Prehospital Invasive Arterial Pressure: Use of a Minimized Flush System

Area of Science:

• Critical Care Medicine
• Physiology
• Medical Devices

Background:

• Invasive blood pressure (IBP) monitoring is crucial for prehospital trauma and cardiac arrest patients.
• Conventional IBP devices have drawbacks, including lengthy preparation times and cumbersome tubing.
• Simplifying IBP equipment, such as replacing continuous flush systems, is proposed to enhance usability.

Purpose of the Study:

• To compare the accuracy of a standard IBP (sIBP) transducer kit with continuous flush.
• To evaluate a simplified, minimized flush system IBP (mIBP) using only a syringe.
• To assess the feasibility of mIBP for prehospital critical care.

Main Methods:

• A mechanical experimental model simulated arterial pressure pulsations.
• Simultaneous measurements were taken using sIBP and mIBP devices.
• Data were analyzed using Bland-Altman plots with a 5% measurement error threshold.

Main Results:

• The mIBP system accurately measured Mean Arterial Pressure (MAP) and Diastolic Blood Pressure (DBP) with minimal bias and standard deviation.
• All MAP and 98.4% of DBP measurements had <5% error.
• Systolic Blood Pressure (SBP) showed underestimation, especially at lower MAPs (40 mmHg), with >5% error in those instances.

Conclusions:

• IBP with the mIBP simplified flush system demonstrates accuracy for MAP and DBP across physiological ranges.
• A tendency for SBP underestimation, particularly in lower pressure ranges, was observed.
• This simplified system holds potential for further development to streamline IBP use in prehospital critical care settings.