Key result
Finger-application-type noninvasive continuous hemodynamic monitors show promising ability for rapid detection of hemodynamic derangement, but have relatively large bias and confidence intervals.
Why the study?
Are finger-application-type noninvasive continuous hemodynamic monitors accurate and precise compared to invasive methods?
Are finger-application-type noninvasive continuous hemodynamic monitors accurate and precise compared to invasive methods?
While noninvasive continuous finger hemodynamic monitors offer rapid detection of changes, clinicians must account for their relatively large bias and confidence intervals, especially in critically ill patients.
May aid rapid hemodynamic detection perioperatively; leaves open need for larger validation trials before routine use.
The CNAP HD Monitor (CNSystems, Graz, Austria) and the ccNexfin (The ClearSight System: Edwards Lifesciences Corporation, Irvine, CA) are continuous, noninvasive blood pressure monitors using a finger-application device. These devices show a promising ability to allow for rapid detection of hemodynamic derangement when compared with oscillometry. The accuracy and precision of these devices as blood pressure monitors has been evaluated when compared with intra-arterial catheters. Additionally, they can be used to measure beat-to-beat cardiac output (CO). As CO monitors, they are capable of trending changes in CO when compared with a transpulmonary thermodilution monitor. Difficulty with use in critically ill and awake patients has been encountered because of altered microvascular physiology and patient movement. The principles of operation and clinical validation of these devices are presented. The clinicians who are interested in using these devices in their clinical setting should be aware of the relatively large bias and CIs in the hemodynamic measurements.
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Raggi et al. (2017) reported a review. Finger-application-type noninvasive continuous hemodynamic monitors (CNAP and ccNexfin) vs. Intra-arterial catheters and transpulmonary thermodilution monitors was evaluated. Finger-application-type noninvasive continuous hemodynamic monitors show promising ability for rapid detection of hemodynamic derangement, but have relatively large bias and confidence intervals.
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