Biomedical Systems Research Laboratory, School of Electrical Engineering and Telecommunications, University of NSW, Sydney, NSW, Australia.
PLoS One. 2018 Aug 6;13(8):e0201123. doi: 10.1371/journal.pone.0201123. eCollection 2018.
We present a robust method for testing and calibrating the performance of oscillometric non-invasive blood pressure (NIBP) monitors, using an industry standard NIBP simulator to determine the characteristic ratios used, and to explore differences between different devices. Assuming that classical auscultatory sphygmomanometry provides the best approximation to intra-arterial pressure, the results obtained from oscillometric measurements for a range of characteristic ratios are compared against a modified auscultatory method to determine an optimum characteristic ratio, Rs for systolic blood pressure (SBP), which was found to be 0.565. We demonstrate that whilst three Chinese manufactured NIBP monitors we tested used the conventional maximum amplitude algorithm (MAA) with characteristic ratios Rs = 0.4624±0.0303 (Mean±SD) and Rd = 0.6275±0.0222, another three devices manufactured in Germany and Japan either do not implement this standard protocol or used different characteristic ratios. Using a reference database of 304 records from 102 patients, containing both the Korotkoff sounds and the oscillometric waveforms, we showed that none of the devices tested used the optimal value of 0.565 for the characteristic ratio Rs, and as a result, three of the devices tested would underestimate systolic pressure by an average of 4.8mmHg, and three would overestimate the systolic pressure by an average of 6.2 mmHg.
我们提出了一种稳健的方法来测试和校准基于示波法的无创血压（NIBP）监测仪的性能，使用行业标准的 NIBP 模拟器来确定所使用的特征比，并探索不同设备之间的差异。假设经典的听诊法血压测量最接近动脉内压，我们将一系列特征比的示波测量结果与改良听诊法进行比较，以确定收缩压（SBP）的最佳特征比 Rs，结果为 0.565。我们证明，虽然我们测试的三种中国制造的 NIBP 监测仪使用传统的最大幅度算法（MAA），特征比 Rs = 0.4624±0.0303（Mean±SD）和 Rd = 0.6275±0.0222，但另外三种在德国和日本制造的设备要么不执行此标准协议，要么使用不同的特征比。使用包含 102 名患者的 304 个记录的参考数据库，其中包含柯氏音和示波波形，我们发现测试的设备中没有一个使用特征比 Rs 的最佳值 0.565，因此，测试的三个设备将平均低估收缩压 4.8mmHg，而三个设备将平均高估收缩压 6.2mmHg。
