A Pilot Study of Blood Pressure Monitoring After Cardiac Surgery Using a Wearable, Non-invasive Sensor

Erez Kachel; Keren Constantini; Dean Nachman; Shemy Carasso; Romi Littman; Arik Eisenkraft; Yftach Gepner

doi:10.3389/fmed.2021.693926

A Pilot Study of Blood Pressure Monitoring After Cardiac Surgery Using a Wearable, Non-invasive Sensor

Front Med (Lausanne). 2021 Aug 5:8:693926. doi: 10.3389/fmed.2021.693926. eCollection 2021.

Authors

Erez Kachel^{1

2}, Keren Constantini³, Dean Nachman^{4

5

6}, Shemy Carasso^{1

2}, Romi Littman⁷, Arik Eisenkraft^{4

5

7}, Yftach Gepner³

Affiliations

¹ Division of Cardiac Surgery, Cardiovascular Center, Padeh-Poriya Hospital, Tiberias, Israel.
² Faculty of Medicine, Bar-Ilan University, Ramat Gan, Israel.
³ Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine and Sylvan Adams Sports Institute, Tel Aviv University, Tel Aviv, Israel.
⁴ Institute for Research in Military Medicine, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.
⁵ Israel Defense Force Medical Corps, Tel Aviv, Israel.
⁶ Heart Institute, Hadassah Ein Kerem Medical Center, Jerusalem, Israel.
⁷ Biobeat Technologies Ltd., Petah Tikva, Israel.

Abstract

Background: Continuous blood pressure (BP) measurement in intensive care units is based on arterial line (AL) transducers, sometimes associated with clinical complications. Our objective was to evaluate continuous BP measurements obtained from a non-invasive, wireless photoplethysmography (PPG)-based device using two distinct configurations (wristwatch and chest-patch monitors) compared to an AL. Methods: In this prospective evaluation study, comparison of the PPG-based devices to the AL was conducted in 10 patients immediately following cardiac surgery. Pulse rate (PR), systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP) were recorded using both the AL and the PPG-based devices simultaneously for an average of 432 ± 290 min starting immediately after cardiac surgery. Bland-Altman plots and Pearson's correlations were used to assess the accuracy and degree of agreement between techniques. Results: A total of ~4,000 data points were included in the final analysis. AL measurements for PR, SBP, DBP and MAP were significantly (p < 0.001) and strongly correlated with both the wristwatch (r = 0.99, r = 0.94, r = 0.93 and r = 0.96, respectively) and the chest-patch (r = 0.99, r = 0.95, r = 0.93 and r = 0.95, respectively) monitors. Both configurations showed a marginal bias of <1 mmHg for BP measurements and <1 beat/min for PR [95% limits of agreement -3,3 beat/min; BP measurements: (-6)-(-10), 6-10 mmHg] compared to AL measurements. Conclusion: The PPG-based devices offer a high level of accuracy for cardiac-related parameters compared to an AL in post-cardiac surgery patients. Such devices could provide advanced monitoring capabilities in a variety of clinical settings, including immediate post-operative and intensive care unit settings. Clinical Trial Registration:www.clinicaltrials.gov, NCT03603860.

Keywords: blood pressure; cardiac surgery; mean arterial pressure; non-invasive sensor; wearable.

Associated data

ClinicalTrials.gov/NCT03603860