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Intensive Care Medicine
Published in: Intensive Care Medicine 9/2013

01-09-2013 | Original

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

Authors: Juan C. Ruiz-Rodríguez, Adolf Ruiz-Sanmartín, Vicent Ribas, Jesús Caballero, Alejandra García-Roche, Jordi Riera, Xavier Nuvials, Miriam de Nadal, Oriol de Sola-Morales, Joaquim Serra, Jordi Rello

Published in: Intensive Care Medicine | Issue 9/2013

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Abstract

Purpose

To develop and validate a continuous non-invasive blood pressure (BP) monitoring system using photoplethysmography (PPG) technology through pulse oximetry (PO).

Methods

This prospective study was conducted at a critical care department and post-anesthesia care unit of a university teaching hospital. Inclusion criteria were critically ill adult patients undergoing invasive BP measurement with an arterial catheter and PO monitoring. Exclusion criteria were arrhythmia, imminent death condition, and disturbances in the arterial or the PPG curve morphology. Arterial BP and finger PO waves were recorded simultaneously for 30 min. Systolic arterial pressure (SAP), mean arterial pressure (MAP), and diastolic arterial pressure (DAP) were extracted from computer-assisted arterial pulse wave analysis. Inherent traits of both waves were used to construct a regression model with a Deep Belief Network-Restricted Boltzmann Machine (DBN-RBM) from a training cohort of patients and in order to infer BP values from the PO wave. Bland–Altman analysis was performed.

Results

A total of 707 patients were enrolled, of whom 135 were excluded. Of the 572 studied, 525 were assigned to the training cohort (TC) and 47 to the validation cohort (VC). After data processing, 53,708 frames were obtained from the TC and 7,715 frames from the VC. The mean prediction biases were −2.98 ± 19.35, −3.38 ± 10.35, and −3.65 ± 8.69 mmHg for SAP, MAP, and DAP respectively.

Conclusions

BP can be inferred from PPG using DBN-RBM modeling techniques. The results obtained with this technology are promising, but its intrinsic variability and its wide limits of agreement do not allow clinical application at this time.
Appendix
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Metadata
Title
Innovative continuous non-invasive cuffless blood pressure monitoring based on photoplethysmography technology
Authors
Juan C. Ruiz-Rodríguez
Adolf Ruiz-Sanmartín
Vicent Ribas
Jesús Caballero
Alejandra García-Roche
Jordi Riera
Xavier Nuvials
Miriam de Nadal
Oriol de Sola-Morales
Joaquim Serra
Jordi Rello
Publication date
01-09-2013
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 9/2013
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-013-2964-2

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