Abstract
The oscillometric fixed-ratio method is widely employed for non-invasive measurement of systolic and diastolic pressures (SP and DP) but is heuristic and prone to error. We investigated the accuracy of this method using an established mathematical model of oscillometry. First, to determine which factors materially affect the errors of the method, we applied a thorough parametric sensitivity analysis to the model. Then, to assess the impact of the significant parameters, we examined the errors over a physiologically relevant range of those parameters. The main findings of this model-based error analysis of the fixed-ratio method are that: (1) SP and DP errors drastically increase as the brachial artery stiffens over the zero trans-mural pressure regime; (2) SP and DP become overestimated and underestimated, respectively, as pulse pressure (PP) declines; (3) the impact of PP on SP and DP errors is more obvious as the brachial artery stiffens over the zero trans-mural pressure regime; and (4) SP and DP errors can be as large as 58 mmHg. Our final and main contribution is a comprehensive explanation of the mechanisms for these errors. This study may have important implications when using the fixed-ratio method, particularly in subjects with arterial disease.
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Acknowledgments
This work was supported by the Telemedicine and Advanced Technology Research Center (TATRC) at the U.S. Army Medical Research and Materiel Command (USAMRMC) through award W81XWH-10-2-0124, a US National Science Foundation CAREER Grant [0643477], and the Natural Sciences and Engineering Research Council of Canada (NSERC).
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Associate Editor Joan Greve oversaw the review of this article.
Jiankun Liu and Jin-Oh Hahn are equally contributing first authors.
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Liu, J., Hahn, JO. & Mukkamala, R. Error Mechanisms of the Oscillometric Fixed-Ratio Blood Pressure Measurement Method. Ann Biomed Eng 41, 587–597 (2013). https://doi.org/10.1007/s10439-012-0700-7
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DOI: https://doi.org/10.1007/s10439-012-0700-7