Continuous non-invasive remote automated blood pressure monitoring with novel wearable technology: A Validation Study (Preprint)

2020 ◽  
Author(s):  
Michael McGillion ◽  
Nazari Dvirnik ◽  
Stephen Yang ◽  
Emilie Belley-Côté ◽  
Andre Lamy ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Vital Signs ◽  
Standard Of Care ◽  
Non Invasive ◽  
Vital Signs Monitoring ◽  
Measuring Devices ◽  
Cuffless Blood Pressure

BACKGROUND Background: Continuous hemodynamic monitoring is the standard of care for patients intraoperatively, but vital signs monitoring is performed only periodically on post-surgical wards, and patients are routinely discharged home with no surveillance. Wearable continuous monitoring biosensor technologies have the potential to transform postoperative care with early detection of impending clinical deterioration. OBJECTIVE Objective: Our aim was to validate the accuracy of the Cloud DX Vitaliti™ Continuous Vital Signs Monitor (CVSM) continuous non-invasive blood pressure measurements in post-surgical patients. Usability of the Vitaliti™ CVSM was also examined. METHODS Methods: Included patients were recovering from surgery in a cardiac intensive care unit. Validation procedures were according to AAMI - ISO 81060-2 2013 standards for Wearable, Cuffless Blood Pressure Measuring Devices. In static (seated in bed) and supine positons, three 30-second cNIBP measurements were taken for each patient with the Vitaliti™ CVSM and an invasive arterial catheter. The errors of these determinations were calculated. Participants were interviewed about device acceptability RESULTS Results: Data for 21 patients were included in the validation analysis. The overall mean and SD of the errors of determination for the static position were -0.784 mmHg (SD 4.594) for systolic blood pressure and 0.477 mmHg (SD 1.668) for diastolic blood pressure. Errors of determination were slightly higher for the supine position at 3.533 mmHg (SD 6.335) for systolic blood pressure and 3.050 mmHg (SD 3.619) for diastolic blood pressure. The majority rated the Vitaliti™ CVSM as comfortable. CONCLUSIONS Conclusion: The Vitaliti™ CVSM was compliant with AAMI-ISO 81060-2:2013 standards and well-received by patients. CLINICALTRIAL Trial Registration: ClinicalTrials.gov (NCT03493867)

Non-Invasive Cuffless Blood Pressure Monitoring System

2017 ◽  
pp. 174-194
Author(s):  
Harinderjit Singh ◽  
Dilip Kumar
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Pulse Transit Time ◽  
The Body ◽  
Peak Time ◽  
Non Invasive ◽  
Inflatable Cuff ◽  
Measuring Devices ◽  
Cuffless Blood Pressure ◽  
Electrocardiogram Ecg

These days most of the Blood Pressure (BP) measuring devices are having inflatable cuff that is needed to be occluded on the patient's arm for measuring blood pressure. This technique is not suitable in cases where continuous measurement of BP is required. Therefore, this work is aimed at designing of non-invasive and continuously monitors the blood pressure by using Pulse Transit Time (PTT) technique. For taking out PTT both of the signals are extracted from the body of the patient with the help of bio sensors i.e. Electrocardiogram (ECG) sensor and Photoplethysmogram (PPG) sensor. PTT was measured by taking the peak to peak time difference of ECG signal and PPG signal and this PTT is indirectly correlated with blood pressure, based on which Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) is calculated.

A comparison of CAT Doppler and oscillometric Memoprint machines for non-invasive blood pressure measurement in conscious cats

2005 ◽  
Vol 7 (3) ◽  
pp. 147-152 ◽  
Author(s):  
Rosanne E. Jepson ◽  
Vivien Hartley ◽  
Michael Mendl ◽  
Sarah ME Caney ◽  
David J Gould
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Blood Pressure Measurement ◽  
Systemic Hypertension ◽  
Pressure Measurements ◽  
Non Invasive ◽  
Measuring Devices ◽  
Oscillometric Device ◽  
Significant Difference

Indirect blood pressure measurements were compared in 28 conscious cats using Doppler and oscillometric blood pressure-measuring devices. Ten cats were used to compare Doppler measurements between two examiners and 18 cats were used to compare Doppler and oscillometric measurements. The Doppler machine obtained systolic and diastolic blood pressure readings in 100% and 51% of attempts, respectively. With the oscillometric machine, systolic and diastolic blood pressure readings were obtained in 52% of the attempts. With the Doppler, measures of mean systolic blood pressure between two examiners were positively correlated, but there was no correlation for diastolic blood pressure measures. When comparing the results obtained by Doppler and oscillometric machines there was no significant difference between mean systolic blood pressure readings, but the oscillometric machine produced significantly higher estimates of diastolic blood pressure. In both cases, the standard deviations for the oscillometric machine were considerably larger than those for the Doppler machine. The first reading of systolic blood pressure obtained with the Doppler machine was an excellent predictor of the mean of five readings, but this was not so for the oscillometric machine. It took less than 5 min to obtain five readings in 37.5% of cases with the Doppler machine but this was true for only 5% of cases with the oscillometric machine. Two cats with ophthalmological lesions consistent with systemic hypertension were identified. In these two patients, systolic blood pressure measurements were between 200 and 225 mmHg when measured by Doppler, and between 140 and 150 mmHg when measured by the oscillometric machine. This suggests that a lower reference range for normal systolic blood pressure values should be used for the oscillometric device.

scholarly journals Ambulatory blood pressure monitoring changes in hypertensive patients

2019 ◽  
Vol 2 (8) ◽  
pp. 53-57
Author(s):  
V.S. Pasko
Keyword(s):  
Blood Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
Middle Aged ◽  
Hypertensive Patients

The aim of the study was to determine the peculiarities of ABPM indices in middle-aged and elderly hypertensive patients depending on the daily BP profile. Material and methods. Indices of ambulatory blood pressure monitoring were identified in 57 middle-aged patients (45-59 years) (group I) and 43 elderly patients (60-74 years) (group II), who underwent two-week in-patient treatment. The control group consisted of 15 patients for every of the surveyed categories (group III - middle-aged and group IV – elderly respectively) matched with basic by age and gender. Results. We have shown that one of the factors that determines the change in hemodynamics in patients with essential hypertension is age, with the age patients experience the decrease in diastolic blood pressure with steadily increased systolic blood pressure, that should be considered in the prescription of antihypertensive treatment. With age, a gradual increase in systolic blood pressure is associated with the increased aortic stiffness, partially with the increase in collagen and the decrease in elastic fibrils and the formation of isolated systolic hypertension. Thus, it is proved that in the formation of isolated hypertension the growth of pulse blood pressure for more than 60 mm Hg is unfavorable in a development of cerebrovascular events. Pulse arterial blood pressure was stronger risk factor than systolic blood pressure and diastolic blood pressure or average arterial pressure in the elderly. Recently, taking into account age characteristics, all three indices were recognized as comparable predictors at the age of 50-59 years as the transitional period, and at the age of 60-79 years diastolic blood pressure adversely affecting the cardiovascular risk, increased pulse blood pressure prognostically above the level of systolic arterial pressure.

scholarly journals The Effect of Captopril on the Decrease of Systolic and Diastolic Blood Pressure in Hypertension Rat with Kidney Dysfunction Complications

2021 ◽  
Vol 6 (5) ◽  
pp. 21-31
Author(s):  
Aisa Dinda Mitra ◽  
Helmi Arifin ◽  
Harrizul Rivai
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Renal Dysfunction ◽  
Diastolic Blood Pressure ◽  
Enzyme Inhibitor ◽  
Age Groups ◽  
Channel Blockers ◽  
Non Invasive ◽  
Lower Blood ◽  
Histopathologic Findings

The most commonly used antihypertensives in Indonesia vary according to the age of the patient. At the age of 40-60 years, angiotensin-converting enzyme inhibitor (ACEi) and calcium channel blockers (CCBs) are usually given to older patients. All age groups were treated with a combination of CCB and angiotensin receptor blocker (ARB). Captopril is one of the ACE inhibitor classes, and captopril can lower blood pressure, improve renal impairment, and suppress kidney inflammation through the inactivation of NF-κB in hypertensive mice. Hypertension is closely related to renal dysfunction, requiring blood pressure to be lowered to the normotensive range to prevent progressive kidney damage. In the acute reperfusion stage, captopril prevents excessive angiotensin II synthesis, improves renal dysfunction, inhibited intrarenal inflammation, and better histopathologic findings. Most of the renoprotective effects of captopril occur in the acute reperfusion stage. At the same time, captopril significantly reduces NO availability, exacerbates intrarenal hypoxia, and exacerbates oxidative stress. This study aims to determine the effect of captopril on systolic blood pressure and diastolic blood pressure. In this study, all experimental animals were made hypertensive first by inducing 8% NaCl for 21 days given orally. Then the group with renal complications was induced by administering gentamicin for seven days provided intraperitoneally. Blood creatinine levels were measured using a Photometer5010V5 +. Measurement of systolic blood pressure and diastolic blood pressure using the Non-Invasive Blood Pressure (NIBP) instrument. The data from this study were analyzed using two-way ANOVA. The results showed that complications of renal dysfunction in hypertensive rats had a significant effect on reducing systolic blood pressure and diastolic blood pressure (p ˂ 0.05). The administration of captopril at doses of 1.25 mg, 2.5 mg, and 5 mg significantly affected decreased systolic blood pressure and diastolic blood pressure (p ˂ 0.05). Captopril 5 mg dose was the most effective in lowering systolic blood pressure and diastolic blood pressure.

scholarly journals An Automated Blood Pressure Display for Self-Measurement in Patients With Chronic Kidney Disease (iHealth Track): Device Validation Study

10.2196/14702 ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. e14702 ◽  
Author(s):  
Victoria Mazoteras-Pardo ◽  
Ricardo Becerro-De-Bengoa-Vallejo ◽  
Marta Elena Losa-Iglesias ◽  
Daniel López-López ◽  
César Calvo-Lobo ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Public Health Issue ◽  
Global Public Health ◽  
Reference Device ◽  
Device Validation ◽  
Mean Differences

Background Hypertension is a global public health issue and is closely related to chronic kidney disorder (CKD). In people with CKD, strict monitoring of blood pressure is an important part of therapy. Objective The aim of this research was to validate the iHealth Track blood pressure monitoring device for patients with CKD according to the European Society of Hypertension International Protocol 2010 (ESH-IP2). Methods In total, 33 patients who received hemodialysis in Plasencia participated in the study. There were 9 successive measurements made, which conformed to the ESH-IP2. We calculated the differences between the standard reference device (Omron M3 Intellisense) and the test device (iHealth Track) for blood pressure and heart rate values. For 99 total comparisons of paired measurements, we classified differences into various categories (≤5 mmHg, ≤10 mmHg, and ≤15 mmHg for blood pressure; ≤3, ≤5, and ≤8 beats per minute for heart rate). Results In 90 of 99 systolic blood pressure and 89 of 99 diastolic blood pressure comparisons between the devices, measurement differences were within 5 mmHg. In 81 of 99 heart rate comparisons between the devices, measurement differences were within 3 beats per minute. The mean differences between the test and reference standard measurements were 3.27 (SD 2.99) mmHg for systolic blood pressure, 3.59 (SD 4.55) mmHg for diastolic blood pressure, and 2.18 (SD 2.75) beats per minute for heart rate. We also observed that for both systolic and diastolic blood pressure, 31 of 33 participants had at least two of three comparisons between the devices with measurement differences less than 5 mmHg. For heart rate, 28 of 33 patients had at least two of three comparisons between the devices with measurement differences less than 3 beats per minute. Conclusions To our knowledge, this is the first study to show that iHealth Track meets the requirements of the ESH-IP2 in patients with CKD. Therefore, the iHealth Track is suitable for use in renal patients.

Updates in Hemodynamic Monitoring: A Review for Pharmacists

2021 ◽  
pp. 089719002110034
Author(s):  
Chelsea N. Lopez ◽  
Elisabeth M. Sulaica ◽  
Kevin R. Donahue ◽  
Matthew A. Wanat
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Vital Signs ◽  
Hemodynamic Instability ◽  
Cardiac Output Monitoring ◽  
Specific Information ◽  
Pressure Monitoring ◽  
Substantial Impact ◽  
Non Invasive ◽  
Output Monitoring

Vital signs are regularly monitored in hospitalized patients. In the intensive care unit (ICU), traditional non-invasive blood pressure monitoring and telemetry may not provide enough information to determine the etiology of hemodynamic instability or guide intervention. Arterial catheters remain the gold-standard for continuous blood pressure monitoring and are commonly used in ICU patients. Pulmonary artery catheters and central venous catheters are beneficial in select patient populations and provide more advanced and specific information about a patient’s hemodynamics. However, neither are benign and can increase risk of complications such as infection, arrhythmias, pneumothorax and vascular or valvular damage. In the past 10 years, the development of reliable non-invasive (NICOM), or minimally-invasive (MICOM), cardiac output monitoring devices has accelerated. The MICOM devices require an arterial catheter to obtain hemodynamic values, whereas NICOM devices do not require any arterial or venous access. These devices have emerged to be particularly useful in evaluating and managing patients with suspected mixed shock. As these devices become more prevalent, it is imperative that clinical pharmacists become familiar with interpreting this data as it may have a substantial impact on medication selection and optimization. This review will discuss the basics of NICOM and MICOM devices, limitations with these methods of monitoring, and clinical application for pharmacists.

scholarly journals Intraoperative Blood Pressure Monitoring in Obese Patients

2020 ◽  
Author(s):  
Roman Schumann ◽  
Agnes S. Meidert ◽  
Iwona Bonney ◽  
Christos Koutentis ◽  
Wilbert Wesselink ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Lower Leg ◽  
Obese Patients ◽  
Upper Arm ◽  
Better Than

Background The optimal method for blood pressure monitoring in obese surgical patients remains unknown. Arterial catheters can cause potential complications, and noninvasive oscillometry provides only intermittent values. Finger cuff methods allow continuous noninvasive monitoring. The authors tested the hypothesis that the agreement between finger cuff and intraarterial measurements is better than the agreement between oscillometric and intraarterial measurements. Methods This prospective study compared intraarterial (reference method), finger cuff, and oscillometric (upper arm, forearm, and lower leg) blood pressure measurements in 90 obese patients having bariatric surgery using Bland–Altman analysis, four-quadrant plot and concordance analysis (to assess the ability of monitoring methods to follow blood pressure changes), and error grid analysis (to describe the clinical relevance of measurement differences). Results The difference (mean ± SD) between finger cuff and intraarterial measurements was −1 mmHg (± 11 mmHg) for mean arterial pressure, −7 mmHg (± 14 mmHg) for systolic blood pressure, and 0 mmHg (± 11 mmHg) for diastolic blood pressure. Concordance between changes in finger cuff and intraarterial measurements was 88% (mean arterial pressure), 85% (systolic blood pressure), and 81% (diastolic blood pressure). In error grid analysis comparing finger cuff and intraarterial measurements, the proportions of measurements in risk zones A to E were 77.1%, 21.6%, 0.9%, 0.4%, and 0.0% for mean arterial pressure, respectively, and 89.5%, 9.8%, 0.2%, 0.4%, and 0.2%, respectively, for systolic blood pressure. For mean arterial pressure and diastolic blood pressure, absolute agreement and trending agreement between finger cuff and intraarterial measurements were better than between oscillometric (at each of the three measurement sites) and intraarterial measurements. Forearm performed better than upper arm and lower leg monitoring with regard to absolute agreement and trending agreement with intraarterial monitoring. Conclusions The agreement between finger cuff and intraarterial measurements was better than the agreement between oscillometric and intraarterial measurements for mean arterial pressure and diastolic blood pressure in obese patients during surgery. Forearm oscillometry exhibits better measurement performance than upper arm or lower leg oscillometry. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

Innovative continuous non-invasive cuffless blood pressure monitoring based on photoplethysmography technology

2013 ◽  
Vol 39 (9) ◽  
pp. 1618-1625 ◽  
Author(s):  
Juan C. Ruiz-Rodríguez ◽  
Adolf Ruiz-Sanmartín ◽  
Vicent Ribas ◽  
Jesús Caballero ◽  
Alejandra García-Roche ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
Non Invasive ◽  
Cuffless Blood Pressure

scholarly journals Peculiarities of 24 hour ambulatory blood pressure monitoring indices in patients with essential hypertension, stage II of different age groups

2018 ◽  
Vol 1 (4) ◽  
pp. 63-70
Author(s):  
V. S. Pasko
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Age Groups ◽  
Pressure Monitoring

The aim of the study was to determine peculiarities of 24 hour ambulatory blood pressure monitoring indices of patients with essential hypertension, stage II of different age groups. Material and methods. Indices of ambulatory blood pressure monitoring were identified in 57 middle-aged patients (45-59 years) (group I) and 43 elderly patients (60-74 years) (group II), who underwent two-week in-patient treatment. The control group consisted of 15 patients for every of the surveyed categories (group III - middle-aged and group IV – elderly respectively) matched with basic by age and gender. Results. We have shown that one of the factors that determines the change in hemodynamics in patients with essential hypertension is age, with the age patients experience the decrease in diastolic blood pressure with steadily increased systolic blood pressure, that should be considered in the prescription of antihypertensive treatment. With age, a gradual increase in systolic blood pressure is associated with the increased aortic stiffness, partially with the increase in collagen and the decrease in elastic fibrils and the formation of isolated systolic hypertension. Thus, it is proved that in the formation of isolated hypertension the growth of pulse blood pressure for more than 60 mm Hg is unfavorable in a development of cerebrovascular events. Pulse arterial blood pressure was stronger risk factor than systolic blood pressure and diastolic blood pressure or average arterial pressure in the elderly. Recently, taking into account age characteristics, all three indices were recognized as comparable predictors at the age of 50-59 years as the transitional period, and at the age of 60-79 years diastolic blood pressure adversely affecting the cardiovascular risk, increased pulse blood pressure prognostically above the level of systolic arterial pressure.

scholarly journals An Automated Blood Pressure Display for Self-Measurement in Patients With Chronic Kidney Disease (iHealth Track): Device Validation Study (Preprint)

2019 ◽  
Author(s):  
Victoria Mazoteras-Pardo ◽  
Ricardo Becerro-De-Bengoa-Vallejo ◽  
Marta Elena Losa-Iglesias ◽  
Daniel López-López ◽  
César Calvo-Lobo ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Public Health Issue ◽  
Global Public Health ◽  
Reference Device ◽  
Device Validation ◽  
Mean Differences

BACKGROUND Hypertension is a global public health issue and is closely related to chronic kidney disorder (CKD). In people with CKD, strict monitoring of blood pressure is an important part of therapy. OBJECTIVE The aim of this research was to validate the iHealth Track blood pressure monitoring device for patients with CKD according to the European Society of Hypertension International Protocol 2010 (ESH-IP2). METHODS In total, 33 patients who received hemodialysis in Plasencia participated in the study. There were 9 successive measurements made, which conformed to the ESH-IP2. We calculated the differences between the standard reference device (Omron M3 Intellisense) and the test device (iHealth Track) for blood pressure and heart rate values. For 99 total comparisons of paired measurements, we classified differences into various categories (≤5 mmHg, ≤10 mmHg, and ≤15 mmHg for blood pressure; ≤3, ≤5, and ≤8 beats per minute for heart rate). RESULTS In 90 of 99 systolic blood pressure and 89 of 99 diastolic blood pressure comparisons between the devices, measurement differences were within 5 mmHg. In 81 of 99 heart rate comparisons between the devices, measurement differences were within 3 beats per minute. The mean differences between the test and reference standard measurements were 3.27 (SD 2.99) mmHg for systolic blood pressure, 3.59 (SD 4.55) mmHg for diastolic blood pressure, and 2.18 (SD 2.75) beats per minute for heart rate. We also observed that for both systolic and diastolic blood pressure, 31 of 33 participants had at least two of three comparisons between the devices with measurement differences less than 5 mmHg. For heart rate, 28 of 33 patients had at least two of three comparisons between the devices with measurement differences less than 3 beats per minute. CONCLUSIONS To our knowledge, this is the first study to show that iHealth Track meets the requirements of the ESH-IP2 in patients with CKD. Therefore, the iHealth Track is suitable for use in renal patients.

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