Key result
Experimental BP monitor improves MAP accuracy over Doppler, overestimating by only ~1 mm Hg.
Why the study?
The Doppler technique for noninvasive blood pressure measurement does not provide systolic and diastolic pressures and may limit therapy outcomes in patients with LVADs.
Does an experimental BP monitor improve blood pressure measurement accuracy compared to the Doppler technique in patients with end-stage heart failure supported with continuous-flow LVADs?
Observational (n=31)
Does an experimental BP monitor improve blood pressure measurement accuracy compared to the Doppler technique in patients with end-stage heart failure supported with continuous-flow LVADs?
An experimental noninvasive blood pressure monitor provides more accurate MAP measurements and additional SBP/DBP readings compared to standard Doppler in LVAD patients.
The gold standard for noninvasive blood pressure (BP) measurement, the Doppler technique, does not provide systolic blood pressure (SBP) and diastolic blood pressure (DBP) and may limit therapy outcomes. To improve patient care, we tested specifically designed experimental BP (ExpBP) monitor and the Doppler technique by comparing noninvasive measures to the intraarterial (I-A) BP in 31 patients with end-stage heart failure (4 females) 2.6 ± 3.4 days post-LVAD implantation (20 HeartMate II and 11 HeartWare). Bland-Altman plots revealed that the ExpBP monitor overestimated mean arterial pressure (MAP) by 1.2 (4.8) mm Hg (mean difference [standard deviation]), whereas the Doppler by 6.7 (5.8) mm Hg. The ExpBP SBP was overestimated by 0.8 (6.1) mm Hg and DBP by 1.9 (5.3) mm Hg compared with the respective I-A pressures. Both techniques achieved similar measurement reliability. In the measurement "success rate" expressed as a frequency (percent) of readable BP values per measurement attempts, Doppler accomplished 100% vs. 97%, 97%, and 94% of successful detections of MAP, SBP, and DBP provided by the ExpBP monitor. The ExpBP monitor demonstrated higher accuracy in the MAP assessment than the Doppler in addition to providing SBP and DBP in majority of subjects. Improved BP control may help to mitigate related neurologic adverse event rates.
No takes yet. Share an insight, caveat, or question.
Sajgalik et al. (2018) conducted an observational in End-stage heart failure supported with continuous-flow left ventricular assist devices (n=31). Experimental BP (ExpBP) monitor vs. Doppler technique was evaluated on Mean arterial pressure (MAP) overestimation compared to intraarterial BP (mm Hg). The experimental BP monitor demonstrated higher accuracy in mean arterial pressure assessment than the Doppler technique (overestimating by 1.2 vs 6.7 mm Hg) and provided systolic and diastolic BP.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: