Continuous Non-Invasive Blood Pressure Monitoring: A Methodological Review on Measurement Techniques

Abstract

Continuous measurement of blood pressure is crucial to the assessment of many medical conditions. However, the current clinical gold standard involving an arterial catheter, occluding cuff, and other invasive procedures are performed in hospital settings while home-based devices can provide only intermittent measurement and are not as reliable. Therefore, there is a significant need for continuous non-invasive blood pressure (cNIBP) monitoring in the daily life. Pulse transit time (PTT)/pulse arrival time (PAT)-based blood pressure measurement has proven its potential to address this need. In this article, we present state-of-the-art devices and recent literature related to measurement technologies used in PTT/PAT-based methods for cNIBP monitoring. Various physiological signals which could be used to enable cNIBP in the home setting are categorized into two groups (i.e., proximal waveforms and distal waveforms) and are thoroughly discussed and compared. Given insightful analysis of these waveforms, we highlight their combinations to derive PTT/PAT values for BP measurement then discuss challenges presented from the cuffless and PTT/PAT-based nature of these devices. Finally, we conclude with future directions needed for home-based cNIBP adaptation and present societal broader impacts.