Noninvasive cardiovascular monitoring based on electrocardiography and ballistocardiography: a feasibility study on patients in the surgical intensive care unit

Abstract

The time interval between the peaks in the electroccardiogram (ECG) and ballistocardiogram (BCG) waveforms, TEB, has been associated with the pre-ejection period (PEP), which is an important marker of ventricular contractility. However, the applicability of BCG-related markers in clinical practice is limited by the difficulty to obtain a replicable and consistent signal on patients. In this study, we test the feasibility of BCG measurements within a complex clinical setting, by means of an accelerometer under the head pillow of patients admitted to the Surgical Intensive Care Unit (SICU). The proposed technique proved capable of capturing TEB based on the R peaks in the ECG and the BCG in its head-totoe and dorso-ventral directions. TEB detection was found to be consistent and repeatable both in healthy individuals and SICU patients over multiple data acquisition sessions. This work provides a promising starting point to investigate how TEB changes may relate to the patients' complex health conditions and give additional clinical insight into their care needs.

Combining Physiology-Based Modeling and Evolutionary Algorithms for Personalized, Noninvasive Cardiovascular Assessment Based on Electrocardiography and Ballistocardiography

“…Investigations evaluating the applicability of the proposed approach to situations where the data acquisition is not as controlled as in a laboratory setting are currently under-way. Preliminary results obtained when monitoring critically ill patients hospitalized in the Surgical Intensive Care Unit (University Hospital, MU Health Care System) suggest that measurements of BCG amplitudes and timings are feasible and reproducible (Zaid et al, 2021 ), thereby yielding promise for future extension of this study.…”

“…Thus, by using only the J-K amplitudes and timings in the convergence of the EA algorithm, the approach described in this study could be extended to other BCG technologies. An ongoing study in the Surgical Intensive Care Unit (MU Health Care, Columbia, MO) has recently shown that measures of timing between ECG and BCG signals acquired on critically ill patients by means of a three-axis accelerometer positioned under the head pillow are feasible and reproducible (Zaid et al, 2021 ), thereby showing good potential for applications of the proposed methodology beyond a laboratory setting.…”

Mechanism-Driven Modeling to Aid Non-invasive Monitoring of Cardiac Function via Ballistocardiography

“…While swine are widely accepted as reliable pre-clinical models for cardiovascular diseases (44,53), studies on human subjects should be conducted to evaluate the clinical applicability of the method proposed in this work. While the feasibility of BCG acquisitions based on an accelerometer placed under the head pillow has been successfully validated on critically-ill patients in the Surgical Intensive Care Unit of the University Hospital-MU Health Care (18), further studies are required to establish a relationship between the model-predicted BCG changes and actual deterioration in cardiovascular function. These are very important directions for future research which, however, go beyond the scope of this work.…”

“…Thus, BCGbased sensors monitor the cardiovascular activity by capturing the movement of the whole body, or the associated force, that the blood flow generates. In the recent years, numerous sensors have been proposed to measure the BCG signal non-invasively, including weighing scales, bed sensors, and chair sensors, some of which do not even require direct body contact (9)(10)(11)(12)(13)(14)(15)(16)(17)(18). The BCG captures the mechanical and fluid-dynamical properties of the cardiovascular system as a whole, including heart, heart valves, arteries, capillaries, and veins.…”