Validation study of Nexfin® continuous non-invasive blood pressure monitoring in critically ill adult patients (original) (raw)
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Noninvasive Continuous Arterial Blood Pressure Monitoring with Nexfin®
Anesthesiology, 2012
Background: If invasive measurement of arterial blood pressure is not warranted, finger cuff technology can provide continuous and noninvasive monitoring. Finger and radial artery pressures differ; Nexfin (BMEYE, Amsterdam, The Netherlands) measures finger arterial pressure and uses physiologic reconstruction methodologies to obtain values comparable to invasive pressures. Methods: Intra-arterial pressure (IAP) and noninvasive Nexfin arterial pressure (NAP) were measured in cardiothoracic surgery patients, because invasive pressures are available. NAP-IAP differences were analyzed during 30 min. Tracking was quantified by within-subject precision (SD of individual NAP-IAP differences) and correlation coefficients. The ranges of pressure change were quantified by within-subject variability (SD of individual averages of NAP and IAP). Accuracy and precision were expressed as group average Ϯ SD of the differences and considered acceptable when smaller than 5 Ϯ 8 mmHg, the Association for the Advancement of Medical Instrumentation criteria. Results: NAP and IAP were obtained in 50 (34 -83 yr, 40 men) patients. For systolic, diastolic, mean arterial, and pulse pressure, median (25-75 percentiles) correlation coefficients were 0.96 (0.91-0.98), 0.93 (0.87-0.96), 0.96 (0.90 -0.97), and 0.94 (0.85-0.98), respectively. Within-subject precisions were 4 Ϯ 2, 3 Ϯ 1, 3 Ϯ 2, and 3 Ϯ 2 mmHg, and within-subject variations 13 Ϯ 6, 6 Ϯ 3, 9 Ϯ 4, and 7 Ϯ 4 mmHg, indicating precision over a wide range of pressures. Group average Ϯ SD of the NAP-IAP differences were Ϫ1 Ϯ 7, 3 Ϯ 6, 2 Ϯ 6, and Ϫ3 Ϯ 4 mmHg, meeting criteria. Differences were not related to mean arterial pressure or heart rate. Conclusion: Arterial blood pressure can be measured noninvasively and continuously using physiologic pressure reconstruction. Changes in pressure can be followed and values are comparable to invasive monitoring.
BMC Anesthesiology, 2009
Background: Monitoring of cardiac output and blood pressure are standard procedures in critical care medicine. Traditionally, invasive techniques like pulmonary artery catheter (PAC) and arterial catheters are widely used. Invasiveness bears many risks of deleterious complications. Therefore, a noninvasive reliable cardiac output (CO) and blood pressure monitoring system could improve the safety of cardiac monitoring. The aim of the present study was to compare a noninvasive versus a standard invasive cardiovascular monitoring system.
Mediterranean Journal of Emergency Medicine, 2019
Objective: Non-invasive continuous blood pressure (NICBP) monitoring is an alternative to the standard non-invasive sporadic blood pressure monitoring. It allows measuring mean arterial blood pressure (MBP), systolic blood pressure (SBP), and diastolic blood pressure (DBP). Its results seem to have a good correlation with the values of invasive continuous blood pressure. The aim of our study was to assess the feasibility of using this device in a pre-hospital setting. Methods: The measurements taken for adult patients who were treated by Advanced Life Support teams equipped with NICBP (Nexfin™) device from one to 20 August 2015 were analysed prospectively The main outcome parameter was the number of faulty BP measurements obtained by Nexfin™ on one arm compared to the BP cuff on the other arm. Results: Nine patients were included. The mean age was 53 [40-61]. The number of faulty measurements was 1 for Nexfin™ and 10 for the cuff. There was a good correlation and concordance between the measurements recorded by Nexfin™ and cuff for SBP (77% vs 89%), DBP (70% vs 85%), and MBP (64% vs 82%) respectively. Conclusion: Although its big size and the low battery life, NICBP monitoring seems to be a valuable option considering its good correlation with the conventional method.
Anaesthesiology Intensive Therapy
Arterial pressure is a key haemodynamic variable that is often continuously monitored in critically ill patients. In shock management, frequent measurement of blood pressure is mandatory [1], and the Surviving Sepsis Campaign recommends a mean arterial pressure (MAP) target of 65 mmHg as a starting point [2]. Persistent hypotension is associated with worse outcomes in septic shock [3]. The advantages of invasive arterial pressure (IAP) monitoring include precision and instantaneous detection of pressure changes, as well as monitoring and treating blood pressure more closely, but it is invasive and has the risk of complications due to arterial cannulation, such as bleeding, haematoma, pseudoaneurysm, infection, nerve damage, and distal limb ischaemia [4, 5]. Noninvasive intermittent arm blood pressure (NIBP) by oscillometric mode is the first-line
Methods of Blood Pressure Measurement in the ICU*
Critical Care Medicine, 2013
1 B lood pressure monitoring is essential in managing hemodynamically unstableICU patients. Invasive measurement from an arterial line (invasive arterial blood pressure [IAP]) is generally considered to be the gold standard (1, 2), despite recognition that errors may be introduced by over-or underdamping, calibration errors, and movement artifacts (1, 3, 4). Automated noninvasive blood pressure systems (NIBP) using oscillometric techniques (5, 6) have advantages over invasive arterial lines as they avoid bleeding and infection risk, and can be used outside the ICU. Both theoretical (7) and existing clinical studies have suggested that NIBP measurements may differ from intra-arterial estimates. Clinical data comparing the two techniques in the ICU are sparse, however, particularly at the extremes of blood pressure when the absolute value of blood pressure is most critical. Although both invasive and noninvasive methods report systolic, mean, and diastolic pressures, consensus statements regarding patient management and ICU acuity scores have often recommended systolic rather than mean pressures as targets, and the modality-dependence (invasive vs. noninvasive) of pressure measurement has not been appreciated .
Journal of Clinical Monitoring, 1995
Young CC, Mark JB, White W, DeBree A, Vender JS, Fleming A. Clinical evaluation of continuous noninvasive blood pressure monitoring: accuracy and tracking capabilities. J Clin Monit 1995;11:245-252 ABSTRACT. A continuous, noninvasive device for blood pressure measurement using pulse transit time has been recently introduced. We compared blood pressure measurements determined using this device with simultaneous invasive blood pressure measurements in 35 patients undergoing general endotracheal anesthesia. Data were analyzed for accuracy and tracking ability of the noninvasive technique, and for frequency of unavailable pressure measurements by each method.
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 2014
Background: Monitoring cardiovascular function in acutely ill patients in the emergency department (ED) is of paramount importance. Arterial pressure (AP) is usually monitored using intermittent oscillometric measurements with an upper arm cuff. The vascular unloading technique (VUT) allows continuous noninvasive AP monitoring. In this study, we compare continuous AP measurements obtained by VUT with intermittent oscillometric AP measurements in ED patients. In addition, we aimed to investigate whether continuous noninvasive AP monitoring allows detection of relevant hypotensive episodes that might be missed with intermittent AP monitoring.