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Published on: January 20, 2023
Noninvasive continuous arterial pressure monitoring during anesthesia induction in patients undergoing cardiac
Paul Frank1, Frank Logemann1, Clemens Gras1
1Department of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany.
Objective:
In this study we compared noninvasive arterial pressure measurement using ClearSight™ vascular-unloading-technique (Edwards Lifesciences Corp, Irvine, CA) with invasive arterial pressure measurement during induction of anesthesia undergoing mayor cardiac surgery.
Design:
Prospective, monocentric.
Setting:
University hospital.
Participants:
54 patients undergoing mayor cardiac surgery.
Interventions:
During induction all patients were simultaneously monitored with invasive (reference method) and noninvasive arterial pressure measurement (test-method) over a mean time period of 27 minutes.
Measurements And Main Results:
We observed slightly lower systolic and mean arterial pressures noninvasive than invasive. For systolic arterial pressure the mean of the differences was -18,05 mmHg (p < 0,05, SD ±16,78 mmHg), the mean arterial pressure MAP -5,47 mmHg (p < 0,05, SD ±11,08 mmHg) and for diastolic pressure -1,09 mmHg (p < 0,05, SD±11,15 mmHg),. The mean of the differences in heartrate was 1,15 (p < 0,05, SD±6,9 mmHg). When considering all measured values of the invasively measured MAP and the ClearSight ™ -MAP at the same timestamp over the recording interval, an almost identical progress can be seen that indicates a sufficient mapping of the hemodynamic changes. The percentage error for mean arterial, systolic and diastolic pressure measured by ClearSight™ amounts to 25,95 %, 26,77 % and 34,16 %, respectively.
Conclusions:
We conclude that ClearSight ™ is a good option for hemodynamic monitoring during induction of anesthesia. Taking into account the limitations, non-invasive arterial blood pressure measurement offers sufficient security to safely initiate anesthesia, especially when MAP is of particular interest. The use of non-invasive arterial blood pressure measurement with ClearSight ™ during induction of anesthesia in patients scheduled for major cardiac surgery is reliable and easy to use.
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