Wearable Multi-modality Cuffless Blood Pressure Monitoring

可穿戴多模态无袖血压监测

• 批准号: 10588138
• 负责人: QUAN ZHANG
• 金额: $ 54.28万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-01 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10588138
• 关键词: Academia; Accidents; Algorithms; Anesthesia procedures; Annual Reports; Arterial Lines; Benchmarking; Blood; Blood Pressure; Blood Pressure Monitors; Brain; Cardiac Surgery procedures; Catheters; Clinical; Continuity of Patient Care; Data; Databases; Development; Electrocardiogram; Ensure; Evaluation; Finite Element Analysis; Future; Goals; Heart; Hypertension; Hypotension; Impairment; Individual; Industry; Infection; Intensive Care Units; Intervention; Investigation; Kidney; Machine Learning; Measurement; Measures; Methods; Monitor; Operative Surgical Procedures; Organ; Outcome; Pain; Patient Monitoring; Patient Monitoring System; Patients; Performance; Perioperative; Physiologic pulse; Postoperative Period; Process; Pulse Oximetry; Risk; Signal Transduction; Site; Stream; System; Technology; Temporal Arteries; Testing; Time; Transport Process; United States; United States National Institutes of Health; Work; data format; data fusion; data privacy; data sharing; deep learning; experience; feature extraction; high risk; improved; indexing; infection risk; invention; light weight; monitoring device; mortality; multimodality; novel; patient privacy; portability; privacy protection; public database; recurrent neural network; sensor; surgical risk; technology development; tonometry; ultrasound

Abstract Continuous blood pressure (BP) is one of the most critical monitoring parameters during anesthesia, surgery and in intensive care units (ICU). Both hypotension and hypertension can impair the function of vital organs (e.g. brain, heart and kidneys), and intraoperative hypotension is associated with postoperative mortality, which makes it important to detect BP changes as quickly as possible to prompt timely intervention or therapy. However, the current gold standard technology for BP monitoring, an invasive arterial line (a-line), causes patient suffering (physical pain) and increases the risk of infection. In the United States, about 80,000 blood stream infections caused by an arterial catheter are reported annually. Due to the inherent risks associated with a-line, it is used only for clinically indicated high risk surgeries or ICU patients. As a result of the a-line risks and discomforts, even though more than 300 million surgeries are performed worldwide each year, only a small portion receive continuous BP monitoring. In addition, although vital sign (ECG, pulse oximetry, BP etc) monitoring is routine in surgical rooms and ICUs, currently most monitoring devices are fixed in individual rooms, which result in gaps in patient monitoring, accidents during patient transport process, and extra work to disconnect and reconnect sensors when leaving and entering a new facility. Seamless “continuum of care” monitoring—for instance from surgical room to ICUs, including transport in between and without reconnecting sensors—is on top of the wish list by clinician. In recent years, efforts have been made to develop portable ECG monitors and “mobile ICUs”; however so far, no continuous and seamless BP monitoring has been achieved. This proposal fully leverages the outcomes from the related R21 (EB022271) project. We will develop novel machine learning and deep learning based data fusion algorithms to use existing vital signs for continuous BP monitoring, then integrate them with our unique wearable patient monitoring system to form a novel perioperative patient monitoring system. We will test the system’s performance against gold standard a- line and Finapres BP technologies. to develop a fully functional technology for noninvasive, continuous, and seamless BP monitoring. We will also develop a public database for future BP technology development. The proposed multimodality algorithms, seamless BP monitoring system and PhysioNet database will provide major steps forward to meet the clinical need for noninvasive continuous BP monitoring.

抽象的 连续血压（BP）是麻醉期间最关键的监测参数之一 和重症监护病房（ICU）。低血压和高血压都会损害重要器官的功能 （例如大脑，心脏和肾脏），术中低血压与术后死亡率有关 使尽可能快地检测BP更改以提示及时干预或治疗非常重要。 但是，目前用于BP监测的黄金标准技术（一种侵入性动脉线（A-Line））导致 患者痛苦（身体疼痛）并增加感染的风险。在美国，大约80,000血 每年报告由手工艺品引起的溪流感染。由于继承风险相关 使用A线，它仅用于临床指示的高风险手术或ICU患者。由于A线的结果 即使全世界在全球进行超过3亿手术，但只有风险和不适感 小部分接收连续的BP监控。另外，虽然生命体征（ECG，脉搏血氧饱和度，BP等） 监测是手术室和ICU中的常规 房间，导致患者监测差距，患者运输过程中的事故以及额外的工作 离开并进入新设施时断开并重新连接传感器。无缝的“护理连续体” 监视 - 例如，从外科室到ICU，包括在之间和不重新连接的情况下运输 传感器 - 临床上的愿望清单之上。近年来，已经努力开发便携式 ECG监视和“移动ICU”；但是到目前为止，尚无连续和无缝的BP监控 成就了。该提案完全利用了相关R21（EB022271）项目的结果。我们将 开发新颖的机器学习和基于深度学习的数据融合算法，以使用现有的生命体征 连续的BP监控，然后将它们与我们独特的可穿戴患者监控系统集成在一起，以形成 新颖的周期性患者监测系统。我们将根据金标准A-测试系统的性能 线路和Finapres BP技术。为无创，连续和 无缝的BP监控。我们还将为未来的BP技术开发开发一个公共数据库。这 建议的多模式算法，无缝的BP监视系统和Physionet数据库将提供 向前迈进的主要步骤满足了对无创的连续BP监测的临床需求。