Key result
Adding a PPG-based continuous BP monitor to standard cuff-based monitoring reduced mean systolic BP error from 2.6 to 0.5 mmHg and decreased significant-risk data points from 1.1% to 0.0%.
Why the study?
Routine noninvasive cuff-based monitoring during anesthesia is noncontinuous, creating intervals where blood pressure is unavailable and risking undetected rapid variations.
Does adding a PPG-based continuous BP measurement device to standard cuff-based monitoring improve BP measurement accuracy in noncritical patients during anesthesia induction?
Cohort (n=40)
Does adding a PPG-based continuous BP measurement device to standard cuff-based monitoring improve BP measurement accuracy in noncritical patients during anesthesia induction?
Absolute Event Rate: 0.5% vs 2.6%
Adding a PPG-based continuous BP monitor to standard intermittent cuff measurements during anesthesia induction significantly reduces BP measurement error and potentially improves patient safety.
May improve BP accuracy during induction; hypothesis-generating for outcomes, requires RCTs before practice change.
During anesthesia, noncritical patients are routinely monitored via noninvasive cuff-based blood pressure (BP) monitors. Due to the noncontinuous nature of the monitoring, the BP values of the patient remain unavailable between consecutive cuff measurements, carrying the risk of missing rapid and sudden variations in BP. We evaluated the added value of using a photoplethysmography (PPG)-based continuous BP measurement device in addition to the standard cuff-based monitoring in a cohort of 40 patients in comparison with the current approach, in which only intermittent cuff-based measurements are available. When using a three-minute cuff measurement interval, using the PPG-based BP measurement in addition to the cuff-based monitor reduced the error (mean ± SD) of systolic (SBP) and mean (MBP) BP from 2.6 ± 19.6 mmHg and 1.2 ± 13.2 mmHg to 0.5 ± 11.2 mmHg and 0.0 ± 8.1 mmHg, respectively. Error grid analysis was also used to assess the improvement in patient safety. The additional use of the PPG-based BP measurement reduced the amount of data falling into higher risk categories. For SBP, points falling in the significant-, moderate-, and low-risk categories decreased from 1.1%, 8.7%, and 19.3% to 0.0%, 2.3%, and 9.6%, respectively. Similar results were obtained for MBP. These results suggest that using a PPG-based BP monitor-in addition to the standard cuff-based monitor-can improve patient safety during anesthesia induction, with no additional sensor needed.
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Degiorgis et al. (2022) conducted a cohort in Anesthesia induction (n=40). Photoplethysmography (PPG)-based continuous BP measurement vs. Intermittent cuff-based measurements was evaluated on Mean error of systolic blood pressure (SBP) in mmHg. Adding a PPG-based continuous BP monitor to standard cuff-based monitoring reduced mean systolic BP error from 2.6 to 0.5 mmHg and decreased significant-risk data points from 1.1% to 0.0%.
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