Non-invasive monitoring using photoplethysmography technology
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We evaluated the accuracy and precision of a novel non-invasive monitoring device in comparison with conventional monitoring methods used in intensive care units (ICU). The study device was developed to measure blood pressure, pulse rate, respiratory rate, and oxygen saturation, continuously with a single sensor using the photoplethysmographic technique. Patients who were monitored with arterial pressure lines in the ICU were enrolled. Systolic and diastolic blood pressure, pulse rate, respiratory rate, and arterial oxygen saturation were measured continuously for 30 min at 5-min intervals using the conventional methods and the study device. The primary outcome variable was blood pressure. Blood pressure measured by the study device highly correlated with the arterial pressure line values (correlation coefficients > 0.95). Percent errors for systolic, diastolic and mean blood pressures were 2.4% and 6.7% and 6.5%, respectively. Percent errors for pulse rate, respiratory rate and oxygen saturation were 3.4%, 5.6% and 1.4%, respectively. The non-invasive, continuous, multi-parameter monitoring device presented high level of agreement with the invasive arterial blood pressure monitoring, along with sufficient accuracy and precision in the measurements of pulse rate, respiratory rate, and oxygen saturation.
KeywordsNon-invasive Continuous monitoring Blood pressure Photoplethysmography Critically ill patients Single sensor
We thank Mr. Shinji Kondo (K&S Co., Ltd) and Mr. Noriaki Sakakibara (K&S Co., Ltd) for developing the device, and Mr. Yutaka Furukawa, Mr. Minami Nagano, Ms. Eriko Miyazaki, Ms. Shino Tateishi and Ms. Yumiko Yamazaki for supporting data collection.
KT and TN: These authors contributed to the study conceptualization and design, acquisition of data, analysis and interpretation of data, statistical analysis, and drafting and critical revision of the manuscript for important intellectual content. TO and TO: These authors contributed to interpretation of data, drafting and critical revision of the manuscript for important intellectual content. SO: This author contributed to the study conceptualization and critical revision of the manuscript for important intellectual content. All authors read and approved the final manuscript.
This work was supported by AMED (#JPhe1502001) and JSPS KAKENHI (#JP24659232). The funder had no role in the study design, experiments, collection, analysis, interpretation of data, writing of the manuscript, or decision to submit the manuscript for publication.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no competing interests.
- 2.Kause J, Smith G, Prytherch D, Parr M, Flabouris A, Hillman K, Australian and New Zealand Intensive Care Society Clinical Trials Group. A comparison of antecedents to cardiac arrests, deaths and emergency intensive care admissions in Australia and New Zealand, and the United Kingdom—the ACADEMIA study. Resuscitation. 2004;62(3):275–82. https://doi.org/10.1016/j.resuscitation.2004.05.016.CrossRefPubMedGoogle Scholar
- 3.Bleyer AJ, Vidya S, Russell GB, Jones CM, Sujata L, Daeihagh P, Hire D. Longitudinal analysis of one million vital signs in patients in an academic medical center. Resuscitation. 2011;82(11):1387–92. https://doi.org/10.1016/j.resuscitation.2011.06.033.CrossRefPubMedGoogle Scholar
- 15.Wagner JY, Negulescu I, Schofthaler M, Hapfelmeier A, Meidert AS, Huber W, Schmid RM, Saugel B. Continuous noninvasive arterial pressure measurement using the volume clamp method: an evaluation of the CNAP device in intensive care unit patients. J Clin Monit Comput. 2015;29(6):807–13. https://doi.org/10.1007/s10877-015-9670-2.CrossRefPubMedGoogle Scholar
- 16.Kim SH, Lilot M, Sidhu KS, Rinehart J, Yu Z, Canales C, Cannesson M. Accuracy and precision of continuous noninvasive arterial pressure monitoring compared with invasive arterial pressure: a systematic review and meta-analysis. Anesthesiology. 2014;120(5):1080–97. https://doi.org/10.1097/ALN.0000000000000226.CrossRefPubMedGoogle Scholar
- 17.Kondo S, Shimoyama I, Yoshida A, Yoshizaki H, Hayashi F, Nagao K, Oda S. Minimal invasive estimation of blood pressure for continuous monitoring. Chin Med J (Engl). 2008;84:19–25.Google Scholar
- 18.Ruiz-Rodriguez JC, Ruiz-Sanmartin A, Ribas V, Caballero J, Garcia-Roche A, Riera J, Nuvials X, de Nadal M, de Sola-Morales O, Serra J, Rello J. Innovative continuous non-invasive cuffless blood pressure monitoring based on photoplethysmography technology. Intensive Care Med. 2013;39(9):1618–25. https://doi.org/10.1007/s00134-013-2964-2.CrossRefPubMedGoogle Scholar
- 19.O’Brien E, Atkins N, Stergiou G, Karpettas N, Parati G, Asmar R, Imai Y, Wang J, Mengden T, Shennan A, Working Group on Blood Pressure Monitoring of the European Society of Hypertension. European Society of Hypertension International Protocol revision 2010 for the validation of blood pressure measuring devices in adults. Blood Press Monit. 2010;15(1):23–38. https://doi.org/10.1097/MBP.0b013e3283360e98.CrossRefPubMedGoogle Scholar
- 27.AAI. Non-invasive sphygmomanometers-part 2: clinical validation of automated measurement type. Arlington: Association for the Advancement of Medical Instrumentation; 2009. pp. 1–21.Google Scholar