Key result
Non-invasive CNAP monitoring tracks invasive MAP closely during cardiac surgery induction, with ~0 mmHg bias.
Why the study?
Invasive arterial pressure monitoring carries complications, and although a new continuous non-invasive arterial pressure (CNAP) device was validated in non-cardiac surgeries, its performance compared with invasive arterial pressure during general anaesthesia induction in cardiac surgery needed assessment.
Observational (n=60)
Open-label
No
Answers are grounded in this paper and cite their sources.
May support CNAP during cardiac induction; extends non-cardiac validation but leaves open need for larger trials before adoption.
BACKGROUND AND AIMS: Continuous arterial pressure monitoring is essential in cardiac surgical patients during induction of general anaesthesia (GA). Continuous non-invasive arterial pressure (CNAP) monitoring is fast gaining importance due to complications associated with the invasive arterial monitoring. Recently, a new continuous non-invasive arterial pressure device (CNAP™) has been validated perioperatively in non-cardiac surgeries. The aim of our study is to compare and assess the performance of CNAP during GA with invasive arterial pressure (IAP) in patients undergoing cardiac surgeries. METHODS: Sixty patients undergoing cardiac surgery were included. Systolic, diastolic, and mean arterial pressure (MAP) data were recorded every minute for 20 min simultaneously for both IAP and CNAP™. Statistical analysis was performed using mountain plot and Bland Altman plots for assessing limits of agreement and bias (accuracy) calculation. Totally 1200 pairs of data were analysed. RESULTS: The CNAP™ systolic, diastolic and MAP bias was 5.98 mm Hg, -3.72 mm Hg, and - 0.02 mm Hg respectively. Percentage within limits of agreement was 96.0%, 95.2% and 95.7% for systolic, diastolic and MAP. The mountain plot showed similar results as the Bland Altman plots. CONCLUSION: We conclude CNAP™ provides real-time estimates of arterial pressure comparable to IAP during induction of GA for cardiac surgery. We recommend CNAP can be used as an alternative to IAP in situations such as cardiac patients coming for non-cardiac surgeries, cardiac catheterization procedures, positive Allen's test, inability to cannulate radial artery and vascular diseases, where continuous blood pressure monitoring is required.
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Kumar et al. (2015) conducted an observational in Patients undergoing cardiac surgery during induction of general anaesthesia (n=60). Continuous non-invasive arterial pressure (CNAP™) monitoring vs. Invasive arterial pressure (IAP) monitoring via radial artery catheter was evaluated on Mean difference (bias) and limits of agreement in mean arterial pressure (MAP) between CNAP™ and IAP (MD -0.02 mm Hg, 95% CI -11.17 to 11.12). Continuous non-invasive arterial pressure (CNAP™) monitoring showed high agreement with invasive radial pressure during cardiac surgery induction, with biases of 5.98, -3.72, and -0.02 mm Hg for systolic, diastolic, and MAP.
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