From Catheters to Wearables: Advanced Hemodynamic Monitoring and the Emerging Role of PPG-Based Devices

Narrative review (Aliev, Eisenkraft, Nachman) of invasive, minimally invasive and noninvasive hemodynamic monitoring (CO, SV, SVR), with emphasis on PPG-based pulse wave analysis + pulse transit time; Biobeat BB-613WP is the worked case study (swine hemorrhagic shock, ICU/perioperative vs invasive reference, ABPM). Authors conclude agreement can be clinically acceptable in selected populations but evidence is small, single-centre, controlled and lacks independent validation.

• Form factor: wrist/chest (Biobeat BB-613WP wrist-watch and chest patch family; review)

Advanced hemodynamic monitoring, including cardiac output (CO), stroke volume (SV), and systemic vascular resistance (SVR), is important for the management of cardiogenic shock, postoperative patients, and heart failure. Traditional approaches such as pulmonary artery catheterization (PAC) provide comprehensive hemodynamic assessment but are invasive, costly, and associated with procedure‐related risks. This review summarizes established invasive and minimally invasive techniques alongside emerging noninvasive approaches, including pulse contour analysis, bioimpedance, pulse wave transit time, and photoplethysmography (PPG)‐based systems. Particular emphasis is placed on PPG‐based technologies, which combine pulse wave analysis, pulse wave transit time, and advanced signal processing to estimate blood pressure and flow‐related parameters. As a representative case study, the clinical development and evaluation of the Biobeat BB‐613WP wearable are described, including preclinical swine hemorrhagic shock models, intensive care and perioperative validation against invasive reference methods, and ambulatory blood pressure monitoring studies. Available evidence suggests that PPG‐based wearables can achieve clinically acceptable agreement with invasive reference methods in selected populations while offering the potential for continuous, noninvasive, and ambulatory monitoring. However, the available evidence is limited by small sample sizes, single‐center studies, controlled conditions, and limited independent validation. Further multicenter, outcome‐oriented studies are required to establish the clinical role of PPG‐based devices across diverse patient populations and stages of care.

Verbatim from the publisher's DOI record (opens in a new tab) · Publisher licence: https://creativecommons.org/licenses/by/4.0/

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