Electronics and Medical Signal Processing, Technical University of Berlin, Berlin, Germany.
Research Group 'Patient Care Solutions', Philips Research Europe, Eindhoven, The Netherlands.
Biomed Tech (Berl). 2021 Feb 10;66(3):231-245. doi: 10.1515/bmt-2020-0209. Print 2021 Jun 25.
Arterial blood pressure is one of the most often measured vital parameters in clinical practice. State-of-the-art noninvasive ABP measurement technologies have noticeable limitations and are mainly based on uncomfortable techniques of complete or partial arterial occlusion by cuffs. Most commonplace devices provide only intermittent measurements, and continuous systems are bulky and difficult to apply correctly for nonprofessionals. Continuous cuffless ABP measurements are still an unmet clinical need and a topic of ongoing research, with only few commercially available devices. This paper discusses surrogate-based noninvasive blood pressure measurement techniques. It covers measurement methods of continuously and noninvasively inferring BP from surrogate signals without applying external pressures, except for reference or initialization purposes. The BP is estimated by processing signal features, so called surrogates, which are modulated by variations of BP. Discussed techniques include well-known approaches such as pulse transit time and pulse arrival time techniques, pulse wave analysis or combinations thereof. Despite a long research history, these methods have not found widespread use in clinical and ambulatory practice, in part due to technical limitations and the lack of a standardized regulatory framework. This work summarizes findings from an invited workshop of experts in the fields covering clinical expertise, engineering aspects, commercialization and standardization issues. The goal is to provide an application driven outlook, starting with clinical needs, and extending to technical actuality. It provides an outline of recommended research directions and includes a detailed overview of clinical use case scenarios for these technologies, opportunities, and limitations.
动脉血压是临床实践中最常测量的生命参数之一。最先进的无创动脉血压测量技术有明显的局限性，主要基于袖带完全或部分动脉阻塞的不舒适技术。大多数常见的设备仅提供间歇性测量，而连续系统体积庞大，非专业人员难以正确应用。连续无袖带动脉血压测量仍然是一个未满足的临床需求，也是一个正在进行的研究课题，只有少数商业上可用的设备。本文讨论了基于替代的无创血压测量技术。它涵盖了在不施加外部压力（仅用于参考或初始化目的）的情况下，通过替代信号连续和无创地推断血压的测量方法。通过处理信号特征来估计血压，这些信号特征称为替代物，它们受血压变化的调制。讨论的技术包括众所周知的方法，如脉搏传导时间和脉搏到达时间技术、脉搏波分析或它们的组合。尽管有很长的研究历史，但这些方法尚未在临床和动态实践中得到广泛应用，部分原因是技术限制和缺乏标准化的监管框架。这项工作总结了涵盖临床专业知识、工程方面、商业化和标准化问题领域的专家邀请研讨会的研究结果。目的是从临床需求出发，以应用为导向，提供概述。它还概述了推荐的研究方向，并详细介绍了这些技术的临床用例场景、机会和局限性。
