Abstract

Advancements in materials science and fabrication techniques have contributed to the significant growing attention to a wide variety of sensors for digital healthcare. While the progress in this area is tremendously impressive, few wearable sensors with the capability of real-time blood pressure monitoring are approved for clinical use. One of the key obstacles in the further development of wearable sensors for medical applications is the lack of comprehensive technical evaluation of sensor materials against the expected clinical performance. Here, we present an extensive review and critical analysis of various materials applied in the design and fabrication of wearable sensors. In our unique transdisciplinary approach, we studied the fundamentals of blood pressure and examined its measuring modalities while focusing on their clinical use and sensing principles to identify material functionalities. Then, we carefully reviewed various categories of functional materials utilized in sensor building blocks allowing for comparative analysis of the performance of a wide range of materials throughout the sensor operational-life cycle. Not only this provides essential data to enhance the materials’ properties and optimize their performance, but also, it highlights new perspectives and provides suggestions to develop the next generation pressure sensors for clinical use.

Highlights

  • Cardiovascular diseases caused 31% of deaths worldwide [1], and recently, they had the highest confirmed death cases in Italy and China during the novel pandemic known as the coronavirus disease 2019 (COVID-19) [2,3]

  • The full-occlusion technique includes auscultatory [76], oscillometry [77], and palpatory [78]. auscultatory and oscillometry are comparable to a gold standard [6,79], unlike palpatory, which is not used because obtaining a diastolic blood pressure measurement is difficult and may lead to considerable error [78]

  • The wearable impedance cardiography (ICG)/ECG includes flexible dry electrodes made of a Ti-Au composite [134], a Ni-P plated polyester fabric [135], Ag flakes with MWCNT/PDMS composite [136], a woven fabric treated with PEDOT:PSS [137] and an Ecoflex-Ag MPs self-adhesive micropillar electrode inspired by gecko and grasshopper feet [138]

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Summary

Introduction

Cardiovascular diseases caused 31% of deaths worldwide [1], and recently, they had the highest confirmed death cases in Italy and China during the novel pandemic known as the coronavirus disease 2019 (COVID-19) [2,3]. The demand for an accurate home-diagnostic tool for blood pressure measurements, along with other vital signs (e.g., temperature, respiratory rate) has increased massively. These tools, especially if enabled with telemedicine, will help assess a patient’s health status, triage the patient to appropriate care, determine potential diagnoses, and predict recovery, and, it will help provide real-time medical monitoring, for instance, people in home-quarantine [4,5]. Improving the precision and accuracy in blood pressure measurements can help significantly. Improving the precision and accuracy in blood pressure wmietahsuearrelmy ednitasgcnaonshiselapndsigcnairfdicioanvtalsycwuliatrh reiasrklystdriaatgifincoastiisoann[d6–c9a]r,dbioevcaasucsuelainr ardisekqsutraatetifpiceartfioornm[a6–n9c]e, ibnecbaluosoedinpardesesquuraetempeearsfourrmemanencet iwn ibllloiondcrpearessesucurerrmenetasleuvreemlseonft fwatilallinstcrroekaeseacnudrrfeanttallemveylsocoafrfdaitaall isntrfeockteioannsd[1fa0t]a, lams wyoelclaarsdiiaml pinofseectainonasv[o1i0d]a,balsewfinelalnacsiaiml bpuorsdeeann[1a1v]o. Bstyanpdreacridseizlyedsteuvdayluinagtiothneaupnpirqouaecnhaestu[r4e2o].fBmyepdrieccailsneleyedstsuadnydinegvathlueautinnigqutheenfautnucrteioonfamliteydoicfaslenneseindgs panridnceipvlaelsuaantidngmathteerifaulsn,cwtioenwailliltycoomfpsreenhseinnsgivpelryinicdiepnletisfyamndatemriaatlesr’iaplrso,pweretiews iallndcotmhepirreahsseoncsiiavteeldy pideernfotirfmy amncaeteirniallisn’epwroipthersttireuscatunrde tshtreairteagsiesos cniaeteeddedpefrofroramccaunrcaeteinanldinceonwtiitnhuostursucbtluoroedsptrraetsesguirees mneeeadseudrefmoreanctc. uAralstoe,awnde wcoinlltiindueonutisfyblcohoadllepnrgesessuarleonmgeawsiutrhemfuetunrt.eArelssoe,arwche wopilpl oidrteunntiiftyiecsh. aWlleenagimes taolocnrgeawteitahcfruotsusrlienkrebseeatwrceheonphpeoarlttuhncaitrieesp. rWaceticaeimantdo mcreaateteriaalcsrcoisesnlcinekfoblelotwweineng ahetaraltnhscdairsecipprlainctaircye aapnpdrmoaactheriilalul sstcriaetnecdeifnol(lFoiwguinreg1a) ttroanemsdpishcaispilzienathrye aimppprooratacnhcielloufstdreastiegdninan(dFifgaubrreic1a)titoonemelepmhaesnitzseththaet himavpeobrteaennceeiothf edreosivgenrlaonodkefdaborriccaotmiopnreolmemiseendt.s that have been either overlooked or compromised

Blood Pressure Measurement
Invasive and Minimally Invasive Blood Pressure Measurement and Materials
Full Occlusion
Semi Occlusion
No Occlusion
Method Arterial Catheter
All Day Activity
Piezoresistive
Pizocapacitive
Optical
Field Effect Transistor
Triboelectric
AAccttiivveeMMaatteerriiaallss
Conducting Polymers
Electrodes
Operational Lifecycle
Self-Protection
Self-Diagnosis and Reporting
Self-Healing
Self-Degradation
Findings
Outlook
Full Text
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