Investigation of Narrow-Width Cuffs for Wearable Upper-Arm Oscillometric Monitoring of Blood Pressure

Karmen-Chan, Asha

Etd

Investigation of Narrow-Width Cuffs for Wearable Upper-Arm Oscillometric Monitoring of Blood Pressure

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Blood pressure (BP) is one of the four vital signs used to assess the clinical situation of a patient. Abnormalities in BP can be indicative of underlying conditions and serious illnesses. There are two standard ways of measuring BP in a clinical environment: arterial catheterization and oscillometry. Arterial catheterization is an invasive procedure that provides beat-to-beat BP readings. Oscillometric BP measurement is a non-invasive inflatable-cuff-based measurement that provides intermittent BP readings. Multiple shortcomings associated with current BP technology have prompted a new wave of research focused on wearable, non-invasive, continuous BP monitoring. Wearable, continuous BP monitoring has significant potential for both ambulatory and in-hospital care. It has the capacity to improve at-home monitoring and management of hypertension and to enable earlier detection and intervention during in-hospital clinical deterioration. In clinical settings wearable technology could also significantly reduce nursing workload and improve the frequency of intermittent BP measurement. Wearable BP systems are relatively simple, but estimation of BP is complicated by issues with sensor positioning and can be distorted by unpredictable interactions with the cardiovascular, respiratory, and autonomic nervous systems. Because of these complications, current wearable technologies are not standard for in-hospital use. To improve wearable BP systems, this study proposes modifications to the oscillometric method for upper arm BP measurement; in the past, this avenue has been overlooked for creating wearable technology. The oscillometric cuff is a clinically-acceptable simple and standard method for measuring BP in both clinical and ambulatory settings. Modifications to the standard oscillometric cuff could allow for wearable, cuff-based BP monitoring. This study examines the feasibility of a narrow BP cuff for low-profile, wearable BP measurement. To assess feasibility, three BP estimation algorithms were compared and corrected to justify the use of a narrow-width cuff for wearable devices. If a low-volume cuff could be fabricated it would permit a faster inflation and deflation period compared to the standard oscillometric cuff. This could minimize patient discomfort during BP measurement, increase response clinician response time to changes in BP, and reduce rest time between BP readings. With these capabilities, a wearable oscillometric cuff could provide a method for near-continuous, wearable BP measurement.

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