Abstract
We test a new wireless soft capacitance sensor (CAP) based on applanation tonometry at the radial and dorsalis pedis arteries against the gold standard, invasive arterial line (A-Line), for continuous beat to beat blood pressure (BP) measurements in the Operating Room during surgical procedures under anesthesia in 17 subjects with the mean age and body mass index (BMI) of 57. 35 ± 18.72 years and 27.36 ± 4.20 kg/m2, respectively. We have identified several parameters to monitor in order to compare how well the CAP sensor tracks the entire hemodynamic waveform as compared to the A-Line. This includes waveform similarity, heart rate (HR), absolute systolic BP (SBP), diastolic BP (DBP), and temporal response to a vasopressor. Overall, the CAP sensor shows good correlations with A-Line with respect to hemodynamic shape (r > 0.89), HR (mean bias = 0.0006; SD = 0.17), absolute SBP, and DBP in a line of best fit (slope = 0.98 in SBP; 1.08 in DBP) and the mean bias derived from Bland-Altman method to be 1.92 (SD = 12.55) in SBP and 2.38 (SD = 12.19) in DBP across body habitus and age in OR patients under general anesthesia. While we do observe drifts in the system, we still obtain decent correlations with respect to the A-Line as evidenced by excellent linear fit and low mean bias across patients. When we post-process using a different calibration method to account for the drift, the mean bias and SD improve dramatically to −1.85 and 7.19 DBP as well as 1.43 and 7.43 SBP, respectively, indicating a promising potential for improvement when we integrate strategies to account for movement identified by our integrated accelerometer data.
Highlights
Blood pressure (BP) is one of the core physiological measurements of interest in virtually all healthcare contexts as it provides insight into a patient’s cardiac function, volume status, organ perfusion, and overall hemodynamic stability
We have previously demonstrated the accuracy of a soft wearable capacitance sensor (CAP sensor) based on applanation tonometry for continuous non-invasive measurement of BP compared to the FDA-approved non-invasive blood pressure (NIBP) monitor Clearsight in a small cohort of healthy, young individuals [18]
The major finding of the study is that the CAP sensor can noninvasively track BP across different body types and ages in an Operating Room (OR) setting under general anesthesia
Summary
Blood pressure (BP) is one of the core physiological measurements of interest in virtually all healthcare contexts as it provides insight into a patient’s cardiac function, volume status, organ perfusion, and overall hemodynamic stability. It is typically monitored using a non-invasive sphygmomanometer, otherwise known as the BP cuff, and in higher-risk surgery may be monitored using an invasive arterial line. The arterial line (A-Line) is considered the gold standard in capturing beat-to-beat BP values to detect immediate fluctuations This requires the insertion of Wireless Blood Pressure Sensor Validation a catheter into an artery, typically the radial or dorsalis pedis arteries. 30% or less of patients in the Operating Room (OR) or Intensive Care Unit (ICU) receive A-Lines [3]
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