Yonsei Med J.  2010 May;51(3):345-353. 10.3349/ymj.2010.51.3.345.

Non-Invasive Estimation of Systolic Blood Pressure and Diastolic Blood Pressure Using Photoplethysmograph Components

• Jeong I
• Jun S
• Um D
• Oh J
• Yoon H

• KMID: 1074985
• DOI: http://doi.org/10.3349/ymj.2010.51.3.345

Abstract

PURPOSE
Photoplethysmography (PPG) is a noninvasive optical technology that detects changes in blood volume in the vascular system. This study aimed to investigate the possibilities of monitoring the cardiovascular system status by using PPG.
MATERIALS AND METHODS
Forced hemodynamic changes were induced using cardiac stimulants; dopamine and epinephrine, and PPG components were recorded by a noninvasive method at the peripheral blood vessels. The results were compared among 6 dogs. Endotracheal intubation was performed after an intramuscular injection of 25 mg/kg ketamine sulfate, and anesthesia was maintained with 2% enflurane. After stabilizing the animals for 15 min, 16 mg/mL diluted dopamine was injected into a vein for 2 min at 20 microgram/kg.min(-1) by using an infusion pump. Thereafter, the infusion pump was stopped, and 1 mg epinephrine was injected intravenously. Fluid administration was controlled to minimize preload change in blood pressure.
RESULTS
After stimulant administration, systolic blood pressure (SBP) and diastolic blood pressures (DBP) increased. The direct current (DC) component, which reflects changes in blood volume, decreased while the alternating current (AC) component, which reflects changes in vascular compliance and resistance, increased. The correlation coefficient between SBP and the foot of the DC component was 0.939 (p < 0.01), while it was 0.942 (p < 0.01) for DBP and the peak of the DC component. The AC component could predict the increase in vascular resistance from a stable pulse blood volume, even with increased pulse pressure. Conclusions: These results support the possibility that PPG components may be used for easy and noninvasive measurement of hemodynamic changes in the cardiovascular system.

Keyword

Photoplethysmography; invasive blood pressure; cardiovascular system; blood volume; vascular resistance and compliance; epinephrine; dopamine

MeSH Terms

Animals
Blood Pressure/*physiology
*Blood Pressure Monitors
Dogs/*physiology
Humans
Models, Animal
Photoplethysmography/*methods

Figure

• 

  Fig. 1 (A) Sensor positions in the animal experiment. (B) External view and cross section of contact pressure-fixed type sensor. (C) Flow diagram showing the course of experiment in this study. RA, right arm; LA, left arm; RL, right leg; PPG, photoplethysmograph; LED, light emitting diode.

• 

  Fig. 2 (A) IBP and PPG waveform from animal experimentation. (B) PPG components for analyzing. Just before 23 : 20, dog's tail moved so it caused a temporary fluctuation in PPG components. However, our data analysis focused from Cardiac stimulation. IBP, invasive blood pressure; PPG, photoplethysmograph; DC, direct current; AC, alternating current.

• 

  Fig. 3 Response of blood pressure and heart rate to intravenous infusion and injection of cardiac stimulants. Systolic blood pressure (Systolic) and diastolic blood pressure (Diastolic) were monitored continuously by an invasive method. Heart rate was calculated from ECG. Points represent average values over a 30 sec period. Data shown as mean and SD. *p < 0.05, **p < 0.01: significant increase / decrease. IBP, invasive blood pressure; HR, heart rate; ECG, echocardiogram.

• 

  Fig. 4 Response of PPG components (IT: foot and peak of the DC component of PPG, IS: amplitude of the AC component of PPG) to intravenous infusion and injection of cardiac stimulants. PPG were continuously measured by a non-invasive method, and normalized in order to compare the results of all the subjects under the same conditions. Points represent average values over a 30 sec period. Data shown as mean and SD. *p < 0.05, **p < 0.01: significant increase / decrease. PPG, photoplethysmograph; DC, direct current; AC, alternating current.

• 

  Fig. 5 Relationship between invasive blood pressure (IBP) and the DC component of PPG (IT). (A) Systolic blood pressure vs. foot of the DC component of PPG (ITsys). (B) Diastolic blood pressure vs. peak of the DC component of PPG (ITsys). PPG, photoplethysmograph; DC, direct current.

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