Clinical Compendium - Cuffless ABPM
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Clinical Compendium - Cuffless ABPM - 1

Blood Pressure Measurement using PTT . Compendium Non-invasive | continuous | non-reactive

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Clinical Compendium - Cuffless ABPM - 3

CARDIO diagnostics A division of SOMNOmedics

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1. LONG-TERM BLOOD PRESSURE MEASUREMENTS 2. LONG-TERM BP MEASUREMENTS ACCORDING TO RIVA-ROCCI – 6 IS THE METHOD STILL STATE-OF-THE-ART? 3. THE CONTINUOUS, NON-REACTIVE BP MEASUREMENT USING PULSE TRANSIT TIME (PTT) Recording of BP using the PTT Method 5. SOMNOtouch™ NIBP APPLICATIONS 24h Ambulatory BP Measurement ▶ Blood Pressure Analysis during Daytime ▶ Blood Pressure analysis during Sleep ▶ Clinical relevance: Nocturnal Blood Pressure Fluctuations (NBPFTM) and Superposition ▶ Clinical relevance: Nocturnal Blood Pressure and Restless Leg Syndrome Extended Diagnosis ▶ Oximetry Blood...

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7. ADVANTAGES OF THE SOMNOTOUCH™ NIBP COMPARED TO THE 26 CUFF-BASED METHOD 8. APPLICATION NOTES AND TROUBLESHOOTING Application of the SOMNOtouch™ NIBP Validation of the SOMNOtouch™ NIBP according to ESH International Protocol Comparison of the PTT Method against the CUFF-BASED Method: during ERGOMETRY Comparison of the PTT Method against the CUFF-BASED Method: over 24 HOURS Comparison of the PTT Method against the PENAZ-Method Comparison of the PTT Method against the INVASIVE Blood Pressure Recording: DOBUTAMINE Comparison of the PTT Method against an INVASIVE Blood Pressure Recording:...

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LONG-TERM BLOOD PRESSURE MEASUREMENTS Arterial hypertension (high blood pressure) is a very common disease - affecting approximately 30% of the world‘s population (1). High blood pressure is one of the main risk factors for cardiovascular diseases, such as coronary heart disease, heart attack, stroke and peripheral artery disease. Often, however, arterial hypertension is a symptomless condition making detection of the disease more difficult. The current European guidelines (ESH / ESC Guidelines 2018) recommend, in addition to the formerly recommended in-office blood pressure (BP)...

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Normally, in a healthy person, the BP during the night can drop by between 10% to 20% of the daytime average BP (Dipper; 4). Patients in whom the nocturnal BP drop is less pronounced (Non-Dipper) or in whom BP even rises during the night (Inverted Dipper) have an increase in cardiovascular morbidity and mortality. It is only possible to record this important BP behavior at night with a 24h ABPM measurement. Additionally, ABPM allows the exclusion of the so-called in-office hypertension (“whitecoat hypertension“). Here, high levels of BP are only measured in a medical environment like the...

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LONG-TERM BP MEASUREMENTS ACCORDING TO RIVA-ROCCI – IS THE METHOD STATE-OF-THE-ART? The cuff-based method for measuring BP was introduced in 1896 by Scipione Riva-Rocci. Until today, long-term BP measurements are usually carried out with automated devices based on this method. Thereby, recordings are taken four times per hour during the day and twice per hour during the night (10 pm - 6 am). The established cuff devices were designed for the following conditions: 1) 2) 3) 4) 5) The measurement should be performed after 5 minutes at rest. Patients should be in a relaxed sitting position with...

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THE CONTINUOUS, NON-REACTIVE BP MEASUREMENT USING PULSE TRANSIT TIME (PTT) The PTT (pulse transit time) describes the time a pulse pressure wave needs to cover the distance between two points within the arterial system – in our case from the left ventricle of the heart (defined by the R-peak of the ECG) – to the fingertip (detected by the plethysmograph). By using the distance (d = running distance from the heart to the fingertip) the pulse wave velocity (PWV) can be determined from the PTT: PWV directly depends on the elasticity modulus (also stiffness) of the blood vessel (E): The...

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Recording of BP using the PTT Method The calculation of systolic (SBP) and diastolic blood pressure (DBP) is based on a nonlinear correlation between BP (in mmHg) and PTT (in ms) (5). The PTT method is patented (6) and clinically validated. A validation according the ESH International Protocol (revision 2010) is also available (7). Measuring the PTT is a simple method for determining a persons blood pressure. As such, the interval between the R-wave of the ECG and the arrival of the corresponding pulse wave at the peripheral site (the finger) is measured. The turning point of the finger...

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A one-point calibration during the ongoing recording is used to correlate the PTT, the BP and the vessel properties. By adding the patient‘s height (to determine the running distance of the pulse wave), an accurate SBP and DBP value can be calculated for each PTT value. Beat-to-Beat determination of SBP and DBP by one-point calibration from systolic and diastolic PTT.

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The SOMNOtouch™ NIBP is an ambulatory Blood Pressure (BP) device for continuous, non-invasive and non-reactive determination of SBP and DBP with a recording duration of up to 24h. By simultaneously recording ECG and finger plethysmogram (including oxygen saturation), the PTT can be calculated by the software. The exact values for SBP and DBP are also displayed on the colour touch screen display. The SOMNOtouch™ NIBP device. Application of sensors for SOMNOtouch™ NIBP. More than just an ambulant BP recording device  Syst./diast. BP, beat-to-beat  3-channel ECG  SpO2, Pulse rate  12-Bit...

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AREAS OF APPLICATION FOR THE SOMNOtouch™ NIBP The SOMNOtouch™ NIBP allows three simultaneously routine examinations:  The simultaneous recording of different vital parameters provides a more precise pathophysiological profile of the patient in one procedure. It has the additional benefit of reducing costs as well as minimising stress for the patient. With the SOMNOtouch™ NIBP a continuous, beat-to-beat, systolic and diastolic BP reading over 24h can be performed. In general, the BP represents a highly fluctuating vital parameter which should not be examined separately from other vital...

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Blood Pressure Analysis during Daytime Simultaneous recording of BP and motoric activity allows a differentiation between physically and psychogenically triggered BP increases. Increase of heart rate (HR) and BP (Systolic/Diastolic) due to motoric activity. Blood Pressure analysis during Sleep With the help of the sleep/wake analysis (8), BP values can be assigned to periods of sleep or wake and can be considered for analysis. BP (Systol/ Diastol) during sleep, sleep/wake determination via recorded activity and body position. Example measurement of a patient with several wake phases during...

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