Manifestations of the interaction of arterial and venous hemodynamics when measuring blood pressure using the oscillometric technique

Digital devices for measuring blood pressure (BP) using a compression arm cuff, based on the oscillometric method of estimating BP, have been used in clinics and at home for over fifty years. Their operating principle is based on the test occlusion of brachial arteries and the assessment of their response. However, the individual properties of blood vessels and many hemodynamic features of the arm during occlusion are not taken into account. In this pilot study, the dynamics of interaction between the arterial and venous vascular beds of the upper limb during occlusion and decompression of the brachial artery in the course of blood pressure measurement by the standard oscillometric method were analyzed using synchronous recording of sphygmograms and dual-wavelength reflective pulse oximetry signals. It is hypothesized that significant spikes in the pulse oscillation envelope during cuff decompression are due to the autoregulatory response of the microcirculatory system during obstructed venous outflow. It is shown that recorded changes in the time delays between pulse signal fronts during decompression may reflect the transition between different hemodynamic regimes associated with the restoration of arterial inflow, venous outflow, and pulse wave velocity. The obtained results indicate the relevance of developing an expanded three-chamber model of the arm vascular network, as well as the creation of BP-monitors with additional remote sensors for recording peripheral hemodynamic parameters in order to enhance diagnostic capabilities for BP-monitors.

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