Study of Validity and Intra-rater Reliability of a New Noninvasive Continuous Blood Pressure Monitor (KKU-KMITL NICBP) in Cardiovascular Model and Human

Main Article Content

นนทนัตถ์ สถาพร
วัจนารัตน์ พันธ์วงค์
พงศธร วังพิลา
กิติพล ชิตสกุล
ชุลี โจนส์


Background and Objective: A new noninvasive continuous blood pressure monitor (KKU-KMTL NICBP) has been developed using applanation tonometry principle and force sensing resistor. This study aimed to evaluate the validity, reliability of measurement in a cardiovascular model and intra-rater reliability in human.

Methods: Fluid pressure was measured continuously and simultaneously by KKU-KMITL NICBP and a standard pressure monitor while increasing the fluid circulating into the model 5 steps from 0.1-0.5 ml, and at constant volume of 0.1 ml, every 10 seconds 10 minutes a time, 10 times. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded every minute for 10 minutes a time 2 times in 10 healthy volunteers (aged 23.09±1.45 years). Validity and reliability of measurements were analyzed by comparison, Pearson correlation coefficient (r) and intra-class correlation coefficient (ICC), coefficient of variation (CV) and mean difference between 2 measurements of Bland-Altman method.

Results: The results show no differences in pressure measured by the both monitors and has high correlation coefficient (r=0.997) in the model. The reliability of measurements was very good with ICC=0.998.  Intra-rater reliability in human were good with ICC, CV were 0.825, 9.03 % for SBP and 0.775, 9.73% for DBP respectively. The mean difference between 2 measurements of SBP was 1.70 ± 3.86 mmHg and of DBP 0.7 ± 4.50 mmHg.

Conclusions: It is concluded that a new KKU-KMITL NICBP has a high validity and reliability of measurement in a cardiovascular model and good intra-rater reliability of blood pressure measurement in man. Further study is warrant.  


Download data is not yet available.

Article Details

Original Articles


1. Romagnoli S, Ricci Z, Quattrone D, Tofani L, Tujjar O, Villa G, et al. Accuracy of invasive arterial pressure monitoring in cardiovascular patients: an observational study. Crit Care 2014; 18: 644.
2. Esper SA, Pinsky MR. Arterial waveform analysis. Best Pract Res Clinl Anaesthesiol 2014; 28: 363-80.
3. Safdar N, O'Horo JC, Maki DG. Arterial catheter-related bloodstream infection: incidence, pathogenesis, risk factors and prevention. J Hosp Infect 2013; 85:189-95.
4. Scheer B, Perel A, Pfeiffer UJ. Clinical review: complications and risk factors of peripheral arterial catheters used for haemodynamic monitoring in anaesthesia and intensive care medicine. Crit care 2002; 6:199-204.
5. Peter L, Noury N, Cerny M. A review of methods for non-invasive and continuous blood pressure monitoring: Pulse transit time method is promising? IRBM. 2014; 35:271-82.
6. Pickering TG, Hall JE, Appel LJ, Falkner BE, Graves J, Hill MN, et al. Recommendations for blood pressure measurement in humans and experimental animals: part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Circulation 2005; 111: 697-716.
7. Dueck R, Goedje O, Clopton P. Noninvasive continuous beat-to-beat radial artery pressure via TL-200 applanation tonometry. J Clin Monit Comput 2012; 26: 75-83.
8. Meidert AS, Huber W, Hapfelmeier A, Schofthaler M, Muller JN, Langwieser N, et al. Evaluation of the radial artery applanation tonometry technology for continuous noninvasive blood pressure monitoring compared with central aortic blood pressure measurements in patients with multiple organ dysfunction syndrome. J Crit care 2013; 28: 908-12.
9. Saugel B, Fassio F, Hapfelmeier A, Meidert AS, Schmid RM, Huber W. The T-Line TL-200 system for continuous non-invasive blood pressure measurement in medical intensive care unit patients. Intensive Care Med 2012; 38: 1471-7.
10. Saugel B, Meidert AS, Hapfelmeier A, Eyer F, Schmid RM, Huber W. Non-invasive continuous arterial pressure measurement based on radial artery tonometry in the intensive care unit: a method comparison study using the T-Line TL-200pro device. Br J Anaesth 2013; 111: 185-90.
11. Ariyadamrongkwan C, Chitsakul K, Treetriluxana S. Continuous non-invasive blood pressure monitoring based on applanation tonometry. JICTEE-2014 Proceedings of the 4th Joint International Conference on Information and Communication Technology, Electronic and Electrical Engineering; 2014 Mar 3-5 Chiang Rai, Thailand. New Jersey: Institute of Electrical and Electronics Engineers (IEEE); 2014: 1-4.
12. Wang J, Liu S, Chern C, Hsieh J. Development of an arterial applanation tonometer for detecting arterial blood pressure and volume. Biomed EngAppl Basis Commun 2004; 16: 322-30.
13. Shioya k, Dohi T. Blood pressure measurement device based on the arterial tonometry method with micro triaxial force sensor. 2013 Transducers & Eurosensors XXVII: Proceedings of the 17th International Conference on Solid-State Sensors, Actuators and Microsystems; 2013 Jun 16-20 Barcelona, Spain. New Jersey: Institute of Electrical and Electronics Engineers (IEEE); 2013: 2389-92.
14. Tomczuk K, Werszko M, Sasiadek JZ, Kosek J, Berny W, Weiser A, et al. Development of a tonometric sensor for measurement and recording of arterial pressure waveform. Rev SciInstrum 2013; 84: 3-9.
15. Kim EG, Nam KC, Heo H, Huh Y. Development of an arterial tonometer sensor. EMBC 2009: Proceedings of Annual International Conference of the IEEE Engineering in Medicine and Biology Society; 2009 Sept 3-6 Minneapolis, USA. New Jersey: Institute of Electrical and Electronics Engineers (IEEE); 2009: 3771-4.
16. Lee B, Jeong J, Kim J, Kim B, Chun K. Cantilever arrayed blood pressure sensor for arterial applanation tonometry. IET nanobiotechnology 2014; 8: 37-43.
17. Choudhury MI, Singh P, Juneja R, Tuli S, Deepak KK, Prasad A, et al. A novel modular tonometry-based device to measure pulse pressure waveforms in radial artery. J Med Devices. 2018; 12: 1-10.
18. Tsang S, Sperling SA, Park MH, Helenius IM, Williams IC, Manning C. Blood Pressure Variability and Cognitive Function Among Older African Americans: Introducing a New Blood Pressure Variability Measure. Cogn Behav Neurol 2017; 30: 90-7.
19. Wan Y, Heneghan C, Stevens R, McManus R, Ward A, Perera R, et al. Determining which automatic digital blood pressure device performs adequately: a systematic review. J Hum Hypertens 2010; 24: 431-8.
20. Swami A, Spodick DH. Pulsusparadoxus in cardiac tamponade: a pathophysiologic continuum. Clin Cardiol 2003; 26: 215-7.
21. Michard F. Changes in arterial pressure during mechanical ventilation. Anesthesiology 2005; 103: 419-28.