Theoretical analysis of non-invasive oscillometric maximum amplitude algorithm for estimating mean blood pressure

A theoretical analysis is performed to evaluate the effect of arterial mechanical and blood pressure pulse properties on the accuracy of non-invasive oscillometric maximum amplitude algorithm (MAA) estimates of the mean blood pressure obtained using air-filled occlusive cuffs. Invasively recorded blood pressure pulses, selected for their varied shapes, are scaled to simulate a wide range of blood pulse pressures (diastolic blood pressure minus systolic blood pressure). Each scaled blood pressure pulse is transformed through an exponential model of an artery to create a series of blood volume pulses from which a simulated oscillometric waveform is created and the corresponding MAA estimate of the mean blood pressure and error (mean blood pressure minus MAA estimate) are determined. The MAA estimates are found to depend on the arterial blood pressure. The errors are found to depend on the arterial mechanical properties, blood pressure pulse shape and blood pulse pressure. These results suggest that there is no direct relationship between the mean blood pressure and MAA estimate, and that multiple variables may affect the accuracy of MAA estimates of the mean blood pressure obtained using air-filled occlusive cuffs.