Key result
Non-invasive fPRx using Finapres strongly correlated with invasive PRx (R=0.92, p<0.001, bias=-0.04) and distinguished active from passive cerebrovascular reactivity in >89% of cases.
Why the study?
Does non-invasive Finapres arterial blood pressure (fABP) accurately estimate the cerebrovascular pressure reactivity index compared to invasive ABP monitoring in head injury patients?
Observational (n=10)
Does non-invasive Finapres arterial blood pressure (fABP) accurately estimate the cerebrovascular pressure reactivity index compared to invasive ABP monitoring in head injury patients?
Effect estimate: R(Spearman) 0.92
p-value: p=< 0.001
Non-invasive Finapres arterial blood pressure monitoring provides a reliable estimate of cerebrovascular pressure reactivity index, offering an alternative when invasive monitoring is not feasible.
May enable non-invasive cerebrovascular reactivity monitoring when invasive ABP is unavailable; leaves open prospective validation before clinical adoption.
A pressure reactivity index (PRx) can be assessed in patients with continuous monitoring of arterial blood pressure (ABP) and intracranial pressure (ICP) as a moving correlation coefficient between slow fluctuations of these two signals within a low frequency bandwidth. The study aimed to investigate whether the invasive ABP monitoring can be replaced with non-invasive measurement of ABP using a Finapres plethysmograph (fABP) to calculate the fPRx. There is a well-defined group of patients, suffering from hydrocephalus and undergoing CSF pressure monitoring, which may benefit from such a measurement. 41 simultaneous day-by-day monitoring of ICP, ABP and fABP were performed for about 30 min in 10 head injury patients. A Bland-Altman assessment for agreement was used to compare PRx and fPRx calculations. Performance metrics and the McNemary test were used to determine whether fPRx is sensitive enough to distinguish between functioning and disturbed cerebrovascular pressure reactivity. The fPRx correlated with PRx (R(Spearman) = 0.92, p < 0.001; bias = -0.04; lower and upper limits of agreement: -0.26 and 0.17, respectively). The fPRx distinguished between active and passive reactivity in more than 89% cases. The fPRx can be used with care for assessment of cerebrovascular reactivity in patients for whom invasive ABP measurement is not feasible. The fPRx is sensitive enough to distinguish between functional and deranged reactivity.
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Kasprowicz et al. (2010) conducted an observational in Head injury (n=10). Non-invasive measurement of ABP using a Finapres plethysmograph (fABP) vs. Invasive ABP monitoring was evaluated on Correlation between fPRx and PRx (R(Spearman) 0.92, p=< 0.001). Non-invasive fPRx using Finapres strongly correlated with invasive PRx (R=0.92, p<0.001, bias=-0.04) and distinguished active from passive cerebrovascular reactivity in >89% of cases.
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