TY - JOUR
T1 - Clinical agreement of a novel algorithm to estimate radial artery blood pressure from the non-invasive finger blood pressure
AU - Kho, Eline
AU - van der Ster, Björn J. P.
AU - van der Ven, Ward H.
AU - Vlaar, Alexander P. J.
AU - Immink, Rogier V.
AU - Veelo, Denise P.
N1 - Funding Information: RVI reports having received a grant from Edwards Lifesciences. Publisher Copyright: © 2022
PY - 2022/12/1
Y1 - 2022/12/1
N2 - Study objective: A new algorithm was developed that transforms the non-invasive finger blood pressure (BP) into a radial artery BP (B̂PRad), whereas the original algorithm estimated brachial BP (B̂PBra). In this study we determined whether this new algorithm shows better agreement with invasive radial BP than the original one and whether in the operating room this algorithm can be used safely. Design, setting and patients: This observational study was conducted on thirty-three non-cardiac surgery patients. Intervention and measurements: Invasive radial and non-invasive finger BP were measured, of the latter B̂PRad and B̂PBra were transformed. Agreement of systolic, mean, and diastolic arterial BP (SAP, MAP, and DAP, respectively) was assessed traditionally with Bland-Altman and trend analysis and clinically safety was quantified with error grid analyses. A bias (precision) of 5 (8) mmHg or less was considered adequate. Main results: Thirty-three patients were included with an average of 676 (314) 20 s segments. For both comparisons, bias (precision) of MAP was within specified criteria, whereas for SAP, precision was higher than 8 mmHg. B̂PRad showed a better agreement than B̂PBra with BPRad for DAP values (bias (precision): 0.7 (6.0) and − 6.4 (4.3) mmHg, respectively). B̂PRad and B̂PBra both showed good concordance in following changes in BPRad (for all parameters overall degree was <7°). There were slightly more measurement pairs of MAP within the no-risk zone for B̂PRad than for B̂PBra (96 vs 77%, respectively). Conclusions: In this cohort of non-cardiac surgery patients, we found good agreement between BPRad and B̂PRad. Compared to B̂PBra, B̂PRad shows better agreement although clinical implications are small. This trial was registered with ClinicalTrials.gov (https://clinicaltrials.gov/ct2/show/NCT03795831).
AB - Study objective: A new algorithm was developed that transforms the non-invasive finger blood pressure (BP) into a radial artery BP (B̂PRad), whereas the original algorithm estimated brachial BP (B̂PBra). In this study we determined whether this new algorithm shows better agreement with invasive radial BP than the original one and whether in the operating room this algorithm can be used safely. Design, setting and patients: This observational study was conducted on thirty-three non-cardiac surgery patients. Intervention and measurements: Invasive radial and non-invasive finger BP were measured, of the latter B̂PRad and B̂PBra were transformed. Agreement of systolic, mean, and diastolic arterial BP (SAP, MAP, and DAP, respectively) was assessed traditionally with Bland-Altman and trend analysis and clinically safety was quantified with error grid analyses. A bias (precision) of 5 (8) mmHg or less was considered adequate. Main results: Thirty-three patients were included with an average of 676 (314) 20 s segments. For both comparisons, bias (precision) of MAP was within specified criteria, whereas for SAP, precision was higher than 8 mmHg. B̂PRad showed a better agreement than B̂PBra with BPRad for DAP values (bias (precision): 0.7 (6.0) and − 6.4 (4.3) mmHg, respectively). B̂PRad and B̂PBra both showed good concordance in following changes in BPRad (for all parameters overall degree was <7°). There were slightly more measurement pairs of MAP within the no-risk zone for B̂PRad than for B̂PBra (96 vs 77%, respectively). Conclusions: In this cohort of non-cardiac surgery patients, we found good agreement between BPRad and B̂PRad. Compared to B̂PBra, B̂PRad shows better agreement although clinical implications are small. This trial was registered with ClinicalTrials.gov (https://clinicaltrials.gov/ct2/show/NCT03795831).
KW - Blood pressure monitoring
KW - Brachial artery
KW - ClearSight
KW - Non-invasive
KW - Radial artery
UR - http://www.scopus.com/inward/record.url?scp=85139235793&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jclinane.2022.110976
DO - https://doi.org/10.1016/j.jclinane.2022.110976
M3 - Article
C2 - 36174389
SN - 0952-8180
VL - 83
JO - Journal of Clinical Anesthesia
JF - Journal of Clinical Anesthesia
M1 - 110976
ER -