Key result
Noninvasive middle finger arterial measurements with waveform reconstruction provided an acceptable surrogate for invasive intra-arterial recording, with a mean arterial pressure bias of 0.4±5.3 mmHg.
Why the study?
Continuous beat-to-beat blood pressure monitoring using noninvasive finger blood pressure is accurate in adults, but data were lacking on its validity compared to invasive intra-arterial monitoring in children.
Does noninvasive finger blood pressure monitoring accurately measure blood pressure compared to invasive intra-arterial monitoring in children?
Cross-Sectional (n=18)
Does noninvasive finger blood pressure monitoring accurately measure blood pressure compared to invasive intra-arterial monitoring in children?
Middle finger arterial measurements with waveform reconstruction provide an acceptable and accurate noninvasive surrogate for invasive intra-arterial blood pressure recording in children.
Supports noninvasive finger BP monitoring in pediatric research; leaves open prospective validation before clinical adoption.
BACKGROUND: Continuous beat-to-beat blood pressure monitoring permits the rapid detection of blood pressure fluctuations for cardiovascular reflex testing and clinical haemodynamic monitoring. In adults, this can be achieved noninvasively with high accuracy, using finger blood pressure monitoring with volume clamp photoplethysmography. However, data are lacking on the validity of finger blood pressure monitoring in children compared to the gold standard - invasive intra-arterial blood pressure monitoring. AIM: We aimed to evaluate the accuracy of novel noninvasive index and middle finger arterial pressure (FinAP) measurements in children. METHODS: Using prototype paediatric finger cuffs, we compared: mean differences, bias and limits of agreement (Bland-Altman analyses); cumulative percentage differences [clinical grade A-D (based on the percentage of heartbeats in agreement with the standard)]; and waveform morphology (regression analysis and smoothing) between both raw FinAP (Finapres NOVA) and reconstructed finger-brachial arterial pressure (reBAP) compared to intra-arterial blood pressure measurements. RESULTS: Eighteen children were tested (aged 3-13 years; 12 male), with data from 13 included in the analysis. The bias for reBAP for the middle finger was 1.8±6.9, 0.3±6.1 and 0.4±5.3 mmHg for systolic, diastolic and mean arterial pressure, with clinical grades of C, B and A, respectively. reBAP improved numerical accuracy, but reduced waveform morphological agreement. CONCLUSION: Middle finger arterial measurements with waveform reconstruction provide an acceptable surrogate for invasive intra-arterial recording in children. Finger blood pressure monitoring is a novel comfortable, convenient and accurate alternative approach for noninvasive beat-to-beat blood pressure monitoring in children.
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Heeney et al. (2019) conducted a cross-sectional in Children requiring blood pressure monitoring (n=18). Noninvasive finger arterial pressure monitoring (FinAP/reBAP) vs. Invasive intra-arterial blood pressure monitoring was evaluated on Mean differences, bias and limits of agreement between noninvasive and invasive blood pressure measurements. Noninvasive middle finger arterial measurements with waveform reconstruction provided an acceptable surrogate for invasive intra-arterial recording, with a mean arterial pressure bias of 0.4±5.3 mmHg.
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