Hybrid modeling on reconstitution of continuous arterial blood pressure using finger photoplethysmography

The continuous estimation of arterial blood pressure (ABP) waveforms directly from single-channel photoplethysmography (PPG) signals will predictably change the way to monitor blood pressure in the future. This article proposed a new hybrid mathematical model for continuous blood pressure monitoring by investigating the relationship between the finger PPG signal and the radial ABP signal based on a public database. Considering potential damping factors and wave propagation/reflection in blood circulation, we combined the electrical network model with the tube-load model. The optimal range of model parameters was obtained through the system identification method to realize the individualized continuous blood pressure measurements. Compared with the invasive measurement, the hybrid model performed superior blood pressure estimation with high consistency. The estimated ABP waveforms correlated highly with the reference waveforms with an average correlation coefficient of 0.96. The mean absolute error/standard deviation of the estimated systolic blood pressure (SBP), mean arterial blood pressure (MAP), and diastolic blood pressure (DBP) were 3.0/4.4, 2.1/3.0 and 2.1/3.2 mmHg, respectively. The results met the requirements of the Association for the Advancement of Medical Instrumentation (AAMI). The hybrid model is expected to be embedded in small wearable devices to directly estimate the continuous blood pressure waveforms at the radial artery site through the PPG signals, pioneering the synchronous non-sensing monitoring on blood pressure and blood flow.