Performance of a Cuffless Photoplethysmography-based Device for Continuous Monitoring of Blood Pressure After Cardiac Surgery
2Department of Cardiac Surgery, Leviev Heart and Vascular Center, Chaim Sheba Medical Center, Israel
3Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, USA
4Department of Cardiothoracic Surgery, Tzafon Medical Center, Israel
Introduction:
Blood pressure (BP) measurement is a routine medical procedure, essential for monitoring both hypertension and hypotension, which are linked to high morbidity and mortality. Accurate and convenient BP monitoring remains a challenge, particularly relying on cuff-based devices or invasive measurements in postoperative and intensive care settings. This study aimed to assess the accuracy of BP readings obtained from a novel, cuffless, non-invasive photoplethysmography (PPG)-based chest patch monitor (Biobeat) compared to invasive arterial pressure (IAP) monitoring in cardiac surgery patients.
Methods:
This prospective, single-center study enrolled adults who had undergone cardiac surgery. A PPG-based chest patch was placed on the patients’ chest post-surgery, and the data were compared with simultaneous IAP measurements. Accuracy and agreement between the two methods were evaluated using Bland-Altman plots and Pearson`s correlations.
Results:
Ninety-six patients participated, with BP and heart rate (HR) data available for 88 and 92 patients, respectively. The average patient age was 63.2 years (±12.2), with 33% women. The average monitoring time was 25.6 hours (±17.2). A total of 78,659 systolic BP (SBP) readings, 78,818 diastolic BP (DBP) readings, and 92,544 HR readings were analysed. Excellent correlations were found for SBP (r=0.959), DBP (r=0.973), mean arterial pressure (MAP) (r=0.966), and HR (r=0.962). Bland-Altman analysis showed biases of 0.1 ± 4.8 mmHg for SBP, 0.4 ± 2.1 mmHg for DBP, 0.26 ± 2.6 mmHg for MAP, and 0.15 ± 3.6 beats per minute for HR. 86% of SBP measurements and all DBP readings were within 10 mmHg of the reference values. BP and HR changes measured by IAP were mirrored by the cuffless device.
Conclusion:
The cuffless device demonstrated high accuracy and agreement for BP and HR measurements compared to IAP monitoring in post-cardiac surgery patients. Further studies are required to confirm these findings across various clinical settings and populations using standardized validation protocols for cuffless devices
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