Cuff-free blood pressure estimation using signal processing techniques

Since blood pressure is a significant parameter to examine people's physical attributes and it is useful to indicate cardiovascular diseases, the measurement/estimation of blood pressure has gained increasing attention. The continuous, cuff-less and non-invasive blood pressure estimation is required for the daily health monitoring. In recent years, studies have been focusing on the ways of blood pressure estimation based on other physiological parameters. It is widely accepted that the pulse transit time (PTT) is related to arterial stiffness, and can be used to estimate blood pressure. A promising signal processing technology, Hilbert-Huang Transform (HHT), is introduced to analyze both ECG and PPG data, which are applied to calculate PTT. The relationship between blood pressure and PTT is illustrated, and the problems of calibration and re-calibration are also discussed. The proposed algorithm is tested based on the continuous data from MIMIC database. To verify the algorithm, the HHT algorithm is compared with other used processing technique (wavelet transform). The accuracy is calculated to validate the method. Furthermore, we collect data using our own developed system and test our algorithm

Wearable Piezoelectric-Based System for Continuous Beat-to-Beat Blood Pressure Measurement

Non-invasive continuous blood pressure measurement is an emerging issue that potentially can be applied to cardiovascular disease monitoring and prediction. Recently, many groups have proposed the pulse transition time (PTT) method to estimate blood pressure for long-term monitoring. However, the PTT-based methods for blood pressure estimation are limited by non-specific estimation models and require multiple calibrations. This study aims to develop a low-cost wearable piezoelectric-based system for continuous beat-to-beat blood pressure measurement. The pressure change in the radial artery was extracted by systolic and diastolic feature points in pressure pulse wave (PPW) and the pressure sensitivity of the sensor. The proposed system showed a reliable accuracy of systolic blood pressure (SBP) (mean absolute error (MAE) ± standard deviation (SD) 1.52 ± 0.30 mmHg) and diastolic blood pressure (DBP, MAE ± SD 1.83 ± 0.50), and its performance agreed with standard criteria of MAE within 5 mmHg and SD within ±8 mmHg. In conclusion, this study successfully developed a low-cost, high-accuracy piezoelectric-based system for continuous beat-to-beat SBP and DBP measurement without multiple calibrations and complex regression analysis. The system is potentially suitable for continuous, long-term blood pressure-monitoring applications

A complete set-up to evaluate the correlation between blood pressure and pulse transit time

Blood pressure (BP) has always been one of the most important parameters in monitoring cardiovascular system conditions and coronary artery diseases (CAD), such as angina and myocardial infarction (commonly known as a heart attack). This is due to the fact that many of the changes within the cardiovascular system, such as clogged arteries, for example, are reflected by changes in BP. A number of methods and devices that can measure BP are available on the market for both clinical and consumer use. However, being able to measure one’s own BP non-invasively, with the required frequency (even continuously) in a comfortable fashion remains an unsolved problem using currently available systems. To date, the Pulse Transit Time (PTT) measurement method has been seen as a feasible approach to help bring current blood pressure monitoring systems to a stage where non-invasive, continuous measurements are viable. However, developing a system which uses the PTT method for blood pressure measurement is as yet an unsolved problem and it remains a challenge to achieve accurate BP results despite considerable research in the past decade. In this paper, we present the first step in building a smart sensing system that overcomes the technical difficulties associated with accurate measurement of PTT. The novel hardware developed incorporates multi-modal sensing capability to explore and quantify the relationship between blood pressure and PTT. The evaluation system is completed by efficient, simple and fast embedded software algorithms, user interface, and clinical validation trials that will enable delivering a novel PTT-based blood pressure monitor

A review of machine learning techniques in photoplethysmography for the non-invasive cuff-less measurement of blood pressure

Hypertension or high blood pressure is a leading cause of death throughout the world and a critical factor for increasing the risk of serious diseases, including cardiovascular diseases such as stroke and heart failure. Blood pressure is a primary vital sign that must be monitored regularly for the early detection, prevention and treatment of cardiovascular diseases. Traditional blood pressure measurement techniques are either invasive or cuff-based, which are impractical, intermittent, and uncomfortable for patients. Over the past few decades, several indirect approaches using photoplethysmogram (PPG) have been investigated, namely, pulse transit time, pulse wave velocity, pulse arrival time and pulse wave analysis, in an effort to utilise PPG for estimating blood pressure. Recent advancements in signal processing techniques, including machine learning and artificial intelligence, have also opened up exciting new horizons for PPG-based cuff less and continuous monitoring of blood pressure. Such a device will have a significant and transformative impact in monitoring patients’ vital signs, especially those at risk of cardiovascular disease. This paper provides a comprehensive review for non-invasive cuff-less blood pressure estimation using the PPG approach along with their challenges and limitations

A NOVEL WAVEFORM MIRRORING TECHNIQUE FOR SYSTOLIC BLOOD PRESSURE ESTIMATION FROM ANACROTIC PHOTOPLETHYSMOGRAM

Continuous cuffless Blood Pressure (BP) measurement is an important tool to monitor the health of individuals at risk. In this study, a new method is proposed for Systolic BP (SBP) estimation utilizing Photoplethysmograms (PPG). To this end, toe and carotid PPG were recorded from seventeen subjects aged 20-28 years, whereas their SBP were measured using a standard BP cuff monitor for validation purpose. The proposed method is based on a novel mirroring technique, which allows for an accurate estimation of the Pulse Transit Time (PTT) from the PPG’s rising part (anacrotic) waveform using an ARX System Identification approach. Based on the modified Moens-Korteweg equation, SBP was then calculated based on the estimated PTT values obtained from the ARX model. The estimated PTT was found to be highly correlated to the measured SBP (R2 = 0.98). Comparison of calculated SBP to the measured SBP obtained using standard BP cuff monitor results in a mean error of 3.4%. Given that 95% of the estimated SBP values are accurate in the +/- 8 mmHg range, this method seems promising for non-invasive, continuous BP monitorin

Evaluation of the Linear Relationship Between Pulse Arrival Time and Blood Pressure in ICU Patients: Potential and Limitations

A variety of techniques based on the indirect measurement of blood pressure (BP) by Pulse Transit Time (PTT) have been explored over the past few years. Such an approach has the potential in providing continuous and non-invasive beat to beat blood pressure without the use of a cuff. Pulse Arrival Time (PAT) which includes the cardiac pre-ejection period has been proposed as a surrogate of PTT, however, the balance between its questioned accuracy and measurement simplicity has yet to be established. The present work assessed the degree of linear relationship between PAT and blood pressure on 96 h of continuous electrocardiography and invasive radial blood pressure waveforms in a group of 11 young ICU patients. Participants were selected according to strict exclusion criteria including no use of vasoactive medications and presence of clinical conditions associated with cardiovascular diseases. The average range of variation for diastolic BP was 60 to 79 mmHg while systolic BP varied between 123 and 158 mmHg in the study database. The overall Pearson correlation coefficient for systolic and diastolic blood pressure was −0.5 and −0.42, respectively, while the mean absolute error was 3.9 and 7.6 mmHg. It was concluded that the utilization of PAT for the continuous non-invasive blood pressure estimation is rather limited according to the experimental setup, nonetheless the correlation coefficient performed better when the range of variation of blood pressure was high over periods of 30 min suggesting that PAT has the potential to be used as indicator of changes relating to hypertensive or hypotensive episodes

Cuff-Less Methods for Blood Pressure Telemonitoring.

Blood pressure telemonitoring (BPT) is a telemedicine strategy that uses a patient\u27s self-measured blood pressure (BP) and transmits this information to healthcare providers, typically over the internet. BPT has been shown to improve BP control compared to usual care without remote monitoring. Traditionally, a cuff-based monitor with data communication capabilities has been used for BPT; however, cuff-based measurements are inconvenient and cause discomfort, which has prevented the widespread use of cuff-based monitors for BPT. The development of new technologies which allow for remote BP monitoring without the use of a cuff may aid in more extensive adoption of BPT. This would enhance patient autonomy while providing physicians with a more complete picture of their patient\u27s BP profile, potentially leading to improved BP control and better long-term clinical outcomes. This mini-review article aims to: (1) describe the fundamentals of current techniques in cuff-less BP measurement; (2) present examples of commercially available cuff-less technologies for BPT; (3) outline challenges with current methodologies; and (4) describe potential future directions in cuff-less BPT development

An assessment of pulse transit time for detecting heavy blood loss during surgical operation

Copyright @ Wang et al.; Licensee Bentham Open. This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.The main contribution of this paper is the use of non-invasive measurements such as electrocardiogram (ECG) and photoplethysmographic (PPG) pulse oximetry waveforms to develop a new physiological signal analysis technique for detecting blood loss during surgical operation. Urological surgery cases were considered as the control group due to its generality, and cardiac surgery as experimental group since it involves blood loss and water supply. Results show that the control group has the tendency of a reduction of the pulse transient time (PTT), and this indicates an increment in the blood flow velocity changes from slow to fast. While for the experimental group, the PTT indicates high values during blood loss, and low values during water supply. Statistical analysis shows considerable differences (i.e., P <0.05) between both groups leading to the conclusion that PTT could be a good indicator for monitoring patients' blood loss during a surgical operation.The National Science Council (NSC) of Taiwan and the Centre for Dynamical Biomarkers and Translational Medicine, National Central University, Taiwan

The development of an algorithm to track blood pressure accurately based on the pulse transit time method

Oscillometric blood pressure (BP) monitors are currently used to diagnose hypertension both in home and clinical settings. These monitors take BP measurements once every 15 minutes over a 24 hour period and provide a reliable and accurate system that is minimally invasive. Although intermittent cuff measurements have proven to be a good indicator of BP, a continuous BP monitor is highly desirable for the diagnosis of hypertension and other cardiac diseases. However, no such devices currently exist. A novel algorithm has been developed based on the Pulse Transit Time (PTT) method, which would allow non-invasive and continuous BP measurement. PTT is defined as the time it takes the BP wave to propagate from the heart to a specified point on the body. After an initial BP measurement, PTT algorithms can track BP over short periods of time, known as calibration intervals. After this time has elapsed, a new BP measurement is required to recalibrate the algorithm. Using the PhysioNet database as a basis, the new algorithm was developed and tested using 15 patients, each tested 3 times over a period of 30 minutes. The predicted BP of the algorithm was compared to the arterial BP of each patient. It has been established that this new algorithm is capable of tracking BP over 12 minutes without the need for recalibration, using the BHS standard, a 100% improvement over what has been previously identified. The algorithm was incorporated into a new system based on its requirements and was tested using three volunteers. The results mirrored those previously observed, providing accurate BP measurements when a 12 minute calibration interval was used. This new system provides a significant improvement to the existing method allowing BP to be monitored continuously and non-invasively, on a beat-to-beat basis over 24 hours, adding major clinical and diagnostic value