ABSTRACT
OBJECTIVE: One promising approach for a continuous, noninvasive, cuff-less ambulatory blood pressure (BP) monitor is to measure the pulse wave velocity or the inversely proportional pulse transit time (PTT), based on electrical and optical physiological measurements in the chest area. A device termed IsenseU-BP+ has been developed for measuring continuous BP, as well as other physiological data. The objective of this paper is to present results from the first clinical evaluation with a wide range of patients. The study was set up to verify whether IsenseU-BP+ can be used to measure raw signals with sufficient quality to derive PTT. Methods: The test protocol, run 23 times on 18 different patients with nonalcoholic fatty liver disease, includes both supine measurement at rest as well as measurements during indoor cycling. Changes in PTT were compared with the BP changes measured using validated reference sensors. Results: IsenseU-BP+ measured signals with good quality during rest on 17 of 18 patients despite the high diversity in age, body shape, and body mass index. Evaluation during cycling was difficult due to a lack of good reference measurements. CONCLUSION: IsenseU-BP+ measures PTT with high quality during supine rest and exercise and could therefore be suitable for deriving noninvasive continuous BP, although evaluation during exercise was limited due to inaccurate reference BP measurements. SIGNIFICANCE: Continuous, noninvasive measurement of BP would be highly beneficial in a number of clinical settings. Systems currently considered as the gold standard for the investigation of hypertension carry considerable limitations, which could be overcome by the method proposed here.
Subject(s)
Blood Pressure Determination/instrumentation , Hypertension/diagnosis , Monitoring, Ambulatory/instrumentation , Non-alcoholic Fatty Liver Disease/diagnosis , Plethysmography, Impedance/instrumentation , Pulse Wave Analysis/instrumentation , Adult , Aged , Blood Pressure Determination/methods , Electrocardiography, Ambulatory/instrumentation , Equipment Design , Equipment Failure Analysis , Female , Humans , Hypertension/etiology , Hypertension/physiopathology , Male , Middle Aged , Monitoring, Ambulatory/methods , Non-alcoholic Fatty Liver Disease/complications , Non-alcoholic Fatty Liver Disease/physiopathology , Pilot Projects , Pulse Wave Analysis/methods , Reproducibility of Results , Sensitivity and Specificity , SphygmomanometersABSTRACT
Sensor-based monitoring of congestive heart-failure (CHF) patients living at home can improve quality of care, detect exacerbations of disease at an earlier stage and motivate the patient for better self care. This paper reports on a usability study of the ESUMS system that provides continuous measurements of heart rate, activity, upper body posture and skin temperature via a sensor belt and a smartphone as patient terminal. Five CHF patients were included in the trial, all recently discharged from hospital. The nurses experienced continuous heart rate, activity and posture monitoring as useful and objective tools that helped them in their daily assessment of patient health. They also saw the system as an important educational tool to help patients gain insight into their own condition. Three patients liked that they could have a view of their own physiological and activity data, however the smartphones used in the study turned out to be too complicated for the patients to operate. A smartphone is built to be a multi-purpose device, and this may (conceptually and practically) be incompatible with the patients' demands for ease of use.
