What question did this study set out to answer?

To assess the efficacy of pulse arrival time, pulse transit time, and physiological confounding factors for non-invasive continuous blood pressure estimation.

October 24, 2019SHILAP Revista de lepidopterologíaOpen Access

Analysis of Pulse Arrival Time as an Indicator of Blood Pressure in a Large Surgical Biosignal Database: Recommendations for Developing Ubiquitous Blood Pressure Monitoring Methods

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Why the study?

Most studies estimating BP using PAT or PTT have used small homogeneous subject pools to generate models based on particular interventions.

Does pulse arrival time (PAT) or pulse transit time (PTT) accurately estimate blood pressure in surgical patients?

Population

2309 surgical patients from a large open biosignal database

Comparison

Efficacy of PAT, PTT, and confounding factors on the estimation of BP

Design

Retrospective database analysis

Authors

JLJoonnyong LeeSeoul National University Hospital SYSeung-Man YangSamsung (South Korea)SLSaram LeeSeoul National University Hospital

Discussion

Member takes

Implication

PAT may estimate DBP in surgical patients but not SBP; leaves open clinical adoption pending prospective validation.

Key Points

To assess the efficacy of pulse arrival time, pulse transit time, and physiological confounding factors for non-invasive continuous blood pressure estimation.
Analyzed an open biosignal database consisting of 2,309 diverse surgical patients.
Extracted 6,777,308 paired data points of continuous blood pressure and temporal features derived from electrocardiograms and photoplethysmograms.
Evaluated correlation metrics across pulse feature extraction points and tested linear calibration models against international standards for automatic blood pressure monitors.
Intersecting-tangent pulse arrival time (PAT) demonstrated the highest correlation with blood pressure, yielding mean correlations of -0.37 for systolic BP and -0.30 for diastolic BP.
Pulse transit time (PTT) performed poorly compared to PAT, showing mean correlations of -0.12 for systolic BP and -0.11 for diastolic BP.
A linear calibration model using PAT met international standards for diastolic BP estimation, but failed to meet accuracy standards for systolic BP due to high error rates and inconsistent confounding effects.

Structured PICO

Does pulse arrival time (PAT) or pulse transit time (PTT) accurately estimate blood pressure in surgical patients?

Population

2309 surgical patients from a large open biosignal database

Intervention

Pulse arrival time (PAT) and pulse transit time (PTT) extracted from electrocardiogram (ECG) and photoplethysmogram (PPG)

Comparator

Standard blood pressure measurements

Outcome

Correlation between PAT/PTT and systolic/diastolic blood pressure, and accuracy of a linear model for BP estimationsurrogate

Pulse arrival time outperforms pulse transit time for estimating blood pressure and can predict diastolic blood pressure to international standards, but is insufficient for accurate systolic blood pressure prediction.

Cite This Study

Lee et al. (2019) studied this question.

synapsesocial.com/papers/69d5707d75589c71d767dc85 https://doi.org/10.3390/jcm8111773

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Analysis of Pulse Arrival Time as an Indicator of Blood Pressure in a Large Surgical Biosignal Database: Recommendations for Developing Ubiquitous Blood Pressure Monitoring Methods

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Analysis of Pulse Arrival Time as an Indicator of Blood Pressure in a Large Surgical Biosignal Database: Recommendations for Developing Ubiquitous Blood Pressure Monitoring Methods

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider