Estimation of the central arterial pressure waveform and beat-to-beat stroke volume from multiple peripheral arterial pressure waveforms

We introduce a new technique to estimate the clinically more relevant central arterial pressure (AP) waveform and relative beat-to-beat changes in stroke volume (SV) from multiple, less invasively measured peripheral AP waveforms distorted by wave reflections. The basic idea is to first reconstruct the central AP waveform by applying multi-channel blind system identification and to then estimate beat-to-beat proportional SV by fitting a Windkessel model to the reconstructed waveform in which wave distortion should be attenuated. We evaluated the technique in four swine in which two peripheral AP waveforms and gold standard central AP and SV were simultaneously measured during diverse hemodynamic interventions. We report an overall central AP error of 5.6% and an overall beat-to-beat SV error of 14.7%.