A Literature Review on Current and Proposed Technologies of Noninvasive Blood Pressure Measurement.

BACKGROUND Noninvasive continuous blood pressure (BP) measurement has become an evolving topic in the field of remote healthcare. The classical noninvasive BP measurement techniques provide spontaneous values of systolic and diastolic BP. On the other hand, intrusive type BP measurement techniques provide continuous values of systolic and diastolic BP. However, these techniques are very painful, cannot be used for long-term monitoring, and are obtainable only in an intensive care unit environment. With the advancement of the remote healthcare industry, there is a growing demand for noninvasive continuous BP monitoring. OBJECTIVE The objective of this research was to present a compact literature review on the various prospective approaches of noninvasive continuous BP measurement techniques. MATERIALS & METHODS The most contemporary and advanced technologies on noninvasive continuous BP measurement are Tactile Sensing, Vascular Unloading Technique, Pulse Transit Time, Photoplethysmography, Ultrasound-based BP measurement, BP measurement from image processing, etc. The literature search based on these technologies was conducted in EMBASE, Web of Science, IEEE, PubMed, and Ovid MEDLINE databases. In this study, each selected approach was evaluated and characterized using the following criteria: (1) accuracy; (2) cost; (3) portability; (4) comfort and convenience of use; (5) clinical health and safety; and (6) ability to integrate with the remote healthcare system. RESULTS A detailed technical analysis was done to determine the advantages and limitations of each technique in the context of the abovementioned parameters. It was observed that BP measurement, using photoplethysmography (using camera or sensor or both), perhaps was the most promising technique among all. CONCLUSION The study emphasized the fact that the noninvasive, continuous BP measurement technique needs to evolve further to make it reliable, accurate, and user-friendly. Lastly, a possible direction toward a more reliable and comfortable noninvasive continuous BP measurement technique has been discussed.

[1]  Josef Börcsök,et al.  Modeling a safety-related system for continuous non-invasive blood pressure monitoring , 2013, 2013 IEEE Biomedical Circuits and Systems Conference (BioCAS).

[2]  L. A. Geddes,et al.  Pulse arrival time as a method of obtaining systolic and diastolic blood pressure indirectly , 1981, Medical and Biological Engineering and Computing.

[3]  T. Chakravarty,et al.  Bio-optical modeling of human skin to eliminate the skin structure variability in blood pressure measurement , 2016, 2016 2nd International Conference on Advances in Electrical, Electronics, Information, Communication and Bio-Informatics (AEEICB).

[4]  Dingchang Zheng,et al.  Effect of respiration on Korotkoff sounds and oscillometric cuff pressure pulses during blood pressure measurement , 2014, Medical & Biological Engineering & Computing.

[5]  C. Laurent,et al.  Non-invasive measurement of systolic blood pressure on the arm utilising photoplethysmography: development of the methodology , 2006, Medical and Biological Engineering and Computing.

[6]  A. Tajik,et al.  Noninvasive measurement of central vascular pressures with arterial tonometry: clinical revival of the pulse pressure waveform? , 2010, Mayo Clinic proceedings.

[7]  U. Kertzscher,et al.  Continuous blood pressure measurement with ultrasound , 2012, Biomedizinische Technik. Biomedical engineering.

[8]  S. Tanaka,et al.  Ambulatory instrument for monitoring indirect beat-to-beat blood pressure in superficial temporal artery using volume-compensation method , 2006, Medical and Biological Engineering and Computing.

[9]  T. Togawa,et al.  Continuous estimation of systolic blood pressure using the pulse arrival time and intermittent calibration , 2000, Medical and Biological Engineering and Computing.

[10]  Ram Dantu,et al.  Cuffless Differential Blood Pressure Estimation Using Smart Phones , 2013, IEEE Transactions on Biomedical Engineering.

[11]  Alan D. Lopez,et al.  A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010 , 2012, The Lancet.

[12]  S. Mahankali,et al.  A comparison of a continuous noninvasive arterial pressure (CNAP™) monitor with an invasive arterial blood pressure monitor in the cardiac surgical ICU. , 2012, Annals of cardiac anaesthesia.

[13]  C. Deakin,et al.  Accuracy of the advanced trauma life support guidelines for predicting systolic blood pressure using carotid, femoral, and radial pulses: observational study , 2000, BMJ : British Medical Journal.

[14]  Tim Lüth,et al.  Continuous blood pressure monitor with wireless interface , 2010, 2010 IEEE International Conference on Robotics and Biomimetics.

[15]  M. Malaki,et al.  Effect of Peripheral Edema on Oscillometric Blood Pressure Measurement , 2014, Journal of cardiovascular and thoracic research.

[16]  Alexander Hapfelmeier,et al.  Noninvasive continuous versus intermittent arterial pressure monitoring: evaluation of the vascular unloading technique (CNAP device) in the emergency department , 2014, Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.

[17]  T. Westhoff,et al.  Diagnostic Use of Sonography in the Evaluation of Hypertension , 2013 .

[18]  H. Shimazu,et al.  Electric impedance cuff for the indirect measurement of blood pressure and volume elastic modulus in human limb and finger arteries , 2006, Medical and Biological Engineering and Computing.

[19]  Chiyul Yoon,et al.  Ferroelectret film-based patch-type sensor for continuous blood pressure monitoring , 2014 .

[20]  Zane T. Macfarlane,et al.  Validation of the Instant Blood Pressure Smartphone App. , 2016, JAMA Internal Medicine.

[21]  Survi Kyal,et al.  Toward Ubiquitous Blood Pressure Monitoring via Pulse Transit Time: Theory and Practice , 2015, IEEE Transactions on Biomedical Engineering.

[22]  M Arditi,et al.  Non-invasive estimate of the mechanical properties of peripheral arteries from ultrasonic and photoplethysmographic measurements. , 1991, Clinical physics and physiological measurement : an official journal of the Hospital Physicists' Association, Deutsche Gesellschaft fur Medizinische Physik and the European Federation of Organisations for Medical Physics.

[23]  K. Yamakoshi,et al.  Long-term ambulatory monitoring of indirect arterial blood pressure using a volume-oscillometric method , 1985, Medical and Biological Engineering and Computing.

[24]  G. V. van Montfrans,et al.  Oscillometric blood pressure measurement: progress and problems , 2001, Blood pressure monitoring.

[25]  Uldis Rubins,et al.  Finger and ear photoplethysmogram waveform analysis by fitting with Gaussians , 2008, Medical & Biological Engineering & Computing.

[26]  Roger G. Mark,et al.  Continuous cardiac output monitoring by peripheral blood pressure waveform analysis , 2006, IEEE Transactions on Biomedical Engineering.

[27]  R. Nowak,et al.  Noninvasive continuous or intermittent blood pressure and heart rate patient monitoring in the ED. , 2011, The American journal of emergency medicine.

[28]  M. Y. Mashor,et al.  A portable continuous blood pressure monitoring kit , 2011, 2011 IEEE Symposium on Business, Engineering and Industrial Applications (ISBEIA).

[29]  S. Tanaka,et al.  Electrical admittance cuff for non-invasive and simultaneous measurement of haematocrit, arterial pressure and elasticity using volume-oscillometric method , 1994, Medical and Biological Engineering and Computing.