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  1. Home
  3. High-fidelity Measurement Of Pulse Arrival Time In Critically Ill Children Using Standard Bedside Monitoring Equipment.
  1. Home
  3. High-fidelity Measurement Of Pulse Arrival Time In Critically Ill Children Using Standard Bedside Monitoring Equipment.

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High-fidelity measurement of pulse arrival time in critically ill children using standard bedside monitoring

Ian Ruffolo1, Asad Siddiqui2, Binh Nguyen3

  • 1University of Toronto, Computer Science, Toronto, ON, Canada.

Physiological Measurement
|November 4, 2025

View abstract on PubMed

Summary
This summary is machine-generated.

We developed a new method to accurately measure pulse arrival time (PAT) using standard bedside monitors. This approach corrects for device timing errors, improving blood pressure estimation from electrocardiography (ECG) and photoplethysmography (PPG) signals.

Keywords:
blood pressureclinical monitoringelectrocardiographyphotoplethysmographypulse arrival timequantizationsynchronization

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Area of Science:

  • Biomedical Engineering
  • Clinical Monitoring
  • Cardiovascular Physiology

Background:

  • Pulse arrival time (PAT) correlates with blood pressure and can be measured using electrocardiography (ECG) and photoplethysmography (PPG).
  • Hardware limitations in clinical devices cause timing errors between ECG and PPG signals, hindering accurate PAT measurement.
  • Traditional PAT measurement methods are unreliable due to these confounding hardware-specific factors.

Purpose of the Study:

  • To propose a novel methodology for precise PAT measurement using standard bedside monitoring equipment.
  • To account for confounding factors like digital filtering, clock synchronization, and latency in ECG and PPG signals.
  • To improve the accuracy of blood pressure estimation in clinical settings.

Main Methods:

  • Utilized heart rate variability to synchronize heartbeats across ECG and PPG waveforms.
  • Experimentally profiled timing systems of bedside medical devices to correct temporal artifacts.
  • Modeled temporal uncertainties from finite waveform sample resolution to enhance measurement precision.

Main Results:

  • Applied the methodology to a large dataset of 1.6 million hours of continuous ECG and PPG data from over 10,000 pediatric intensive care unit patients.
  • Demonstrated consistent timing artifacts across the dataset.
  • Showed that accounting for these artifacts yields more accurate PAT distributions across different age groups.

Conclusions:

  • The proposed methodology enables precise PAT measurements from routine clinical signals, overcoming hardware-induced timing errors.
  • This work facilitates more reliable blood pressure monitoring using non-invasive bedside equipment.
  • Encourages standardization of PAT measurement techniques in clinical environments.