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Pulse transit time: validation of blood pressure measurement under positive airway pressure ventilation

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Abstract

Purpose

The objective of the present study was to validate noninvasive, continuous blood pressure (BP) measurement using pulse transit time (PTT) to represent absolute values and detect BP changes under continuous positive airway pressure (CPAP) treatment.

Methods

We applied CPAP to 78 patients of a cardiological sleep lab using 0 (baseline), 4, 8, and 12 cmH2O for 10 min at every level and measured BP simultaneous via PTT-based method and standard oscillometric method (OM).

Results

Quality of signal perception was acceptable to convert PTT into BP values in 64 patients (82%). When comparing both methods, we found a strong linear correlation of systolic and diastolic BP (baseline, r = 0.94 for systolic BP; r = 0.95 for diastolic BP, p < 0.001) while no significant differences between absolute values obtained with OM and PTT measurement. Mean bias at baseline was 4.1 ± 3.2 mmHg for systolic BP and 2.3 ± 2.2 mmHg for diastolic BP. With increasing CPAP levels, PTT and OM measurements differed continuously up to a systolic difference of 6.6 ± 4.9 mmHg and a diastolic difference of 4.4 ± 3.5 mmHg. There was no definite trend of PTT method to either over- or underestimate BP.

Conclusions

We found that PTT- and OM-based BP results are closely correlated while applying CPAP over a period of 40 min. With higher CPAP level, bias between both methods increased.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Cardiology, Heart and Diabetes Centre North Rhine-Westphalia, University Hospital, Ruhr-University Bochum, Georgstrasse 11, 32545, Bad Oeynhausen, Germany

    Heidi Schmalgemeier, Thomas Bitter, Stephan Bartsch, Kevin Bullert, Thomas Fischbach, Siegfried Eckert, Dieter Horstkotte & Olaf Oldenburg

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  1. Heidi Schmalgemeier
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  2. Thomas Bitter
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  3. Stephan Bartsch
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  4. Kevin Bullert
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  5. Thomas Fischbach
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  6. Siegfried Eckert
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  7. Dieter Horstkotte
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  8. Olaf Oldenburg
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Correspondence to Olaf Oldenburg.

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Schmalgemeier, H., Bitter, T., Bartsch, S. et al. Pulse transit time: validation of blood pressure measurement under positive airway pressure ventilation. Sleep Breath 16, 1105–1112 (2012). https://doi.org/10.1007/s11325-011-0609-7

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  • DOI: https://doi.org/10.1007/s11325-011-0609-7

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