Cuffless Noninvasive Continuous Blood Pressure Monitoring Using Superficial Temporal Arterial Tonometry

Objective: Continuous monitoring of blood pressure (BP) is a key parameter for cardiovascular assessment and hemodynamics monitoring. Current noninvasive methods are limited by frequent calibration, motion and environmental artifacts, and delayed response to rapid BP changes. In perioperative and critical-care settings, even short-duration hypotensive episodes and rapid BP lability have been associated with adverse outcomes, motivating technologies with high temporal fidelity. This study introduces a noninvasive blood pressure monitoring technique using superficial temporal artery tonometry (STAT), which employs a biomechanics-based transfer function to improve accuracy, reduce calibration requirements, and detect rapid BP changes in dynamic conditions. Methods: Twenty-nine recording sessions of continuous BP monitoring were collected in human subjects (n [Formula: see text] 10) during rest and during handgrip-induced BP fluctuations. Measurements were recorded simultaneously using the STAT method and compared to a noninvasive reference device (Finapres/Finometer volume-clamp) and Pulse Transit Time (PTT) baseline (derived from timing features) method. Results: Using the Finapres/Finometer as a noninvasive reference, our method achieved a mean absolute difference (MAD) of 4.8 [Formula: see text] 2.2 mmHg during rest and 6.5 [Formula: see text] 3.4 mmHg during handgrips, significantly outperforming PTT, especially under dynamic conditions. Conclusion: BP monitoring with STAT and its biomechanics-based transfer function achieved improved detection of rapid BP fluctuations, and higher accuracy than PTT under dynamic conditions. Significance: STAT with biomechanics-based modeling enables real-time, robust noninvasive BP monitoring, overcoming calibration, motion, and detection limitations of current methods.