Evaluation of the linear relationship between pulse arrival time and blood pressure in ICU patients: Potential and limitations

Braiam Escobar-Restrepo, Robinson Torres-Villa, Panayiotis A Kyriacou, Dingchang Zheng (Editor)

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Abstract

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 noninvasive 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.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 noninvasive 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.
Original languageEnglish
Article number1848
Number of pages9
JournalFrontiers in Physiology
Volume9
DOIs
Publication statusPublished - 21 Dec 2018
Externally publishedYes

Bibliographical note

This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms

Keywords

  • pulse arrival time
  • pulse tranist time
  • pulse wave velocity
  • blood pressure
  • intensive care unit

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