Advances in Oscillometric Blood Pressure Measurement

Advances in Oscillometric Blood Pressure Measurement
Author: Anand Chandrasekhar
Publisher:
Total Pages: 75
Release: 2019
Genre: Electronic dissertations
ISBN: 9781392722336

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High blood pressure (BP) is a major cardiovascular risk factor that is treatable, yet hypertensionawareness and control rates are low. Ubiquitous BP monitoring technology could improve hypertensionmanagement, but existing devices require an inflatable cuff and are not compatible withsuch anytime, anywhere measurement of BP. Oscillometry is the blood pressure (BP) measurementprinciple of most automatic cuff devices. We extended the oscillometric principle, which is usedby most automatic cuff devices, to develop a couple of instruments to measure cuff-less BP usinga smartphone-based device and standalone iPhone application. As the user presses her/his fingeragainst the smartphone, the external pressure of the underlying artery is steadily increased while thephone measures the applied pressure and resulting variable amplitude blood volume oscillations.A smartphone application provides visual feedback to guide the amount of pressure applied overtime via the finger pressing and computes systolic and diastolic BP from the measurements.We prospectively tested the smartphone-based device for real-time BP monitoring in humansubjects to evaluate usability (n = 30) and accuracy against a standard automatic cuff-based device(n = 32). We likewise tested a finger cuff device, which uses the volume-clamp method of BPdetection. About 90% of the users learned the finger actuation required by the smartphone-baseddevice after one or two practice trials. The device yielded bias and precision errors of 3.3 and 8.8mmHg for systolic BP and [Special character(s) omitted]5:6 and 7:7 mmHg for diastolic BP over a 40 to 50 mmHg range of BP.These errors were comparable to the finger cuff device. Cuff-less and calibration-free monitoringof systolic and diastolic BP may be feasible via a smartphone. In addition, we tested the iPhoneapplication. The application yielded bias and precision errors of -4.0 and 11.4 mmHg for systolicBP and -9.4 and 9.7 mmHg for diastolic BP (n = 18). These errors were near the finger cuff deviceerrors. This proof-of-concept study surprisingly indicates that cuff-less and calibration-free BPmonitoring may be feasible with many existing and forthcoming smartphones.These devices use empirical algorithms, already descried in the literature, to estimate bloodpressure. Hence, the next objective was to establish formulas to explain three popular empiricalalgorithms- the maximum amplitude, derivative, and fixed ratio algorithms. A mathematicalmodel of the oscillogram was developed and analyzed to derive parametric formulas for explainingeach algorithm. Exemplary parameter values were obtained by fitting the model to measuredoscillograms. The model and formulas were validated by showing that their predictions correspondto measurements. The formula for the maximum amplitude algorithm indicates that it yields aweighted average of systolic and diastolic BP (0.45 and 0.55 weighting) instead of commonlyassumed mean BP. The formulas for the derivative algorithm indicate that it can accurately estimatesystolic and diastolic BP (1.5 mmHg error), if oscillogram measurement noise can be obviated.The formulas for the fixed ratio algorithm indicate that it can yield inaccurate BP estimates, becausethe ratios change substantially (over a 0.5-0.6 range) with arterial compliance and pulse pressureand error in the assumed ratio translates to BP error via large amplification (40). The establishedformulas allow for easy and complete interpretation of perhaps the three most popular oscillometricBP estimation algorithms in the literature while providing new insights. The model and formulasmay also be of some value towards improving the accuracy of automatic cuff BP measurementdevices.

Home Blood Pressure Monitoring

Home Blood Pressure Monitoring
Author: George S. Stergiou
Publisher: Springer Nature
Total Pages: 174
Release: 2019-10-31
Genre: Medical
ISBN: 3030230651

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Hypertension remains a leading cause of disability and death worldwide. Self-monitoring of blood pressure by patients at home is currently recommended as a valuable tool for the diagnosis and management of hypertension. Unfortunately, in clinical practice, home blood pressure monitoring is often inadequately implemented, mostly due to the use of inaccurate devices and inappropriate methodologies. Thus, the potential of the method to improve the management of hypertension and cardiovascular disease prevention has not yet been exhausted. This volume presents the available evidence on home blood pressure monitoring, discusses its strengths and limitations, and presents strategies for its optimal implementation in clinical practice. Written by distinguished international experts, it offers a complete source of information and guide for practitioners and researchers dealing with the management of hypertension.

Advanced Monitoring and Procedures for Small Animal Emergency and Critical Care

Advanced Monitoring and Procedures for Small Animal Emergency and Critical Care
Author: Jamie M. Burkitt Creedon
Publisher: John Wiley & Sons
Total Pages: 896
Release: 2012-04-03
Genre: Medical
ISBN: 1118242084

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Advanced Monitoring and Procedures for Small Animal Emergency and Critical Care is a comprehensive yet practical reference, providing hands-on information essential to veterinarians and veterinary technicians involved in emergency and critical care. Written by an expert team of veterinarians and veterinary technicians, this well-referenced book offers step-by-step protocols for performing advanced emergency and critical care procedures and monitoring techniques. Packed with practical guidance in an easy-to-use format, this book is ideally suited for quick access in emergency rooms or intensive care units. Organized primarily by body system, each chapter covers general principles, indications, equipment, techniques, basic interpretation, troubleshooting, and contraindications. Standardized protocols supply equipment lists and step-by-step instructions throughout, and a companion website offers images from the book in PowerPoint and protocols as downloadable Word files. Advanced Monitoring and Procedures for Small Animal Emergency and Critical Care is a valuable resource for any veterinary staff member with an interest in improving the standard of care in emergency and critical care medicine.

Blood Pressure Measurements

Blood Pressure Measurements
Author: W. Meyer-Sabellek
Publisher: Springer Science & Business Media
Total Pages: 547
Release: 2012-12-06
Genre: Medical
ISBN: 364272423X

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In addition to standardized casual blood pressure readings, ambulatory blood pressure monitoring (ABPM) - using automatic noninvasive (= indirect) devices for home readings and fully automated monitors for 24-h profiles - have become a widely used necessary tool in clinical research. This book summarizes the state of the art in the whole field of indirect blood pressure monitoring. It is based on two international meetings and on invited papers. We have divided the subject matter into two main areas: 1) Automatic blood pressure devices for discontinuous registration, and 2) Portable, fully automated programmable monitors for continuous monitoring. The availability of all new technologies is described in detail and current technical and physiological problems have been covered in depth. Both topics have been subdivided into a) Methods and Techniques, and b) Clinical Applications. Both parts are updated and have critically evaluated available automatic sphygmomanometers and portable computers equipped with different techni ques (e. g. , auscultation, oscillometry, plethysmography). Reliability in the intensiv Care unit as well as in outpatients management, common clinical problems, clinical relevance compared to casual blood pressure are described in the first part. In the second part, ten years of experience on fully automated noninvasive methodology - compared to intraarterial techniques - have been elaborated by international experts; the possibilities and limitations are clearly demonstrated. Analyses in different clinical fields in the diagnosis of primary and secondary hypertension are given. Different statistical analyses of blood pressure variability and circadian rhythms are discussed.

Pulse Volume Sensing and Analysis for Advanced Blood Pressure Monitoring

Pulse Volume Sensing and Analysis for Advanced Blood Pressure Monitoring
Author: Keerthana Natarajan
Publisher:
Total Pages: 87
Release: 2021
Genre: Electronic dissertations
ISBN:

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Approximately a quarter of the world's population is affected by high blood pressure (BP). It is a major risk factor for stroke and heart disease, which are leading causes of mortality. Management of hypertension could be improved by increased accuracy and convenience of BP measurement devices. Existing devices are not convenient or portable enough. In this work, we investigate three approaches to improve the accuracy and convenience of BP measurement.A physiologic method was developed to further advance central BP measurement. A patient-specific method was applied to estimate brachial BP levels from a cuff pressure waveform obtained during conventional deflation via a nonlinear arterial compliance model. A physiologically-inspired method was then employed to extract the PVP waveform from the same waveform via ensemble averaging and calibrate it to the brachial BP levels. A method based on a wave reflection model was thereafter employed to define a variable transfer function, which was applied to the calibrated waveform to derive central BP. This method was evaluated against invasive central BP measurements from patients. The method yielded central systolic, diastolic, and pulse pressure bias and precision errors of −0.6 to 2.6 and 6.8 to 9.0mmHg. The conventional oscillometric method produced similar bias errors but precision errors of 8.2 to 12.5mmHg (p≤0.01). The new method can derive central BP more reliably than some current non-invasive devices and in the same way as traditional cuff BP.We then developed an iPhone X application to measure cuff-less BP via the "oscillometric finger pressing method". The user presses her fingertip on both the front camera and screen to increase the external pressure of the underlying artery, while the application measures the resulting variable-amplitude blood volume oscillations via the camera and applied pressure via the strain gauge array under the screen. The application also visually guides the fingertip placement and actuation and then computes BP from the measurements just like many automatic cuff devices. We tested the application, along with a finger cuff device, against a standard cuff device. The application yielded bias and precision errors of −4.0 and 11.4mmHg for systolic BP and −9.4 and 9.7mmHg for diastolic BP (n=18). These errors were near the finger cuff device errors. This proof-of-concept study surprisingly indicates that cuff-less and calibration-free BP monitoring may be feasible with many existing and forthcoming smartphones. Finally, we developed easy-to-understand models relating PPG waveform features to BP changes (after a single cuff calibration) and determined conclusively whether they provide added value or not in BP measurement accuracy. Stepwise linear regression was employed so as to create parsimonious models for predicting the intervention-induced BP changes from popular PPG waveform features, pulse arrival time (PAT, time delay between ECG R-wave and PPG foot), and subject demographics. The finger b-time (PPG foot to minimum second derivative time) and ear STT (PPG amplitude divided by maximum derivative), when combined with PAT, reduced the systolic BP change prediction RMSE of reference models by 6-7% (p

Advances in Blood Pressure Determination Research and Application: 2012 Edition

Advances in Blood Pressure Determination Research and Application: 2012 Edition
Author:
Publisher: ScholarlyEditions
Total Pages: 51
Release: 2012-12-26
Genre: Medical
ISBN: 148161715X

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Advances in Blood Pressure Determination Research and Application / 2012 Edition is a ScholarlyBrief™ that delivers timely, authoritative, comprehensive, and specialized information about Blood Pressure Determination in a concise format. The editors have built Advances in Blood Pressure Determination Research and Application / 2012 Edition on the vast information databases of ScholarlyNews.™ You can expect the information about Blood Pressure Determination in this eBook to be deeper than what you can access anywhere else, as well as consistently reliable, authoritative, informed, and relevant. The content of Advances in Blood Pressure Determination Research and Application / 2012 Edition has been produced by the world’s leading scientists, engineers, analysts, research institutions, and companies. All of the content is from peer-reviewed sources, and all of it is written, assembled, and edited by the editors at ScholarlyEditions™ and available exclusively from us. You now have a source you can cite with authority, confidence, and credibility. More information is available at http://www.ScholarlyEditions.com/.

Photoplethysmography

Photoplethysmography
Author: Panicos A. Kyriacou
Publisher: Academic Press
Total Pages: 508
Release: 2021-11-03
Genre: Technology & Engineering
ISBN: 012823525X

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Photoplethysmography: Technology, Signal Analysis, and Applications is the first comprehensive volume on the theory, principles, and technology (sensors and electronics) of photoplethysmography (PPG). It provides a detailed description of the current state-of-the-art technologies/optical components enabling the extreme miniaturization of such sensors, as well as comprehensive coverage of PPG signal analysis techniques including machine learning and artificial intelligence. The book also outlines the huge range of PPG applications in healthcare, with a strong focus on the contribution of PPG in wearable sensors and PPG for cardiovascular assessment. Presents the underlying principles and technology surrounding PPG Includes applications for healthcare and wellbeing Focuses on PPG in wearable sensors and devices Presents advanced signal analysis techniques Includes cutting-edge research, applications and future directions

ABC of Hypertension

ABC of Hypertension
Author: D. Gareth Beevers
Publisher: John Wiley & Sons
Total Pages: 89
Release: 2010-07-15
Genre: Medical
ISBN: 1405171359

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Hypertension is a condition which affects millions of peopleworldwide and its treatment greatly reduces the risk of strokes andheart attacks. This fully revised and updated edition of the ABCof Hypertension is an established guide providing all thenon-specialist needs to know about the measurement of bloodpressure and the investigation and management of hypertensivepatients. This new edition provides comprehensively updated andrevised information on how and whom to treat. The ABC of Hypertension will prove invaluable to generalpractitioners who may be screening large numbers of patients forhypertension, as well as nurse practitioners, midwives and otherhealthcare professionals.

Manual, Electronic, Or Automated Sphygmomanometers

Manual, Electronic, Or Automated Sphygmomanometers
Author: Association for the Advancement of Medical Instrumentation
Publisher:
Total Pages: 70
Release: 2003-05
Genre: Sphygmomanometers
ISBN: 9781570201837

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