{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:17:02Z","timestamp":1760235422664,"version":"build-2065373602"},"reference-count":24,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2021,8,19]],"date-time":"2021-08-19T00:00:00Z","timestamp":1629331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Eindhoven MedTech Innovation Center (e\/MTIC).","award":["Eindhoven MedTech Innovation Center (e\/MTIC)."],"award-info":[{"award-number":["Eindhoven MedTech Innovation Center (e\/MTIC)."]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>In standard critical care practice, cuff sphygmomanometry is widely used for intermittent blood pressure (BP) measurements. However, cuff devices offer ample possibility of modulating blood flow and pulse propagation along the artery. We explore underutilized arrangements of sensors involving cuff devices which could be of use in critical care to reveal additional information on compensatory mechanisms. In our previous work, we analyzed the response of the vasculature to occlusion perturbations by means of observations obtained non-invasively. In this study, our aim is to (1) acquire additional insights by means of invasive measurements and (2) based on these insights, further develop cuff-based measurement strategies. Invasive BP experimental data is collected downstream from the cuff in two patients monitored in the OR. It is found that highly dynamic processes occur in the distal arm during cuff inflation. Mean arterial pressure increases in the distal artery by 20 mmHg, leading to a decrease in pulse transit time by 20 ms. Previous characterizations neglected such distal vasculature effects. A model is developed to reproduce the observed behaviors and to provide a possible explanation of the factors that influence the distal arm mechanisms. We apply the new findings to further develop measurement strategies aimed at acquiring information on pulse arrival time vs. BP calibration, artery compliance, peripheral resistance, artery-vein interaction.<\/jats:p>","DOI":"10.3390\/s21165593","type":"journal-article","created":{"date-parts":[[2021,8,19]],"date-time":"2021-08-19T09:58:06Z","timestamp":1629367086000},"page":"5593","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Modulation of Pulse Propagation and Blood Flow via Cuff Inflation\u2014New Distal Insights"],"prefix":"10.3390","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5512-7306","authenticated-orcid":false,"given":"Laura I.","family":"Bogatu","sequence":"first","affiliation":[{"name":"Department of Electrical Engineering, Eindhoven University of Technology, 5612AZ Eindhoven, The Netherlands"},{"name":"Philips Research, 5656AE Eindhoven, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simona","family":"Turco","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering, Eindhoven University of Technology, 5612AZ Eindhoven, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1179-5385","authenticated-orcid":false,"given":"Massimo","family":"Mischi","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering, Eindhoven University of Technology, 5612AZ Eindhoven, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars","family":"Schmitt","sequence":"additional","affiliation":[{"name":"Philips Research, 5656AE Eindhoven, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7073-0573","authenticated-orcid":false,"given":"Pierre","family":"Woerlee","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering, Eindhoven University of Technology, 5612AZ Eindhoven, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik","family":"Bresch","sequence":"additional","affiliation":[{"name":"Philips Research, 5656AE Eindhoven, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerrit J.","family":"Noordergraaf","sequence":"additional","affiliation":[{"name":"Elisabeth-TweeSteden Hospital, 5022GC Tilburg, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Igor","family":"Paulussen","sequence":"additional","affiliation":[{"name":"Philips Research, 5656AE Eindhoven, The Netherlands"},{"name":"Elisabeth-TweeSteden Hospital, 5022GC Tilburg, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arthur","family":"Bouwman","sequence":"additional","affiliation":[{"name":"Catharina Ziekenhuis, 5623EJ Eindhoven, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hendrikus H. M.","family":"Korsten","sequence":"additional","affiliation":[{"name":"Catharina Ziekenhuis, 5623EJ Eindhoven, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens","family":"Muehlsteff","sequence":"additional","affiliation":[{"name":"Philips Research, 5656AE Eindhoven, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,8,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Bresch, E., Muehlsteff, J., and Schmitt, L. (2017). Cuff-induced changes of pulse arrival time: Models and experimental results. EMBEC & NBC 2017 IFMBE, Springer.","DOI":"10.1007\/978-981-10-5122-7_26"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"105492","DOI":"10.1016\/j.cmpb.2020.105492","article-title":"A modelling framework for assessment of arterial compliance by fusion of oscillometry and pulse wave velocity information","volume":"196","author":"Bogatu","year":"2020","journal-title":"Comput. Methods Programs Biomed."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/cc10291","article-title":"Clinical review: Update on hemodynamic monitoring\u2014A consensus of 16","volume":"15","author":"Vincent","year":"2011","journal-title":"Crit. Care"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Yan, Y.S., and Zhang, Y.T. (December, January 29). A model-based calibration method for noninvasive and cuffless measurement of arterial blood pressure. Proceedings of the 2006 IEEE Biomedical Circuits and Systems Conference, London, UK.","DOI":"10.1109\/BIOCAS.2006.4600351"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Yan, Y.S., and Zhang, Y.T. (2007, January 19\u201322). A novel calibration method for noninvasive blood pressure measurement using pulse transit time. Proceedings of the 2007 4th IEEE\/EMBS International Summer School and Symposium on Medical Devices and Biosensors, Cambridge, UK.","DOI":"10.1109\/ISSMDBS.2007.4338283"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1007\/BF02368225","article-title":"Theory of the oscillometric maximum and the systolic and diastolic detection ratios","volume":"22","author":"Drzewiecki","year":"1994","journal-title":"Ann. Biomed. Eng."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1161\/01.CIR.100.1.41","article-title":"In Vivo Human Brachial Artery Elastic Mechanics","volume":"100","author":"Bank","year":"1999","journal-title":"Circulation"},{"key":"ref_8","first-page":"1","article-title":"Oscillometric measurement of systolic and diastolic blood pressures validated in a physiologic mathematical model","volume":"56","author":"Babbs","year":"2012","journal-title":"BioMed. Eng. OnLine"},{"key":"ref_9","unstructured":"Philips (2021, August 17). 2021 Patient Monitoring Systems|Philips Healthcare. Available online: https:\/\/www.philips.nl\/healthcare\/solutions\/patientbewaking\/clinical-measurement-modules."},{"key":"ref_10","unstructured":"Edwards (2021, June 07). TruWave Pressure Transducers|Edwards Lifesciences. Available online: https:\/\/www.edwards.com\/devices\/pressure-monitoring\/transducer."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1007\/BF02443739","article-title":"Interpretation of venous occlusion plethysmographic measurements using a simple model","volume":"22","author":"Seagar","year":"1984","journal-title":"Med. Biol. Eng. Comput."},{"key":"ref_12","unstructured":"Seshadri, R. (2019). Venous Hemodynamics, Elsevier. [2nd ed.]. Chapter 2."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Rothe, C. (2011). Venous System: Physiology of the Capacitance Vessels. Compr. Physiol., 397\u2013452.","DOI":"10.1002\/cphy.cp020313"},{"key":"ref_14","unstructured":"Smink, J., Bogatu, L., Muehlsteff, J., and Bresch, E. (2019, January 11\u201316). Dynamic MRI visualization of the brachial artery during upper arm inflations. Proceedings of the Meeting of ISMRM, Montreal, QC, Canada."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Bogatu, L., Muehlsteff, J., Bresch, E., Smink, J., and Woerlee, P.H. (2019, January 23\u201327). Insights into oscillometry: An Experimental Study for Improvement of Cuff-Based Blood Pressure Measurement Technology. Proceedings of the 2019 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society, Berlin, Germany.","DOI":"10.1109\/EMBC.2019.8856994"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1080\/10255840600985477","article-title":"Can the modified Allen\u2019s test always detect sufficient collateral flow in the hand? A computational study","volume":"9","author":"Alastruey","year":"2006","journal-title":"Comput. Methods Biomech. Biomed. Eng."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1097\/ALN.0b013e3181672607","article-title":"Venous Function and Central Venous Pressure: A Physiologic Story","volume":"108","author":"Gelman","year":"2008","journal-title":"Anesthesiology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1097\/MCC.0b013e3283378185","article-title":"Bedside assessment of mean systemic filling pressure","volume":"16","author":"Jansen","year":"2010","journal-title":"Curr. Opin. Crit. Care"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1452","DOI":"10.1007\/s00134-012-2586-0","article-title":"Estimation of mean systemic filling pressure in postoperative cardiac surgery patients with three methods","volume":"38","author":"Maas","year":"2012","journal-title":"Intensive Care Med."},{"key":"ref_20","unstructured":"Kruschke, J. (2011). Doing Bayesian Data Analysis, Academic Press."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1109\/TIM.2020.3023218","article-title":"An Experimental Study on the Blood Pressure Cuff as a Transducer for Oscillometric Blood Pressure Measurements","volume":"70","author":"Bogatu","year":"2020","journal-title":"IEEE Trans. Instrum. Meas."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1186\/cc3927","article-title":"Functional hemodynamic monitoring","volume":"9","author":"Pinsky","year":"2005","journal-title":"Crit. Care"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/S0002-8703(03)00094-2","article-title":"Assessment of peripheral vascular endothelial function with finger arterial pulse wave amplitude","volume":"146","author":"Kuvin","year":"2003","journal-title":"Am. Heart J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.ccc.2014.08.005","article-title":"Functional Hemodynamic Monitoring","volume":"31","author":"Pinsky","year":"2015","journal-title":"Crit. 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