Non-invasive Blood Pressure and Cardiac Output Measurement by Using Applanation Tonometry
Validation of Non-invasive Blood Pressure and Cardiac-output Measurement by Using Applanation Tonometry in Cardiological Patients
To evaluate and to validate accuracy, precision and trending ability of blood pressure and cardiac output measurement by applanation tonometry in cardiological patients having:
- atrial fibrillation
- severe impaired leftventricular function
- severe aortic valve stenosis
- patients having left ventricular assist device
Experimental measurement: continuous blood pressure measurement and cardiac output measurement is performed by the T-Line 200 pro device (Tensys Medical Inc., San Diego, USA) Control measurement: gold-standard continuous blood pressure measurement is performed by invasive blood pressure measurement by arterial cannulation and cardiac output reference is assessed by transcardiopulmonary thermodilution
Study Overview
Status
Status
Conditions
Conditions
Detailed Description
Increasing complexity of medical interventions and critical care treatment in an elderly getting population requires precise and accurate hemodynamic monitoring.(1) However, advanced invasive hemodynamic monitoring is often combined with complications by arterial or central venous catheterization. Complications such as vessel harming, infection, cardiac arrhythmias and nervous lesions are likely to occur.(2-4) Therefore, in the past various techniques of minimal- or non-invasive hemodynamic monitoring devices have been evaluated.(5, 6) One of the very promising technique is continuous non-invasive blood pressure monitoring by applanation tonometry. Published data revealed efficacy of this technique. (7) However, ability of this technique remains unclear in patients suffering from cardiological pathologies leading to changing stroke volumes as in arterial fibrillation, to highly reduces stroke volume as in severe impaired left-ventricular function or in severe aortic valve stenosis. Further, ability of applanation tonometry in patients without having pulsatile blood flow such as in patients with left-ventricular assist device remains unclear. Therefore, validation of this technique should be performed in the presented study.
Further development of applanation tonometry including pulse contour analysis now enables assessment of cardiac output. However, till now there is limited data assessing validation cardiac output measurement by this method. Cardiac output validation should also be performed in the planed clinical study.
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Contacts and Locations
Study Contact
Study Contact
- Name: Sebastian Haas
- Email: s.haas@uke.de
Study Contact Backup
- Name: Daniel Reuter
- Email: dreuter@uke.de
Study Locations
-
-
-
Hamburg, Germany
- Recruiting
- University Medical Center Hamburg-Eppendorf
-
Contact:
- Daniel Reuter
- Email: dreuter@uke.de
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Patients enable for study enrollement need to suffer from one of the four cardiological pathologies:
- atrial fibrillation,
- severe impaired leftventricular function,
- severe aortic valve stenosis
- patients having left ventricular assist device
All patients have to be clinically monitored by invasive blood pressure assessment and transcardiopulmonary thermodilution.
Description
Inclusion Criteria:
- atrial fibrillation
- severe impaired leftventricular function
- severe aortic stenosis
- LVAD Patients
Exclusion Criteria:
- Age <18 years
- pregnancy
- patients having blood pressure difference of more than 10 mmHg on both arms (measurement by "Riva-Rocci" before study enrolment)
- pre-existing on arterial vessels of the arms
- patients who are not able to give informed consent
Study Plan
How is the study designed?
Design Details
- Observational Models: Case-Only
- Time Perspectives: Prospective
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
|---|
|
Patients with atrial fibrillation
It is Primarily a comparison of methods , non-invasive measured blood pressure versus invasively measured blood pressure and non-invasively measurement of cardiac output versus invasive cardiac output measurement in patients with atrial fibrillation.
|
|
Patients with highly reduced LV function
It is Primarily a comparison of methods , non-invasive measured blood pressure versus invasively measured blood pressure and non-invasively measurement of cardiac output versus invasive cardiac output measurement in patients with a highly reduced left ventricular function (LV function)
|
|
Patients with aortic stenosis
It is Primarily a comparison of methods , non-invasive measured blood pressure versus invasively measured blood pressure and non-invasively measurement of cardiac output versus invasive cardiac output measurement in patients with severe aortic stenosis
|
|
Patients with LVAD
It is Primarily a comparison of methods , non-invasive measured blood pressure versus invasively measured blood pressure and non-invasively measurement of cardiac output versus invasive cardiac output measurement in patients with left ventricular assist-device (LVAD)
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Accuracy and precision of blood pressure and cardiac output by applanation tonometry
Time Frame: 30 minutes
|
30 minutes
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Trending ability of blood pressure monitoring by applanation tonometry
Time Frame: 30 minutes
|
30 minutes
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Daniel Reuter, University Hamburg
Publications and helpful links
General Publications
- Weiser TG, Regenbogen SE, Thompson KD, Haynes AB, Lipsitz SR, Berry WR, Gawande AA. An estimation of the global volume of surgery: a modelling strategy based on available data. Lancet. 2008 Jul 12;372(9633):139-144. doi: 10.1016/S0140-6736(08)60878-8. Epub 2008 Jun 24.
- Saugel B, Reuter DA. Are we ready for the age of non-invasive haemodynamic monitoring? Br J Anaesth. 2014 Sep;113(3):340-3. doi: 10.1093/bja/aeu145. Epub 2014 May 31. No abstract available.
- Mandel MA, Dauchot PJ. Radial artery cannulation in 1,000 patients: precautions and complications. J Hand Surg Am. 1977 Nov;2(6):482-5. doi: 10.1016/s0363-5023(77)80030-0.
- Russell JA, Joel M, Hudson RJ, Mangano DT, Schlobohm RM. Prospective evaluation of radial and femoral artery catheterization sites in critically ill adults. Crit Care Med. 1983 Dec;11(12):936-9. doi: 10.1097/00003246-198312000-00007.
- Reuter DA, Huang C, Edrich T, Shernan SK, Eltzschig HK. Cardiac output monitoring using indicator-dilution techniques: basics, limits, and perspectives. Anesth Analg. 2010 Mar 1;110(3):799-811. doi: 10.1213/ANE.0b013e3181cc885a.
- Saugel B, Trepte CJ, Heckel K, Wagner JY, Reuter DA. Hemodynamic management of septic shock: is it time for "individualized goal-directed hemodynamic therapy" and for specifically targeting the microcirculation? Shock. 2015 Jun;43(6):522-9. doi: 10.1097/SHK.0000000000000345.
- Saugel B, Meidert AS, Hapfelmeier A, Eyer F, Schmid RM, Huber W. Non-invasive continuous arterial pressure measurement based on radial artery tonometry in the intensive care unit: a method comparison study using the T-Line TL-200pro device. Br J Anaesth. 2013 Aug;111(2):185-90. doi: 10.1093/bja/aet025. Epub 2013 Mar 13.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Anticipated)
Primary Completion
Study Completion (Anticipated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- TNSYS2015
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