@article{0a2a6b731da44068bae2373cf5a7a223,
title = "The Effect of Intermittent versus Continuous Non-Invasive Blood Pressure Monitoring on the Detection of Intraoperative Hypotension, a Sub-Study",
abstract = "Intraoperative hypotension is associated with postoperative complications. However, in the majority of surgical patients, blood pressure (BP) is measured intermittently with a non-invasive cuff around the upper arm (NIBP-arm). We hypothesized that NIBP-arm, compared with a non-invasive continuous alternative, would result in missed events and in delayed recognition of hypotensive events. This was a sub-study of a previously published cohort study in adult patients undergoing surgery. The detection of hypotension (mean arterial pressure below 65 mmHg) was compared using two non-invasive methods; intermittent oscillometric NIBP-arm versus continuous NIBP measured with a finger cuff (cNIBP-finger) (Nexfin, Edwards Lifesciences). cNIBP-finger was used as the reference standard. Out of 350 patients, 268 patients (77%) had one or more hypotensive events during surgery. Out of the 286 patients, 72 (27%) had one or more missed hypotensive events. The majority of hypotensive events (92%) were detected with NIBP-arm, but were recognized at a median of 1.2 (0.6–2.2) minutes later. Intermittent BP monitoring resulted in missed hypotensive events and the hypotensive events that were detected were recognized with a delay. This study highlights the advantage of continuous monitoring. Future studies are needed to understand the effect on patient outcomes.",
keywords = "anesthesiology, hemodynamics, perioperative, surgery",
author = "Marije Wijnberge and {van der Ster}, Bj{\"o}rn and Vlaar, {Alexander P. J.} and Hollmann, {Markus W.} and Geerts, {Bart F.} and Veelo, {Denise P.}",
note = "Funding Information: The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results. Bart Geerts and Denise Veelo received consultancy fees and research grants from Philips and Edwards Lifesciences outside of the submitted work. Alexander Vlaar received consultancy fees and research grants from Edwards Lifesciences and InflaRx. Bj{\"o}rn van der Ster received research grants from Edwards Lifesciences outside of the submitted work. Marije Wijnberge received consultancy fees from Edwards Lifesciences outside of the submitted work. Markus W. Hollmann is Executive Section Editor Pharmacology with Anesthesia & Analgesia, Section Editor Anesthesiology with Journal of Clinical Medicine and Editor with Frontiers in Physiology. He received research grants from ZonMW, EACTA, ESAIC, SCA, IARS and consultancy/speaker{\textquoteright}s fees from CSL Behring, BBraun and IDD Pharma. Funding Information: This research was funded by un unrestricted research grant from Edwards Lifesciences LCC, grant number PA-1412-0001-AMC. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results. The APC was not funded by Edwards Lifesciences but paid by the authors. Publisher Copyright: {\textcopyright} 2022 by the authors.",
year = "2022",
month = jul,
day = "1",
doi = "https://doi.org/10.3390/jcm11144083",
language = "English",
volume = "11",
journal = "Journal of clinical medicine",
issn = "2077-0383",
publisher = "MDPI AG",
number = "14",
}