Key result
High-fidelity upper arm cuff accurately measures MAP versus invasive femoral catheterization with a 0.96 correlation.
Why the study?
Standard oscillometric cuffs overestimate intraarterial pressure in hypotension and underestimate it in hypertension, prompting evaluation of whether a new high-fidelity cuff corresponds to invasive arterial catheter measurements.
Does a high-fidelity upper arm cuff accurately measure arterial blood pressure compared to a femoral artery catheter in patients undergoing noncardiac surgery?
Observational (n=110)
Does a high-fidelity upper arm cuff accurately measure arterial blood pressure compared to a femoral artery catheter in patients undergoing noncardiac surgery?
A novel high-fidelity upper arm cuff provides accurate and precise noninvasive blood pressure measurements comparable to invasive femoral artery catheters during noncardiac surgery.
Answers are grounded in this paper and cite their sources.
May support noninvasive MAP monitoring in noncardiac surgery; leaves open need for prospective validation before practice change.
BACKGROUND: In most patients having noncardiac surgery, blood pressure is measured with the oscillometric upper arm cuff method. Although the method is noninvasive and practical, it is known to overestimate intraarterial pressure in hypotension and to underestimate it in hypertension. A high-fidelity upper arm cuff incorporating a hydraulic sensor pad was recently developed. The aim of the present study was to investigate whether noninvasive blood pressure measurements with the new high-fidelity cuff correspond to invasive measurements with a femoral artery catheter, especially at low blood pressure. METHODS: Simultaneous measurements of blood pressure recorded from a femoral arterial catheter and from the high-fidelity upper arm cuff were compared in 110 patients having major abdominal surgery or neurosurgery. RESULTS: 550 pairs of blood pressure measurements (5 pairs per patient) were considered for analysis. For mean arterial pressure measurements, the average bias was 0 mmHg, and the precision was 3 mmHg. The Pearson correlation coefficient was 0.96 (P < 0.0001; 95% CI, 0.96 to 0.97), and the percentage error was 9%. Error grid analysis showed that the proportions of mean arterial pressure measurements done with the high-fidelity cuff method were 98.4% in zone A (no risk), 1.6% in zone B (low risk) and 0% in zones C, D, and E (moderate, significant, and dangerous risk, respectively). The high-fidelity cuff method detected mean arterial pressure values less than 65 mmHg with a sensitivity of 84% (95% CI, 74 to 92%) and a specificity of 97% (95% CI, 95% to 98%). To detect changes in mean arterial pressure of more than 5 mmHg, the concordance rate between the two methods was 99.7%. Comparable accuracy and precision were observed for systolic and diastolic blood pressure measurements. CONCLUSIONS: The new high-fidelity upper arm cuff method met the current international standards in terms of accuracy and precision. It was also very accurate to track changes in blood pressure and reliably detect severe hypotension during noncardiac surgery.
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Briegel et al. (2020) conducted an observational in Patients having major abdominal surgery or neurosurgery (n=110). High-fidelity upper arm cuff vs. Femoral artery catheter was evaluated on Mean arterial pressure measurement correlation (Pearson correlation coefficient 0.96, 95% CI 0.96 to 0.97, p=< 0.0001). A high-fidelity upper arm cuff accurately measured mean arterial pressure compared to invasive femoral catheterization, with a bias of 0 mmHg and a correlation of 0.96.
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