Systolic blood pressure accuracy enhancement in the electronic palpation method using pulse waveform

Abstract

Abstract-This paper presents and evaluates some methods to improve the accuracy of systolic blood pressure measurements based on pulse waveform. A set of measurement was carried out with elderly cardiac surgery patients. The experiments comprised two to five measurements per patient, each including a one-minute follow-up, after which the cuff was slowly inflated over the systolic blood pressure. Systolic pressure errors were defined and correlations with other specific values, like pressure rise time, pulse wave velocity, systolic pressure, augmentation, arm circumference and body mass index were calculated. These indices may be affected by arterial stiffness, a common source of errors in blood pressure measurements. With a value of -0.52, the character which correlated best with systolic error was found to be the peak level of the first derivative of the pressure signal. Also rise time (10%…90%) exhibits a moderate correlation, +0.49. On the other hand, pulse wave velocity, body mass index, cardiac output, peripheral and intra-arterial temperature do not seem to correlate with systolic blood pressure error. It is also noteworthy that indices describing the rising edge of the pressure pulse correlated better with systolic pressure error than those describing the falling part. Using the first derivative peak level method, accuracy improved slightly.

Precision and accuracy of a new device (CNAP™) for continuous non-invasive arterial pressure monitoring: assessment during general anaesthesia

“…The diastolic AP value was calculated as the minimum value of the pulse beat occurring between the onset of the pulse beat and the systolic AP value. 10 The mean AP value was calculated by the sum between diastolic AP value plus 5 and one-third of the difference between systolic and diastolic AP value. 11 FCAP was defined as absolute differences between the end and start point of a linear regression line on systolic AP during intraoperative time episodes of 3 min length that were .20 mm Hg.…”

Blood pressure measurement

“…Detection techniques were developed to de-noise the signal, identify the bloodpressure pulses and then to eventually determine the systolic and diastolic points. [27], [32] and [33] were working on palpation method. However, signal processing technique used in other biomedical areas are insightful and they can be adapted for our blood-pressure measurement.…”

Blood pressure measurement

“…There are some literature associated with blood-pressure measurement: [4] and [18] deal with the oscillometric method; [31], [23] and [26] used ultrasound detector method; [8] used statistical and fuzzy model with ECG data approach to determine systolic point; [41], [27], [32] and [33] were working on palpation method. However, signal processing technique used in other biomedical areas are insightful and they can be adapted for our blood-pressure measurement.…”