Oscillometric sphygmomanometers: a critical appraisal of current technology
Oscillometric sphygmomanometers: a critical appraisal of current technology
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DOI：
10.1097/mbp.0b013e32835026b0
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发表时间：
2012-04-01
影响因子：
1.3
通讯作者：
Amoore, John Nicholas
中科院分区：
文献类型：
--
作者：
Amoore, John Nicholas
目的血压作为一项重要的生命体征，监测着人体的总体健康状况.示波器越来越多地用于测量，尽管其准确性仍然存在争议。一个功能框图是用来审查的组件，影响accuracy.Methods一个框图，涵盖组件从袖带算法。考虑到可能改变其形状的因素，描述了示波器波形。用于评估准确性的方法，包括潜在的使用模拟器，described.Results和讨论框图侧重于袖口，放大器，信号处理和算法。强调了正确袖带尺寸的重要性。准确度可能会受到测量脉冲的提取和补偿更高放气速率的插值的影响。现代电子放大器被假定是稳定的，不会漂移，这一假设在很大程度上未经验证。准确性的关键是算法，但没有标准的算法和有限的理论基础，导致患者组中的显著测量误差，即使是通过批准的设备。原因尚不清楚，但已观察到患者组之间的听诊波形形状差异，并可能解释听诊-听诊差异。理论模型的能力来解释动脉僵硬度对BP测量的影响进行了讨论。验证仍然是统计，虽然已采取措施，以改善它。结论BP测量的间接性质提出了特别的问题，以确保准确性。批判性评估在提高标准方面做了很多工作，但对该技术的坚实理论理解尚未形成，需要进一步的工作。血压监测17：80-88（C）2012年威科健康|利平科特·威廉姆斯和威尔金斯。
Aim Blood pressure (BP), a key vital sign, monitors general health. Oscillometric devices are increasingly used for measurement, although their accuracy continues to be critically debated. A functional block diagram is used to review the components that affect accuracy.Methods A block diagram is presented covering the components from cuff to algorithm. The oscillometric waveform is described, considering factors that can alter its shape. Methods used to assess accuracy, including the potential use of simulators, are described.Results and discussion The block diagram focuses attention on cuff, amplifier, signal processing and algorithm. The importance of correct cuff size is emphasized. Accuracy can be affected by the extraction of the oscillometric pulses and the interpolation to compensate for higher deflation rates. Modern electronic amplifiers are assumed to be stable and do not drift, an assumption largely untested. Crucial to accuracy is the algorithm, but there is no standard algorithm and limited theoretical basis, leading to significant measurement errors in groups of patients, even by approved devices. The causes are not well understood, but differences in oscillometric waveform shape between patient groups have been observed and may explain auscultatory-oscillometric differences. The ability of theoretical models to explain the effects of arterial stiffness on BP measurements is discussed. Validation remains statistical though steps have been taken to improve it.Conclusion The indirect nature of BP measurement poses particularly problems for ensuring accuracy. Critical assessment has done much to improve standards, but a solid theoretical understanding of the technique has not been formulated and further work is required. Blood Press Monit 17:80-88 (C) 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.