Effect of tissue mechanical properties on cuff-based blood pressure measurements

Lan, Hongzhi; Al‐Jumaily, Ahmed M.; Lowe, Andrew; Hing, Wayne

doi:10.1016/j.medengphy.2011.06.006

Cited by 35 publications

(27 citation statements)

References 14 publications

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“…In the literature, several models for the oscillometric technique have been proposed. This literature can be classified into two categories: (i) the studies that build models to study and test the validity of empirical coefficients for estimation of SBP and DBP from the OMWE [37], [61], [62], [64]- [66], [99]- [102], and (ii) the studies that build models to develop new BP estimation methods [63], [103]- [107].…”

Section: E Model-based Algorithmsmentioning

confidence: 99%

“…In [100]- [102], a finite element upper arm model was developed and clinically validated to study the effect of arm soft tissue, muscle, brachial artery, and humerus mechanical properties on oscillometric measurements. It was shown that the pressure transmission from the external surface of the arm to the tissue surrounding the brachial artery varies longitudinally even if the external pressure is uniformly applied along the arm.…”

Section: ) Arm Soft Tissue Effectmentioning

confidence: 99%

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Oscillometric Blood Pressure Estimation: Past, Present, and Future

Forouzanfar

Dajani

Groza

et al. 2015

IEEE Rev. Biomed. Eng.

156

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The use of automated blood pressure (BP) monitoring is growing as it does not require much expertise and can be performed by patients several times a day at home. Oscillometry is one of the most common measurement methods used in automated BP monitors. A review of the literature shows that a large variety of oscillometric algorithms have been developed for accurate estimation of BP but these algorithms are scattered in many different publications or patents. Moreover, considering that oscillometric devices dominate the home BP monitoring market, little effort has been made to survey the underlying algorithms that are used to estimate BP. In this review, a comprehensive survey of the existing oscillometric BP estimation algorithms is presented. The survey covers a broad spectrum of algorithms including the conventional maximum amplitude and derivative oscillometry as well as the recently proposed learning algorithms, model-based algorithms, and algorithms that are based on analysis of pulse morphology and pulse transit time. The aim is to classify the diverse underlying algorithms, describe each algorithm briefly, and discuss their advantages and disadvantages. This paper will also review the artifact removal techniques in oscillometry and the current standards for the automated BP monitors.

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Section: E Model-based Algorithmsmentioning

confidence: 99%

Section: ) Arm Soft Tissue Effectmentioning

confidence: 99%

Oscillometric Blood Pressure Estimation: Past, Present, and Future

Forouzanfar

Dajani

Groza

et al. 2015

IEEE Rev. Biomed. Eng.

156

View full text Add to dashboard Cite

show abstract

“…Complete artery occlusion is not critical when BP is measured with the oscillometric method because oscillations can also be detected beyond the systolic pressure through the knocking of the pulse at the overinflated bladder wall . Interesting results on the biomechanical basis of oscillometric BP were provided by Han et al using a computational model of the whole upper arm . This study showed that the measured cuff pressure oscillations are a reflection of the entire artery volume change under the cuff thereby presenting a mixture of arterial distension in different closure states during the entire measurement process.…”

Section: The Oscillometric Bp Measurementmentioning

confidence: 99%

“…This study showed that the measured cuff pressure oscillations are a reflection of the entire artery volume change under the cuff thereby presenting a mixture of arterial distension in different closure states during the entire measurement process. One advantage of the oscillometric over the auscultatory measurement was that although the oscillation amplitude was smaller with stiff than with elastic arteries the stiffness variation of the brachial artery did not affect the accuracy of oscillometric BP measurement …”

Section: The Oscillometric Bp Measurementmentioning

confidence: 99%

Cuff challenges in blood pressure measurement

Palatini

Asmar

2018

J of Clinical Hypertension

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The characteristics of the optimal cuff for blood pressure (BP) measurement are still the subject of much debate. The choice of the appropriate cuff in obese individuals depends not only on the arm circumference but also on its shape because a conically shaped arm makes it difficult to fit the cuff to the arm. When a large-size cylindrical cuff is used in conical arms, an overestimation of the true BP is likely to occur with BP discrepancies that may be as large as 10 mm Hg. With the advent of automatic oscillometric devices, the choice of the appropriate cuff became even more controversial because with oscillometric BP measurement the reference point is not the artery occlusion but the oscillometric peak signal. To overcome the problem of miscuffing in obese individuals, special cuffs that can accommodate a wide range of arm sizes have been designed. Using these cuffs, accurate oscillometric BP measurements can be obtained over a wide range of arm circumferences using a unique software algorithm. These wide-range cuffs coupled to oscillometric devices may represent a good option for BP measurement in very obese subjects. However, their reliability should be confirmed in larger populations and different settings.

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“…A tronco‐conical–shaped cuff may be a key component of this instrumentation because it fits better on large, conical arms 28 . In fact, the use of an inappropriately small rectangular cuff can be the source of large errors when BP is measured with the oscillometric method, 28 in which measured cuff pressure oscillations are a reflection of the entire artery volume change under the cuff and does not involve the central section only 29 . Whether validated wrist BP monitors can be an appropriate solution for very obese patients should also be established 19,25 .…”

Section: Bp Measurement In Patients With Large Armsmentioning

confidence: 99%

Techniques for Self‐Measurement of Blood Pressure: Limitations and Needs for Future Research

Palatini

Frick²

2012

J of Clinical Hypertension

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J Clin Hypertens (Greenwich). 2012;14:139–143. ©2012 Wiley Periodicals, Inc. Self blood pressure measurement (SBPM) improves the overall management of hypertension provided it is implemented with methodologic care. This concerns especially the accuracy and technical requirements of blood pressure (BP) measuring devices that should be validated according to internationally accepted protocols. The use of memory‐equipped automatic home monitors is strongly recommended because they reduce observer bias, avoid patients’ misreporting, and allow fully automatic analysis by software. For current use, simple software should be worked out that allow for analysis of readings in an objective manner. Miscuffing is also a frequent source of measurement error in obese arms when oscillometric devices are used. Modern automatic devices can overcome this problem because of special software algorithms that can provide accurate measurements over a wide range of arm circumferences when coupled with a single cuff of standard dimensions. Tronco‐conical–shaped cuffs are a key component of this instrumentation because they better fit on large conical arms frequently present in obese individuals. Semi‐rigid cuffs should be increasingly used because they ensure that the proper amount of tension is applied without the intervention of the user. Continuous technology improvement of instrumentation for SBPM can be achieved through close cooperation between manufacturers and validation centers.

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Effect of tissue mechanical properties on cuff-based blood pressure measurements

Cited by 35 publications

References 14 publications

Oscillometric Blood Pressure Estimation: Past, Present, and Future

Oscillometric Blood Pressure Estimation: Past, Present, and Future

Cuff challenges in blood pressure measurement

Techniques for Self‐Measurement of Blood Pressure: Limitations and Needs for Future Research

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