The relative accuracies of two automated noninvasive arterial pressure measurement devices (original) (raw)

Abstract

We compared the accuracies of two types of noninvasive blood pressure devices. Thirty-two patients requiring an intraarterial catheter for anesthetic management underwent simultaneous monitoring with Dinamap 1846SX and Ohmeda Finapres 3700 devices. For the first 10 minutes of recording, new Dinamap determinations were performed every 60 seconds; subsequent recordings were made at 3-minute intervals. Data were obtained at the time of new Dinamap readings, and twice between new readings to approximate the real-time performance of the two monitors. We defined superior accuracy as a statistically significant difference in mean absolute error greater than 5 mm Hg. With these criteria, pooled data from all patients revealed no difference in performance, even in real time. Pooled data can be misleading since there was a significant amount of variation in accuracy for both monitors. Therefore, we used nonparametric analysis to determine how many individual patients were monitored better by either device. When we compared only data from new Dinamap readings, the Finapres monitor showed superior performance for systolic readings in 13 patients, versus 6 patients for the Dinamap (P<0.05, chi-square test). Similar analysis for diastolic and mean pressure performance did not reach statistical significance. However, in real time, the Finapres unit monitored more patients more accurately for systolic (14 Finapres versus 3 Dinamap), diastolic (11 Finapres versus 3 Dinamap), and mean (10 Finapres versus 3 Dinamap) pressure determinations. The magnitude of these differences were, however, less dramatic than expected. This was probably due to stabilization of arterial pressure during the anesthetic, which minimized the error due to intermittent sampling. We conclude that continuous Finapres readings and new Dinamap determinations are equally accurate for diastolic and mean arterial pressures. The accuracy of Finapres appears to be slightly superior for systolic pressure. The intermittent sampling of oscillometric devices compromises their performance relative to the Finapres in many, but not all, cases.

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References

  1. Boehmer RD. Continuous real-time, noninvasive monitor of blood pressure: Peňaz methodology applied to the finger. J Clin Monit 1987;3:282–287
    PubMed CAS Google Scholar
  2. van Egmond J, Hasenbos M, Crul JF. Invasive v. noninvasive measurement of arterial pressure. Br J Anaesth 1985;57:434–444
    Article PubMed Google Scholar
  3. East TD, Pace NL, Sorenson RM, et al. Effect of peripheral vascular disease on accuracy of noninvasive, continuous, blood pressure measurement from the finger (Finapres). Anesthesiology 1987;67:A186
    Google Scholar
  4. Wesseling KH, Settels JJ, de Wit B. The measurement of continuous finger arterial pressure noninvasively in stationary subjects. In: Schmidt TH, Dembroski TM, Blunchen G, eds. Biological and psychological factors in cardiovascular disease. Berlin: Springer-Verlag, 1986:355–375
    Google Scholar
  5. Molhoek GP, Wesseling KH, Settels JJM, et al. Evaluation of the Peňaz servo-plethysmo-manometer for the continuous, noninvasive measurement of finger blood pressure. Basic Res Cardiol 1984;79:598–609
    Article PubMed CAS Google Scholar
  6. Smith NT, Wesseling KH, de Wit B. Evaluation of two prototype devices producing noninvasive, pulsatile, calibrated blood pressure measurement from a finger. J Clin Monit 1985;1:17–29
    Article PubMed Google Scholar
  7. Dorlas JC, Nijboer JA, Butijn WT, et al. Effects of peripheral vasoconstriction on the blood pressure in the finger, measured continuously by a new noninvasive method (the Finapres). Anesthesiology 1985;62:342–345
    Article PubMed CAS Google Scholar
  8. Kurki T, Smith NT, Head N, et al. Noninvasive continuous blood pressure measurement from the finger: optical measurement conditions and factors affecting reliability. J Clin Monit 1987;3:6–13
    PubMed CAS Google Scholar
  9. Yelderman M, Ream AK. Indirect measurement of mean blood pressure. Anesthesiology 1979;50:253–256
    Article PubMed CAS Google Scholar
  10. Ramsey M. Noninvasive automatic determination of mean arterial pressure. Med Biol Eng Comput 1979;17:11–18
    Article PubMed Google Scholar
  11. Geddes LA, Voelz M, Combs C, et al. Characterization of the oscillometric method for measuring indirect blood pressure. Ann Biomed Eng 1982;10:271–280
    Article PubMed CAS Google Scholar
  12. Davis RF. Clinical comparison of automated auscultatory and oscillometric and catheter-transducer measurements of arterial pressure. J Clin Monit 1985;1:114–119
    Article PubMed CAS Google Scholar
  13. Venus B, Mathru M, Smith RA, Pham CG. Direct vs indirect blood pressure measurements in critically ill patients. Heart Lung 1985;14:228–231
    PubMed CAS Google Scholar
  14. Rutten AJ, Ilsley AH, Skowronski GA, Runciman WB. A comparative study of the measurement of mean arterial blood pressure using automatic oscillometers, arterial cannulation and auscultation. Anaesth Intensive Care 1986;14:58–65
    PubMed CAS Google Scholar
  15. Gourdeau M, Martin R, Lamarche Y, Tetreault L. Oscillometry and direct blood pressure: a comparative clinical study during deliberate hypotension. Can J Anaesth 1986;33:300–307
    Article CAS Google Scholar
  16. Loubser PG. Comparison of intra-arterial and automated oscillometric blood pressure measurement methods in postoperative hypertensive patients. Biomed Instrum Technol 1986;20:255–259
    CAS Google Scholar
  17. Johnson CJH, Kerr JH. Automatic blood pressure monitors. Anaesthesia 1985;40:471–478
    Article PubMed CAS Google Scholar
  18. Johnson PW, Hom M, Mulroy MF. Adequacy of automated blood pressure cuffs with epinephrine test doses in beta blocked patients. Anesthesiology 1987;57:A187
    Google Scholar
  19. Sheiner LB, Beal SL. Some suggestions for measuring predictive performance. J Pharmacokinet Biopharm 1981;9:503–512
    Article PubMed CAS Google Scholar

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Authors and Affiliations

  1. From the Department of Anesthesiology, Duke University Medical Center, Durham, NC
    Michael S. Gorback MD & Timothy J. Quill MD
  2. From the Institute of Statistics and Decision Sciences, Duke University Medical Center, Durham, NC
    Michael L. Lavine PhD

Authors

  1. Michael S. Gorback MD
  2. Timothy J. Quill MD
  3. Michael L. Lavine PhD

Additional information

Presented in part at the annual meeting of the American Society of Anesthesiologists, San Francisco, Oct 1988.

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Gorback, M.S., Quill, T.J. & Lavine, M.L. The relative accuracies of two automated noninvasive arterial pressure measurement devices.J Clin Monitor Comput 7, 13–22 (1991). https://doi.org/10.1007/BF01617893

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