Human skin is a very complex organ that can be separated into three different layers; the epidermis, the dermis, and the hypodermis or subcutaneous tissue (Geerligs, 2006). Research into the human skin’s mechanical properties will help in the creation of accurate, continuous, and non-invasive vital monitoring systems Internal vital measurements, such as blood pressure, are extremely important in determining the health of a patient’s cardiovascular system. “white coat” hypertension, where a patient has high blood pressure due to anxiety during the measurement, has been known to increase a patient’s blood pressure as much as 30 mmHg (Beevers et al, 2001). Due to these downsides of measuring blood pressure using cuffs, other ways of non-invasive measurement should be investigated

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