Collaborative Learning-Enhanced Lightweight Models for Predicting Arterial Blood Pressure Waveform in a Large-scale Perioperative Dataset

Noninvasive arterial blood pressure (ABP) monitoring is essential for patient management in critical care and perioperative settings, providing continuous assessment of cardiovascular hemodynamics with minimal risks. Numerous deep learning models have developed to reconstruct ABP waveform from noninvasively acquired physiological signals such as electrocardiogram and photoplethysmogram. However, limited research has addressed the issue of model performance and computational load for deployment on embedded systems. The study introduces a lightweight sInvResUNet, along with a collaborative learning scheme named KDCL_sInvResUNet. With only 0.89 million parameters and a computational load of 0.02 GFLOPS, real-time ABP estimation was successfully achieved on embedded devices with an inference time of just 8.49 milliseconds for a 10-second output. We performed subject-independent validation in a large-scale and heterogeneous perioperative dataset containing 1,257,141 data segments from 2,154 patients, with a wide BP range (41-257 mmHg for SBP, and 31-234 mmHg for DBP). The proposed KDCL_sInvResUNet achieved lightly better performance compared to large models, with a mean absolute error of 10.06 mmHg and mean Pearson correlation of 0.88 in tracking ABP changes. Despite these promising results, all deep learning models showed significant performance variations across different demographic and cardiovascular conditions, highlighting their limited ability to generalize across such a broad and diverse population. This study lays a foundation work for real-time, unobtrusive ABP monitoring in real-world perioperative settings, providing baseline for future advancements in this area.