A new automated toe blood pressure monitor for assessment of limb ischemia

Abstract

Objective: Toe blood pressure (TBP) is an important method to assess peripheral arterial disease especially in patients with diabetes, but remains difficult to measure. We have developed a simple portable device for TBP measurements. Methods and results: First, TBP was determined in 40 ischemic legs with both laser Doppler and photoplethysmography for perfusion monitoring, to assess if laser Doppler can be used for measurements. The median values recorded were identical, but slightly higher values were obtained with laser Doppler (p = 0.03). Secondly, a computer based algorithm for automatic TBP readings with laser Doppler was compared to manual assessment in 28 legs of 20 patients. The median values differed 3 mmHg (p = 0.10). Finally the applicability of the new device was tested in eight legs of six patients by two nurses. Conclusion: Laser Doppler is appropriate for perfusion monitoring during TBP measurements and automatic pressure readings seem accurate. The automatic portable device is simple to use and can probably determine TBP. © 2002 Elsevier Science Ltd. All rights reserved.