Blood pressure (BP) monitoring has significant importance in the treatment of hypertension and different cardiovascular health diseases. As photoplethysmogram (PPG) signals can be recorded non-invasively, research has been highly conducted to measure BP using PPG recently. In this paper, we propose a U-net deep learning architecture that uses fingertip PPG signal as input to estimate arterial BP (ABP) waveform non-invasively. From this waveform, we have also measured systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP). The proposed method was evaluated on a subset of 100 subjects from two publicly available databases: MIMIC and MIMIC-III. The predicted ABP waveforms correlated highly with the reference waveforms and we have obtained an average Pearson’s correlation coefficient of 0.993. The mean absolute error is 3.68 ± 4.42 mmHg for SBP, 1.97 ± 2.92 mmHg for DBP, and 2.17 ± 3.06 mmHg for MAP which satisfy the requirements of the Association for the Advancement of Medical Instrumentation (AAMI) standard and obtain grade A according to the British Hypertension Society (BHS) standard. The results show that the proposed method is an efficient process to estimate ABP waveform directly using fingertip PPG.

Accurate estimation of blood pressure (BP) waveforms is critical for ensuring the safety and proper care of patients in intensive care units (ICUs) and for intraoperative hemodynamic monitoring. Normal cuff-based BP measurements can only provide systolic blood pressure (SBP) and diastolic blood pressure (DBP). Alternatively, the BP waveform can be used to estimate a variety of other physiological parameters and provides additional information about the patient’s health. As a result, various techniques are being proposed for accurately estimating the BP waveforms. The purpose of this review is to summarize the current state of knowledge regarding the BP waveform, three methodologies (pressure-based, ultrasound-based, and deep-learning-based) used in noninvasive BP waveform estimation research and the feasibility of employing these strategies at home as well as in ICUs. Additionally, this article will discuss the physical concepts underlying both invasive and noninvasive BP waveform measurements. We will review historical BP waveform measurements, standard clinical procedures, and more recent innovations in noninvasive BP waveform monitoring. Although the technique has not been validated, it is expected that precise, noninvasive BP waveform estimation will be available in the near future due to its enormous potential.

A photoplethysmography method has recently been widely used to noninvasively measure blood volume changes during a cardiac cycle. Photoplethysmogram (PPG) signals are sensitive to artifacts that negatively impact the accuracy of many important measurements. In this paper, we propose an efficient system for detecting PPG signal artifacts acquired from a fingertip in the public healthcare database named Multiparameter Intelligent Monitoring in Intensive Care (MIMIC) by using 11 features as the input of the random forest algorithm and classified the signals into two classes: acceptable and anomalous. A real-time algorithm is proposed to identify artifacts by using the method. The efficient Fisher score feature selection algorithm was used to order and select 11 relevant features from 19 available features that represented the PPG signal very effectively. Six machine learning algorithms (random forest, decision tree, Gaussian naïve Bayes, linear support vector machine, artificial neural network, and probabilistic neural network) were applied with the extracted features, and their classification accuracy was measured. Among them, the random forest had the best performance using only 11 out of 19 features with an accuracy of 85.68%. Our proposed method also achieved good sensitivity and specificity value of 86.57% and 85.09%, respectively. The proposed real-time algorithm can be an easy and convenient way for real-time PPG signal artifact detection using smartphones and wearable devices.

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