Utilization of non-invasive hemodynamic monitoring in resource-limiting settings — Preliminary experience

Epstein, Danny; Miller, Asaf; Marcusohn, Erez; Isagara, Peter; Klein, Erez; Petersiel, Neta; Neuberger, Ami; Minha, Sa’ar

doi:10.1016/j.tmaid.2019.04.001

Cited by 1 publication

(1 citation statement)

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“…An advanced technology of this sort would allow monitoring of patients who are not routinely monitored due to the technical and logistical shortfalls of traditional measurement techniques such as the AL. Such technology would ultimately assist in early identification of medical emergencies and would enable retrospective investigation of BP when needed, leading to improved patient care (11)(12)(13). In recently published work, it was shown that a new reflective photoplethysmography (PPG) device provides accurate measures of BP in a large human cohort and in an animal model of controlled hemorrhagic shock (14,15).…”

Section: Introductionmentioning

confidence: 99%

A Pilot Study of Blood Pressure Monitoring After Cardiac Surgery Using a Wearable, Non-invasive Sensor

et al. 2021

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Background: Continuous blood pressure (BP) measurement in intensive care units is based on arterial line (AL) transducers, sometimes associated with clinical complications. Our objective was to evaluate continuous BP measurements obtained from a non-invasive, wireless photoplethysmography (PPG)-based device using two distinct configurations (wristwatch and chest-patch monitors) compared to an AL.Methods: In this prospective evaluation study, comparison of the PPG-based devices to the AL was conducted in 10 patients immediately following cardiac surgery. Pulse rate (PR), systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP) were recorded using both the AL and the PPG-based devices simultaneously for an average of 432 ± 290 min starting immediately after cardiac surgery. Bland-Altman plots and Pearson's correlations were used to assess the accuracy and degree of agreement between techniques.Results: A total of ~4,000 data points were included in the final analysis. AL measurements for PR, SBP, DBP and MAP were significantly (p < 0.001) and strongly correlated with both the wristwatch (r = 0.99, r = 0.94, r = 0.93 and r = 0.96, respectively) and the chest-patch (r = 0.99, r = 0.95, r = 0.93 and r = 0.95, respectively) monitors. Both configurations showed a marginal bias of <1 mmHg for BP measurements and <1 beat/min for PR [95% limits of agreement −3,3 beat/min; BP measurements: (−6)–(−10), 6–10 mmHg] compared to AL measurements.Conclusion: The PPG-based devices offer a high level of accuracy for cardiac-related parameters compared to an AL in post-cardiac surgery patients. Such devices could provide advanced monitoring capabilities in a variety of clinical settings, including immediate post-operative and intensive care unit settings.Clinical Trial Registration:www.clinicaltrials.gov, NCT03603860.

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