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Non Invasive BP Measurement Medical Physics History of BP Measurement 1733 Reverend Stephen Hales first to measure BP Measured the height of a column of blood after cannulating the carotid artery in a horse with a brass pipe. History of BP Measurement The brass pipe was attached to a 12 inch glass tube. Tube was connected to the pipe via trachea of a goose! First to observe respiratory variation and pulsatile nature 100 years later, Poiseuille used a mercury manometer, connected to the artery in a dog to measure BP History of BP Measurement Both of these methods were invasive First attempts at non-invasive BP measurement began in the late 1800抯 History of BP Measurement In late 1890s, Italian physician ?Scipione Riva Rocci invented sphygmomanometer Sphygmos = Pulse (Greek) Manometer = Pressure meter History of BP Measurement Consisted of mercury column manometer Silk covering a rubber sleeve, which is filled with air Squeeze bag to inflate rubber sleeve History of BP Measurement 10 years later, a Russian surgeon ?Nikolai Korotkoff discovered that sounds were present as cuff was deflated Works on principle that normal blood flow is laminar, and hence silent As cuff pressure drops, some blood begins to flow past compressed area of cuff Blood flow is turbulent, non-laminar and audible History of BP Measurement This method of measuring BP is called the Auscultatory method Roy and Adami (1890) developed oscillometric method With cuff being deflated, onset of oscillations in mercury height were noted Called onset of oscillations = Systolic BP History of BP Measurement Maximum oscillations = Diastolic (Nb Incorrect) Hence all indirect BP measurement involves use of Riva-Rocci cuff, either via auscultatory measurement or via oscillometric methods. Automated Auscultatory Method First automated systems used a microphone to replace need for manual auscultation Analysis of sound produced was used to estimate SBP and DBP Problems with this approach -