Measurement of blood pressure

Saugel, Bernd; Dueck, Ronald; Wagner, Julia Y.

doi:10.1016/j.bpa.2014.08.001

Cited by 126 publications

(87 citation statements)

References 73 publications

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“…The CNAP system (CNSystems Medizintechnik AG, Graz, Austria) allows continuous noninvasive beat-by-beat recording of the arterial pressure waveform [1,2].…”

Section: Introductionmentioning

confidence: 99%

“…The CNAP device is easy to apply and uses an enhancement of the Peňáz principle, a method first described in 1973, to generate an arterial waveform [2,3]. For arterial waveform recording, an inflatable finger cuff is applied to the patient's finger [2].…”

Section: Introductionmentioning

confidence: 99%

“…For arterial waveform recording, an inflatable finger cuff is applied to the patient's finger [2]. The finger artery's diameter is assessed by an integrated photo-plethysmograph that controls that the blood volume in the finger artery is kept constant.…”

Section: Introductionmentioning

confidence: 99%

“…A controller adjusts the finger cuff pressure in order to keep the blood volume constant throughout the cardiac cycle. The pressure that is required to keep the volume constant corresponds to the true arterial pressure waveform [2]. But the original Peňáz principle is not working if arterial diameter and wall tension are altered due to vasoconstriction and vasodilation.…”

Section: Introductionmentioning

confidence: 99%

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Continuous noninvasive cardiac output determination using the CNAP system: evaluation of a cardiac output algorithm for the analysis of volume clamp method-derived pulse contour

Wagner

Grond²,

Fortin³

et al. 2015

J Clin Monit Comput

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The CNAP system (CNSystems Medizintechnik AG, Graz, Austria) provides noninvasive continuous arterial pressure measurements by using the volume clamp method. Recently, an algorithm for the determination of cardiac output by pulse contour analysis of the arterial waveform recorded with the CNAP system became available. We evaluated the agreement of the continuous noninvasive cardiac output (CNCO) measurements by CNAP in comparison with cardiac output measurements invasively obtained using transpulmonary thermodilution (TDCO). In this proof-of-concept analysis we studied 38 intensive care unit patients from a previously set up database containing CNAP-derived arterial pressure data and TDCO values obtained with the PiCCO system (Pulsion Medical Systems SE, Feldkirchen, Germany). We applied the new CNCO algorithm retrospectively to the arterial pressure waveforms recorded with CNAP and compared CNCO with the corresponding TDCO values (criterion standard). Analyses were performed separately for (1) CNCO calibrated to the first TDCO (CNCO-cal) and (2) CNCO autocalibrated to biometric patient data (CNCO-auto). We did not perform an analysis of trending capabilities because the patients were hemodynamically stable. The median age and APACHE II score of the 22 male and 16 female patients was 63 years and 18 points, respectively. 18 % were mechanically ventilated and in 29 % vasopressors were administered. Mean ± standard deviation for CNCO-cal, CNCO-auto, and TDCO was 8.1 ± 2.7, 6.4 ± 1.9, and 7.8 ± 2.4 L/min, respectively. For CNCO-cal versus TDCO, Bland-Altman analysis demonstrated a mean difference of +0.2 L/min (standard deviation 1.0 L/min; 95 % limits of agreement -1.7 to +2.2 L/min, percentage error 25 %). For CNCO-auto versus TDCO, the mean difference was -1.4 L/min (standard deviation 1.8 L/min; 95 % limits of agreement -4.9 to +2.1 L/min, percentage error 45 %). This pilot analysis shows that CNCO determination is feasible in critically ill patients. A percentage error of 25 % indicates acceptable agreement between CNCO-cal and TDCO. The mean difference, the standard deviation, and the percentage error between CNCO-auto and TDCO were higher than between CNCO-cal and TDCO. A hyperdynamic cardiocirculatory state in a substantial number of patients and the hemodynamic stability making trending analysis impossible are main limitations of our study.

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“…The CNAP system (CNSystems Medizintechnik AG, Graz, Austria) allows continuous noninvasive beat-by-beat recording of the arterial pressure waveform [1,2].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Continuous noninvasive cardiac output determination using the CNAP system: evaluation of a cardiac output algorithm for the analysis of volume clamp method-derived pulse contour

Wagner

Grond²,

Fortin³

et al. 2015

J Clin Monit Comput

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“…A useful analogy would be the decreased wall tension observed after externally compressing an inflated balloon. 84,85 When the finger artery remains in an ''unstretched'' state, the blood pressure measured in the finger cuff is reflective of mean arterial blood pressure; thus, the key to the numerical determination of blood pressure is identification of this ''unstretched'' state.…”

Section: Technologic Principlesmentioning

confidence: 99%

Advances in photoplethysmography: beyond arterial oxygen saturation

Bartels

Thiele

2015

Can J Anesth/J Can Anesth

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Purpose Photoplethysmography permits continuous measurement of heart rate and peripheral oxygen saturation and has been widely used to inform clinical decisions. Recently, a myriad of noninvasive hemodynamic monitoring devices using this same technology have been increasingly available. This narrative review aims to summarize the principles that form the basis for the function of these devices as well as to comment on trials evaluating their accuracy and clinical application. Principal findings Advanced monitoring devices extend photoplethysmography technology beyond measuring oxygen concentration and heart rate. Quantification of respiratory variation of the photoplethysmographic waveform reflects respiratory variation of the arterial pressure waveform and can be used to gauge volume responsiveness. Both the volume-clamp and physiocal techniques are extensions of conventional photoplethysmography and permit continuous measurement of finger arterial blood pressure. Finger arterial pressure waveforms can subsequently inform estimations of cardiac output. Conclusions Although respiratory variations of the plethysmographic waveform correlate only modestly with the arterial blood pressure waveform, fluid responsiveness can be relatively consistently assessed using both approaches. Continuous blood pressure measurements obtained using the volume-clamp technique may be as accurate as conventional brachial noninvasive blood pressure measurements. Most importantly, clinical comparative effectiveness studies are still needed in order to determine if these technologies can be translated into improvement of relevant patient outcomes. RésuméObjectif La photopléthysmographie permet la mesure continue de la fréquence cardiaque et de la saturation en oxygène périphérique, et elle est largement utilisée pour les prises de décisions cliniques. Depuis peu, un très grand nombre de dispositifs non invasifs de surveillance hémodynamique utilisant la même technologie envahit le marché. Cette synthèse narrative vise à résumer les principes à la base du fonctionnement de ces dispositifs et à commenter les essais évaluant leur exactitude ainsi que leurs applications cliniques. Constatations principales Les dispositifs de surveillance avancée étendent la technologie de photopléthysmographie au-delà de la mesure de la concentration en oxygène et de la fréquence cardiaque. La quantification de la variation respiratoire du tracé photopléthysmographique reflète la variation respiratoire du tracé de pression artérielle et peut servir à jauger la réactivité au volume. Les deux techniques de compression volumique (volume-clamp) au doigt et la technique physiocal sont des prolongements de Author contributions Karsten Bartels wrote approximately 50% of the manuscript and critically edited the remainder. Robert H. Thiele wrote approximately 50% of the manuscript and critically edited the remainder.

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3D Printing of Polyvinylidene Fluoride‐Based Piezoelectric Sensors for Noninvasive Continuous Blood Pressure Monitoring

Mandal,

Morali,

Skorobogatiy

et al. 2023

Adv Eng Mater

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We present successful fabrication and application of 3D printed piezoelectric sensors, made from polyvinylidene fluoride‐barium titanate (PVDF‐BaTiO3) nanocomposites, for continuous blood pressure monitoring. Our sensors are fabricated using direct‐ink write 3D printing technique possessing excellent flexibility, rendering them ideal for wearable applications. We optimize key printing parameters, such as nozzle size and pressure, to achieve a β‐phase of 70% and an overall crystallinity of 48.3%. Our sensors are characterized under dynamic pressures and show excellent linearity with a coefficient of determination (R2) of 0.99 and a pressure sensitivity of 0.024 V kPa‐1, and demonstrate durability over 3600 cycles. We compare the performance of our piezoelectric sensors with a standard blood pressure monitoring device for a subject and find a strong correlation with standard deviation of 3.87 mmHg and 0.63 mmHg for SBP and DBP, respectively. The development of sensors through 3D printing, as demonstrated in this study, represents a significant scientific advancement in the field of personalized healthcare. Our novel approach enables the creation of customized wearable devices tailored for real‐time health monitoring of blood pressure and heart rate.This article is protected by copyright. All rights reserved.

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Measurement of blood pressure

Cited by 126 publications

References 73 publications

Continuous noninvasive cardiac output determination using the CNAP system: evaluation of a cardiac output algorithm for the analysis of volume clamp method-derived pulse contour

Continuous noninvasive cardiac output determination using the CNAP system: evaluation of a cardiac output algorithm for the analysis of volume clamp method-derived pulse contour

Advances in photoplethysmography: beyond arterial oxygen saturation

3D Printing of Polyvinylidene Fluoride‐Based Piezoelectric Sensors for Noninvasive Continuous Blood Pressure Monitoring

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