Comparison of continuous non-invasive finger arterial pressure monitoring with conventional intermittent automated arm arterial pressure measurement in patients under general anaesthesia
J J Vos, M Poterman, E A Q Mooyaart, M Weening, M M R F Struys, T W L Scheeren, A F Kalmar, J J Vos, M Poterman, E A Q Mooyaart, M Weening, M M R F Struys, T W L Scheeren, A F Kalmar
Abstract
Background: For a majority of patients undergoing anaesthesia for general surgery, mean arterial pressure (MAP) is only measured intermittently by arm cuff oscillometry (MAPiNIAP). In contrast, the Nexfin(®) device provides continuous non-invasive measurement of MAP (MAPcNIAP) using a finger cuff. We explored the agreement of MAPcNIAP and MAPiNIAP with the gold standard: continuous invasive MAP measurement by placement of a radial artery catheter (MAPinvasive).
Methods: In a total of 120 patients undergoing elective general surgery and clinically requiring MAPinvasive measurement, MAPiNIAP and MAPcNIAP were measured in a 30 min time period at an arbitrary moment during surgery with stable haemodynamics. MAPiNIAP was measured every 5 min.
Results: Data from 112 patients were analysed. Compared with MAPinvasive, modified Bland-Altman analysis revealed a bias (sd) of 2 (9) mm Hg for MAPcNIAP and -2 (12) mm Hg for MAPiNIAP. Percentage errors for MAPcNIAP and MAPiNIAP were 22% and 32%, respectively.
Conclusions: In a haemodynamically stable phase in patients undergoing general anaesthesia, the agreement with invasive MAP of continuous non-invasive measurement using a finger cuff was not inferior to the agreement of intermittent arm cuff oscillometry. Continuous measurements using a finger cuff can interchangeably be used as an alternative for intermittent arm cuff oscillometry in haemodynamically stable patients, with the advantage of beat-to-beat haemodynamic monitoring.
Clinical trial registration: NCT 01362335 (clinicaltrials.gov).
Trial registration: ClinicalTrials.gov NCT01362335.
Keywords: NIAP; Nexfin; non-invasive arterial pressure; volume clamp.
© The Author [2014]. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Source: PubMed