Abstract
A variety of techniques based on the indirect measurement of blood pressure (BP) by Pulse Transit Time (PTT) have been explored over the past few years. Such an approach has the potential in providing continuous and non-invasive beat to beat blood pressure without the use of a cuff. Pulse Arrival Time (PAT) which includes the cardiac pre-ejection period has been proposed as a surrogate of PTT, however, the balance between its questioned accuracy and measurement simplicity has yet to be established. The present work assessed the degree of linear relationship between PAT and blood pressure on 96 h of continuous electrocardiography and invasive radial blood pressure waveforms in a group of 11 young ICU patients. Participants were selected according to strict exclusion criteria including no use of vasoactive medications and presence of clinical conditions associated with cardiovascular diseases. The average range of variation for diastolic BP was 60 to 79 mmHg while systolic BP varied between 123 and 158 mmHg in the study database. The overall Pearson correlation coefficient for systolic and diastolic blood pressure was −0.5 and −0.42, respectively, while the mean absolute error was 3.9 and 7.6 mmHg. It was concluded that the utilization of PAT for the continuous non-invasive blood pressure estimation is rather limited according to the experimental setup, nonetheless the correlation coefficient performed better when the range of variation of blood pressure was high over periods of 30 min suggesting that PAT has the potential to be used as indicator of changes relating to hypertensive or hypotensive episodes.
Highlights
Arterial blood pressure is one of the four primary vital signs used as an indicator of the health status of the circulatory system that is commonly measured in clinical and ambulatory scenarios
The present study aims at exploring the degree of linear relationship between Pulse Arrival Time (PAT) and systolic and diastolic blood pressure in intensive care unit patients in an effort to provide further information about it capabilities and disadvantages in this particular scenario
The invasive arterial blood pressure (ABP) waveform at the radial artery of either arm was obtained at 125 Hz while the Electrocardiography (ECG) lead II featured a 500 Hz sampling rate
Summary
Arterial blood pressure is one of the four primary vital signs used as an indicator of the health status of the circulatory system that is commonly measured in clinical and ambulatory scenarios. Pulse Arrival Time—Blood Pressure monitoring devices using traditional methods, there is great demand for a system that is non-invasive, nonocclusive, unobtrusive, unsupervised, accurate, and continuous (Sola, 2011). Pulse wave velocity is defined as the ratio between the length of the segment and the time it takes the pulse wave to travel from two arterial sites. When this time is measured from the electrocardiogram to a peripheral site, the cardiac pre-ejection period (PEP) is included and it is usually called Pulse Arrival Time (PAT), otherwise this time is regarded as Pulse Transit time (PTT). The theoretical relationship between PWV and blood pressure is commonly established by the combination of the Moens-Korteweg equation, that relates PWV with the elastic modulus and geometry of the artery (Wilmer Nichols, 2011), with the observations of Hughes that studied the exponential relationship of the elastic modulus with blood pressure (Hughes et al, 1979)
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