A feasibility study of non-invasive continuous estimation of brachial pressure derived from arterial and venous lines during dialysis
Authors
Stewart, JillWalker, Thomas
Eldehini, Tarek
Horner, Daniela Viramontes
Lucas, Bethany
White, Kelly
Muggleton, Andy
Selby, Nicholas M
Taal, Martin W
Stewart, Paul

Issue Date
2020
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Intradialytic haemodynamic instability is a significant clinical problem, leading to end-organ ischaemia and contributing to morbidity and mortality in haemodialysis patients. Non-invasive continuous blood pressure monitoring is not part of routine practice but may aid detection and prevention of significant falls in blood pressure during dialysis. Brachial blood pressure is currently recorded intermittently during haemodialysis via a sphygmomanometer. Current methods of continuous non-invasive blood pressure monitoring tend to restrict movement, can be sensitive to external disturbances and patient movement, and can be uncomfortable for the wearer. Additionally, poor patient blood circulation can lead to unreliable measurements. In this study we performed an initial validation of a novel method and associated technology via a feasibility study to continuously estimate blood pressure using pressure sensors in the extra-corporeal dialysis circuit, which does not require any direct contact with the person receiving dialysis treatment.\\ The paper describes the development of the measurement system and subsequent \emph{in vivo} patient feasibility study with concurrent measurement validation by \emph{Finapres Nova} experimental physiological measurement device. We identify a mathematical function to describe the relationship between arterial line pressure and brachial artery BP, which is confirmed in the patient study. The methodology presented requires no interfacing to proprietery dialysis machine systems, no sensors to be attached to the patient directly, and to be robust to patient movement during treatment and also to the effects of the cyclical pressure waveforms induced by the hemodialysis pump. This represents a key enabling factor to the development of a practical continuous blood pressure monitoring device for dialysis patients.Citation
Stewart, J., Walker, T., Eldehini, T., Viramontes Horner, D., Lucas, B., White, K., Muggleton, A., Selby, N. M., Taal, M. W., and Stewart, P. (2020). ‘A feasibility study of non-invasive Continuous Estimation of Brachial Pressure Derived from Arterial and Venous Lines During Dialysis’. IEEE Journal of Translational Engineering in Health and Medicine, 9, pp. 1-9.Publisher
IEEEJournal
IEEE Journal of Translational Engineering in Health and MedicineDOI
10.1109/JTEHM.2020.3035988Additional Links
https://ieeexplore.ieee.org/document/9248039https://ieeexplore.ieee.org/xpl/tocresult.jsp?isnumber=6563131
Type
ArticleLanguage
enISSN
2168-2372EISSN
2168-2372ae974a485f413a2113503eed53cd6c53
10.1109/JTEHM.2020.3035988
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