Noninvasive Continuous Arterial Blood Pressure Monitoring with Nexfin

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...

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Bibliographic Details
Published in:	Anesthesiology (Philadelphia) Vol. 116; no. 5; pp. 1092 - 1103
Main Authors:	MARTINA, Jerson R, WESTERHOF, Berend E, DE MOL, Bas A. J. M, LIESHOUT, Johannes J. Van, GOUDOEVER, Jeroen Van, DE BEAUMONT, Edouard M. F. H, TRUIJEN, Jasper, KIM, Yu-Sok, IMMINK, Rogier V, JÖBSIS, Dorothea A, HOLLMANN, Markus W, LAHPOR, Jaap R
Format:	Journal Article
Language:	English
Published:	Hagerstown, MD Lippincott Williams & Wilkins 01-05-2012
Subjects:	Adult Aged Aged, 80 and over Anesthesia Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Arteries - physiology Biological and medical sciences Blood Pressure Determination - instrumentation Blood Pressure Monitors Cardiac Surgical Procedures Coronary Artery Bypass Feasibility Studies Female Fingers - blood supply Heart Valve Prosthesis Implantation Humans Male Medical sciences Middle Aged Monitoring, Intraoperative - instrumentation Regional Blood Flow - physiology Reproducibility of Results Thoracic Surgical Procedures Arterial blood Anesthesia Arterial pressure Blood pressure Monitoring
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Summary:	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. 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 ± SD of the differences and considered acceptable when smaller than 5 ± 8 mmHg, the Association for the Advancement of Medical Instrumentation criteria. 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 ± 2, 3 ± 1, 3 ± 2, and 3 ± 2 mmHg, and within-subject variations 13 ± 6, 6 ± 3, 9 ± 4, and 7 ± 4 mmHg, indicating precision over a wide range of pressures. Group average ± SD of the NAP-IAP differences were -1 ± 7, 3 ± 6, 2 ± 6, and -3 ± 4 mmHg, meeting criteria. Differences were not related to mean arterial pressure or heart rate. 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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0003-3022 1528-1175
DOI:	10.1097/ALN.0b013e31824f94ed