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Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva
Minerva Anestesiologica 2013 Marzo;79(3):248-56
A comparison of continuous non-invasive arterial pressure with invasive radial and femoral pressure in patients undergoing cardiac surgery
Broch O. 1, Bein B. 1, Gruenewald M. 1, Carstens A. 1, Illies C. 1, Schöneich F. 2, Steinfath M. 1, Renner J. 1 ✉
1 Department of Anesthesiology and Intensive Care Medicine; University Hospital Schleswig-Holstein, Campus Kiel, Germany;
2 Department of Cardiothoracic and Vascular Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Germany
Background: Non-invasive continous monitoring of finger arterial pressure has gained increasing interest. The aim of the present study was to compare the accuracy of non-invasive reconstructed brachial artery pressure by the Nexfin™ device (NFAP) with invasive femoral (IFAP) and radial (IRAP) artery pressure before and after cardiopulmonary bypass (CPB).
Methods: Fifty patients scheduled for elective coronary surgery were studied before and after CPB, respectively. Each patient was monitored with the non-invasive system, and both an indwelling femoral and radial arterial catheter. A passive leg raising maneuver was also performed before and after CPB. Measurements included mean (MAP), systolic (SAP) and diastolic (DAP) arterial pressure by NFAP (MAP,SAP,DAPNFAP), IFAP (MAP,SAP,DAPIFAP) and IRAP (MAP,SAP,DAPIRAP). Percentage changes of MAP for all measurement sites were also calculated.
Results: There was a moderate correlation between MAPNFAP and MAPIFAP both before (r=0.64, P<0.0001) and after (r=0.57, P<0.0001) CPB, with a percentage error (PE) of 29% and 27%, respectively. Correlation coefficients between MAPNFAP and MAPIRAP were r=0.53, P<0.0001 (PE 34%) before and r=0.54, P<0.0001 (PE 29%) after CPB. There was a significant correlation in percentage changes between ∆MAPNFAP and ∆MAPIFAP before (r=0.70, P<0.0001) and after (r=0.71, P<0.0001) CPB and for ∆MAPNFAP and ∆MAPIRAP (r=0.67, P<0.0001; r=0.74, P<0.0001), respectively.
Conclusion: Non-invasive, reconstructed brachial artery pressure showed moderate correlation compared with both invasive femoral and radial artery pressure. Furthermore, the non-invasive monitoring system was able to reflect percentage changes in mean arterial pressure in a moderate fashion.