Evaluation of the pulse wave arrival time as a marker for blood pressure changes in critically ill infants and children
Abstract
Objective Pulse arrival time (PAT), which is the interval between the R wave of the electrocardiogram (ECG) and the arrival of the pulse wave peripherally, has been reported to be suitable for use as an indirect measure of blood pressure change. The purpose of this study was to evaluate, in critically ill infants and children, the degree to which 1/PAT covaries with systolic, diastolic, and mean blood pressure, as well as heart rate.Methods A laboratory device was used to calculate PAT in real time from the ECG and the plethysmographic curve of pulse oximetry used for routine monitoring. Calculated PAT and corresponding blood pressures and heart rate were stored on hard disk. A total of 15 critically ill patients, aged 6 days to 16 years, weighing 3 to 80 kg, were studied.Results In all patients, one period of 11,000 to 36,000 beats could be evaluated. Mean correlation coefficients were best for systolic blood pressure (r = 0.73), followed by mean blood pressure (r = 0.68) and diastolic blood pressure (r = 0.61), and, finally, heart rate (r = 0.52). In 7 patients, the correlation coefficient for systolic blood pressure was > 0.9; but, in 4 patients, it was < 0.5.Conclusions We conclude that the correlation between 1/PAT and systolic blood pressure is not strong enough to serve as a marker for blood pressure changes in critically ill infants and children. This may be due to changes of the preejection period, which is part of the PAT.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Some studies suggest that the exclusion of the PEP from the PAT may improve correlation with SBP.
“Some studies suggest that the exclusion of the PEP from the PAT may improve correlation with SBP31,32.”
From Skin-interfaced biosensors for advanced wireless physiological monitoring in neonatal and pediatric intensive-care units (2020) · cites this paper as [31]
PAT correlates with blood pressure in infants.
“with prior reports providing evidence that PAT correlates with blood pressure in infants (35–37).”
From Binodal, wireless epidermal electronic systems with in-sensor analytics for neonatal intensive care (2019) · cites this paper as [36]
Cites
Plum, F. (1960) · Archives of Neurology · doi:10.1001/archneur.1960.03840090124020 · Cited by 10,377 · see citing works
Ueber die Fortpflanzungsgeschwindigkeit des Schalles in elastischen Röhren
Korteweg, D. J. (1878) · Annalen der Physik · doi:10.1002/andp.18782411206 · Cited by 376 · see citing works
Influence of vascular smooth muscle on contractile mechanics and elasticity of arteries
Dobrin, P., & Rovick, A. (1969) · American Journal of Physiology-Legacy Content · doi:10.1152/ajplegacy.1969.217.6.1644 · Cited by 322 · see citing works
Pre‐ejection Period: Measuring Beta‐adrenergic Influences Upon the Heart
Newlin, D. B., & Levenson, R. W. (1979) · Psychophysiology · doi:10.1111/j.1469-8986.1979.tb01519.x · Cited by 275 · see citing works
AHMED, S. S., LEVINSON, G. E., SCHWARTZ, C. J., & ETTINGER, P. O. (1972) · Circulation · doi:10.1161/01.cir.46.3.559 · Cited by 241 · see citing works
Pulse Wave Velocity as a Measure of Blood Pressure Change
Gribbin, B., Steptoe, A., & Sleight, P. (1976) · Psychophysiology · doi:10.1111/j.1469-8986.1976.tb03344.x · Cited by 227 · see citing works
Pulse Wave Velocity and Blood Pressure Change: Calibration and Applications
Steptoe, A., Smulyan, H., & Gribbin, B. (1976) · Psychophysiology · doi:10.1111/j.1469-8986.1976.tb00866.x · Cited by 172 · see citing works
Pulse Transit Time: Relationship to Blood Pressure and Myocardial Performance
Obrist, P. A., Light, K. C., McCubbin, J. A., Hutcheson, J. S., & Hoffer, J. L. (1979) · Psychophysiology · doi:10.1111/j.1469-8986.1979.tb02993.x · Cited by 153 · see citing works
Pulse Transit Time and Blood Pressure: An Intensive Analysis
Lane, J. D., Greenstadt, L., Shapiro, D., & Rubinstein, E. H. (1983) · Psychophysiology · doi:10.1111/j.1469-8986.1983.tb00899.x · Cited by 107 · see citing works
THE EFFECT OF BLOOD PRESSURE ALTERATION ON THE PULSE WAVE VELOCITY
Nye, E. R. (1964) · Heart · doi:10.1136/hrt.26.2.261 · Cited by 103 · see citing works
Relationships ol Pulse Transmission Times to Pre‐ejection Period and Blood Pressure
Newlin, D. B. (1981) · Psychophysiology · doi:10.1111/j.1469-8986.1981.tb03042.x · Cited by 89 · see citing works
Relationship between pulse-wave velocity and arterial elasticity
CALLAGHAN, F., Geddes, L. A., Babbs, C. F., & BOURLAND, J. D. (1986) · Medical & Biological Engineering & Computing · doi:10.1007/bf02441620 · Cited by 83 · see citing works
Measurement of pulse-wave velocity using a beat-sampling technique
Pruett, J. D., BOURLAND, J. D., & Geddes, L. A. (1988) · Annals of Biomedical Engineering · doi:10.1007/bf02364622 · Cited by 53 · see citing works
The Covariation of Blood Pressure and Pulse Transit Time in Hypertensive Patients
Allen, R. A., Schneider, J. A., Davidson, D. M., Winchester, M. A., & Taylor, C. B. (1981) · Psychophysiology · doi:10.1111/j.1469-8986.1981.tb03038.x · Cited by 45 · see citing works
Sawayama, T., 落合, 正., Marumoto, S., MATSUURA, T., & Isao, N. I. K. I. (1969) · Circulation · doi:10.1161/01.cir.40.3.327 · Cited by 41 · see citing works
Interpretation of arterial elasticity from measurements of pulse wave velocities
Steele, J. M. (1937) · American Heart Journal · doi:10.1016/s0002-8703(37)90523-4 · Cited by 33 · see citing works
The continuous measurement of arterial pulse wave velocity
Weltman, G., Sullivan, G., & Bredon, D. (1964) · Medical & Biological Engineering & Computing · doi:10.1007/bf02484213 · Cited by 31 · see citing works
The effect of variations in blood‐pressure on pulse wave velocity in the brachial artery in man
Hickson, S. K., & McSwiney, B. A. (1924) · The Journal of Physiology · doi:10.1113/jphysiol.1924.sp002177 · Cited by 24 · see citing works
Effects ot Anesthesia and Related Procedures on Arterial Pressure Wave Arrival Times
HENDERSON, J. B., Rodbard, S., & Morse, H. T. (1972) · Anesthesia & Analgesia · doi:10.1213/00000539-197211000-00028 · Cited by 8 · see citing works
VOLGYESI, G. A., & Shulman, D. (1988) · Anesthesiology · doi:10.1097/00000542-198809010-00325 · Cited by 2 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Binodal, wireless epidermal electronic systems with in-sensor analytics for neonatal intensive care
Chung, H. U., Kim, B. H., Lee, J. Y., Lee, J., Xie, Z., Ibler, E. M., Lee, K., Banks, A., Jeong, J. Y., Kim, J., et al. (2019) · Science · doi:10.1126/science.aau0780 · Cited by 807 · see citing works
Chung, H. U., Rwei, A. Y., Hourlier-Fargette, A., Xu, S., Lee, K., Dunne, E. C., Xie, Z., Liu, C., Carlini, A., Kim, D. H., et al. (2020) · Nature Medicine · doi:10.1038/s41591-020-0792-9 · Cited by 482 · see citing works
Gesche, H., Grosskurth, D., Küchler, G., & Patzak, A. R. (2011) · European Journal of Applied Physiology · doi:10.1007/s00421-011-1983-3 · Cited by 472 · see citing works
Chen, W., Kobayashi, T., Ichikawa, S., Takeuchi, Y., & Togawa, T. (2000) · Medical & Biological Engineering & Computing · doi:10.1007/bf02345755 · Cited by 425 · see citing works
Non-constrained Blood Pressure Monitoring Using ECG and PPG for Personal Healthcare
Yoon, Y.-Z., Cho, J. H., & Yoon, G. (2008) · Journal of Medical Systems · doi:10.1007/s10916-008-9186-0 · Cited by 199 · see citing works
Shin, H., & Min, S. D. (2017) · BioMedical Engineering OnLine · doi:10.1186/s12938-016-0302-y · Cited by 145 · see citing works
Assessment of Non-Invasive Blood Pressure Prediction from PPG and rPPG Signals Using Deep Learning
Schrumpf, F., Frenzel, P., Aust, C., Osterhoff, G., & Fuchs, M. (2021) · Sensors · doi:10.3390/s21186022 · Cited by 146 · see citing works
Naschitz, J. E., Bezobchuk, S., Priselac, R. M., Sundick, S., Dreyfuss, D., Khorshidi, I., Karidis, A., Manor, H., Nagar, M., Peck, E. R., et al. (2004) · Journal of Clinical Monitoring and Computing · doi:10.1007/s10877-005-4300-z · Cited by 114 · see citing works
Ahlstrom, C., Johansson, A., Uhlin, F., Länne, T., & Ask, P. (2005) · Journal of Artificial Organs · doi:10.1007/s10047-005-0301-4 · Cited by 104 · see citing works
Feasibility of cuff-free measurement of systolic and diastolic arterial blood pressure
Masè, M., Mattei, W., Cucino, R., Faes, L., & Nollo, G. (2011) · Journal of Electrocardiology · doi:10.1016/j.jelectrocard.2010.11.019 · Cited by 78 · see citing works
Assessment of deep learning based blood pressure prediction from PPG and rPPG signals
Schrumpf, F., Frenzel, P., Aust, C., Osterhoff, G., & Fuchs, M. (2021) · IEEE/CVF Conference on Computer Vision and Pattern Recognition Workshops (CVPRW) · doi:10.1109/cvprw53098.2021.00423 · Cited by 70 · see citing works
Furtner, M. T., Staudacher, M., Frauscher, B., Brandauer, E., y Rojas, M. M. E., Gschliesser, V., Poewe, W. H., Schmidauer, C., Ritsch‐Marte, M., & Högl, B. (2009) · Sleep Medicine · doi:10.1016/j.sleep.2008.09.011 · Cited by 64 · see citing works
Ochiai, R., Takeda, J., Hosaka, H., Sugo, Y., Tanaka, R., & Soma, T. (1999) · Journal of Clinical Monitoring and Computing · doi:10.1023/a:1009950731297 · Cited by 58 · see citing works
Continuous blood pressure measurement using pulse transit time
Hennig, A., & Patzak, A. R. (2013) · Somnologie - Schlafforschung und Schlafmedizin · doi:10.1007/s11818-013-0617-x · Cited by 58 · see citing works
Kim, S., Song, J., Park, J.-H., Kim, J., Park, Y., & Hwang, G. (2012) · Anesthesia & Analgesia · doi:10.1213/ane.0b013e318270a6d9 · Cited by 54 · see citing works
A Blood Pressure Monitoring Method for Stroke Management
Ma, H. T. (2014) · BioMed Research International · doi:10.1155/2014/571623 · Cited by 46 · see citing works
Integrated Laser Doppler Blood Flowmeter Designed to Enable Wafer-Level Packaging
Kimura, Y., Goma, M., Onoe, A., Higurashi, E., & Sawada, R. (2010) · IEEE Transactions on Biomedical Engineering · doi:10.1109/tbme.2010.2043842 · Cited by 23 · see citing works
Kasbekar, R. S., Ji, S., Clancy, E. A., & Goel, A. (2023) · Scientific Reports · doi:10.1038/s41598-023-34677-9 · Cited by 15 · see citing works
Porta, A., Gasperi, C., Nollo, G., Lucini, D., Pizzinelli, P., Antolini, R., & Pagani, M. (2006) · Medical & Biological Engineering & Computing · doi:10.1007/s11517-006-0042-4 · Cited by 13 · see citing works
Schrumpf, F., Serdack, P. R., & Fuchs, M. (2022) · IEEE/CVF Conference on Computer Vision and Pattern Recognition Workshops (CVPRW) · doi:10.1109/cvprw56347.2022.00236 · Cited by 12 · see citing works
HearBP: Hear Your Blood Pressure via In-ear Acoustic Sensing Based on Heart Sounds
Zhao, Z., Li, F., Xie, Y., Xie, H., Zhang, K., Zhang, L., & Wang, Y. (2024) · IEEE Conference on Computer Communications (INFOCOM) · doi:10.1109/infocom52122.2024.10621249 · Cited by 10 · see citing works
Sifil, A., Bednarz, D., Larive, B., Garcia, M., Lau, S. M., & Paganini, A. E. P. (2003) · ASAIO Journal · doi:10.1097/01.mat.0000093968.20032.69 · Cited by 9 · see citing works
Miao, F., Zhou, B., Liu, Z.-D., Wen, B., Li, Y., & Tang, M. (2021) · Hypertension Research · doi:10.1038/s41440-021-00795-y · Cited by 8 · see citing works
Deshmukh, C. A., Jindal, G. D., Bagal, U. R., & Nagare, G. D. (2022) · MGM Journal of Medical Sciences · doi:10.4103/mgmj.mgmj_23_22 · Cited by 8 · see citing works
Zhang, G., Xu, D., Olivier, N. B., & Mukkamala, R. (2011) · Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) · doi:10.1109/iembs.2011.6091595 · Cited by 7 · see citing works
Douniama, C., Sauter, C. U., & Couronné, R. (2009) · World Congress on Medical Physics and Biomedical Engineering, September 7 - 12, 2009, Munich, Germany · doi:10.1007/978-3-642-03882-2_571 · Cited by 5 · see citing works
Takayanagi, Y., Koike, A., Kubota, H., Wu, L., Nishi, I., Sato, A., Aonuma, K., Kawakami, Y., & Ieda, M. (2020) · Drug Discoveries & Therapeutics · doi:10.5582/ddt.2019.01082 · Cited by 4 · see citing works
Anesthetic Concerns of Children With Skeletal Dysplasia
Theroux, M. C., & Campbell, J. W. (2021) · Neurosurgery Clinics of North America · doi:10.1016/j.nec.2021.09.004 · Cited by 3 · see citing works
Seo, K., Kim, J. S., Ahn, W., Park, K. S., Kim, H. J., Yum, K.-W., & Goo, E.-K. (2007) · Korean Journal of Anesthesiology · doi:10.4097/kjae.2007.53.2.159 · Cited by 2 · see citing works
A new approach for detecting sudden hypotension in hemodialysis by using dual-channel optical system
Heravi, M. A. Y., Golmakani, E., & Joharinia, S. (2016) · Journal of Innovative Optical Health Sciences · doi:10.1142/s1793545816500334 · Cited by 1 · see citing works
Kern, F., & Bernhard, S. (2019) · medRxiv · doi:10.1101/2019.12.19.19015321 · Cited by 1 · see citing works
Essinger, G. (2001) · Deutscher Universitätsverlag eBooks · doi:10.1007/978-3-663-08873-8_2
[A non-contact continuous blood pressure measurement method based on video stream].
Yan, H., Li, X., Zhu, T., Chen, X., Gong, N., & Zhou, Q. (2023) · PubMed Central · doi:10.7507/1001-5515.202211071
Deshmukh, C., Jindal, G. D., & Nagare, G. D. (2025) · Lecture notes in electrical engineering · doi:10.1007/978-981-96-6406-1_10
Revisiting the relationship between pulse transit time and arterial stiffness
Yoshida, M., Dajani, H. R., Bolić, M., & Groza, V. F. (2025) · Pflügers Archiv - European Journal of Physiology · doi:10.1007/s00424-025-03115-2
Rao, R. S., Mishra, A., Panigrahi, A., & Swain, S. (2026) · International Conference on Signal Processing and Communications (SPCOM) · doi:10.1109/spcom71105.2026.11622990
- Authors
- Wippermann, C. F., Schranz, D., & Huth, R. G.
- Affiliations
- Johannes Gutenberg University Mainz (DE)
- ORCID
- Schranz, Dietmar
- Venue
- Journal of Clinical Monitoring
- Published
- 1995-09
- Volume
- 11
- Issue
- 5
- Pages
- 324-328
- ISSN
- 0748-1977 (ISSN-L)
- OpenAlex
- W2046977157
- Cited by
- 36
- References
- 20
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 2 · 2022: 2 · 2021: 4 · 2020: 2 · 2019: 2 · 2017: 1 · 2016: 1 · 2014: 1 · 2013: 1 · 2012: 1
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- The Journal of Clinical Monitoring (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
- Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Keywords
- blood pressure monitoring, critically ill infants, critically ill children, systolic blood pressure, mean arterial pressure, diastolic blood pressure, heart rate, pre-ejection period, hemodynamic monitoring
- MeSH terms
- Adolescent, Blood Pressure, Child, Child, Preschool, Diastole, Heart Rate, Humans, Infant, Infant, Newborn, Pulse, Systole, Critical Illness
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
