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A Pilot Randomized Trial of Continuous Finger-Cuff Blood Pressure Monitoring With Hemodynamic-Guided Management
Siree Dolnimitsakul1, Mutita Chaichalothorn1, Nattanon Songchuen1
1Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Journal of Cardiothoracic and Vascular Anesthesia
|July 30, 2026
Summary
Continuous noninvasive hemodynamic monitoring using finger-cuff blood pressure significantly reduced intraoperative hypotension and vasopressor use in thoracic surgery patients compared to standard monitoring. This pilot study suggests a potential benefit for this advanced hemodynamic management strategy.
Area of Science:
- Anesthesiology and Perioperative Medicine
- Cardiovascular Physiology
- Surgical Patient Monitoring
Background:
- Intraoperative hypotension is linked to adverse postoperative outcomes.
- Effective management of blood pressure during surgery is critical for patient safety.
- Current monitoring methods may not always provide timely or accurate hypotension detection.
Purpose of the Study:
- To evaluate if hemodynamic-guided management with continuous noninvasive finger-cuff blood pressure monitoring reduces intraoperative hypotension.
- To compare this advanced monitoring technique against standard intermittent oscillometric monitoring in open thoracic surgery.
Main Methods:
- A pilot randomized controlled trial involving 40 adult patients undergoing elective open thoracic surgery.
- Patients were randomized to either hemodynamic-guided management (continuous finger-cuff monitoring with Hypotension Prediction Index) or standard care (intermittent oscillometric monitoring).
- The primary outcome was the time-weighted average of mean arterial pressure below 65 mmHg.
Main Results:
- The hemodynamic-guided group showed a significantly lower time-weighted average of hypotension compared to the standard care group (p = 0.001).
- Reduced incidence and duration of hypotensive episodes were observed in the continuous monitoring group.
- Fewer patients in the hemodynamic-guided group required vasopressor therapy (35% vs. 80%, p = 0.004).
Conclusions:
- Continuous noninvasive finger-cuff hemodynamic monitoring effectively reduced intraoperative hypotension and vasopressor use in this pilot study.
- The findings support the feasibility and potential benefits of this advanced monitoring approach.
- Larger trials are necessary to confirm the impact on clinical outcomes.
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