Continuous noninvasive finger blood pressure measurement showed an overall mean bias of 0.10 mm Hg compared to invasive monitoring, with 95% of measurements differing by ≤10 mm Hg.
Observational (n=39)
No
Does continuous noninvasive finger blood pressure measurement accurately reflect invasive arterial blood pressure in critically ill patients?
Noninvasive continuous finger blood pressure measurement using a finger cuff is generally accurate in critically ill patients, though significant discrepancies can occasionally occur.
Mean Difference: 0.1
OBJECTIVE: To evaluate the accuracy and reliability of noninvasive continuous finger blood pressure measurement in critically ill patients. DESIGN: Prospective data collection. SETTING: Emergency department in a 2,000-bed hospital. PATIENTS: Thirty-nine patients admitted to the emergency department requiring invasive arterial blood pressure monitoring were enrolled to the study protocol. INTERVENTIONS: Continuous noninvasive blood pressure measurement was performed on the middle phalanx of the second and third finger, using a test instrument which provides continuous arterial waveform display with the use of a finger cuff. Invasive mean arterial blood pressure measurement was done by cannulation of the radial artery and direct transduction of the systemic arterial pressure waveform. MEASUREMENTS AND MAIN RESULTS: Three thousand one hundred eighteen pairs of simultaneous finger cuff and intra-arterial blood pressure measurements were collected in 1-min intervals from 39 patients over a total of 51.8 hrs. The overall discrepancy between both measurements was 0.10 mm Hg. The standard deviation of the differences was +/- 5.02 mm Hg. The mean bias in patients treated with catecholamines was 0.01 mm Hg and was not different from the bias observed in patients without catecholamines (mean bias: 0.23 mm Hg; p > .22). Whereas 95% of all comparisons between finger cuff and intra-arterial measurement had a discrepancy +/- 15 mm Hg. In 29 (74%) patients, the duration of errors > 10 mm Hg was 10 mm Hg was between 2 to 3 mins and in three (8%) patients, the errors lasted for > 3 mins. CONCLUSIONS: Our data provide a guide to the accuracy and reliability of noninvasive finger blood pressure measurements in critically ill patients. Although most test instrument measurements were reliable, in 8% of all patients large discrepancies (> 10 mm Hg) between both measurements with a duration of > 3 mins were noted. Concerning the considerable risk for arterial cannulation, our preliminary data demonstrate that the test instrument (PORTAPRES, TNO Biomedical Instrumentation Research Unit; The Netherlands) is an advance in noninvasive monitoring of critically ill patients and may be useful in most emergency clinical settings.
Hirschl et al. (Tue,) conducted a observational in Critically ill requiring invasive arterial blood pressure monitoring (n=39). Continuous noninvasive finger blood pressure measurement vs. Invasive mean arterial blood pressure measurement (radial artery cannulation) was evaluated on Discrepancy between noninvasive finger cuff and intra-arterial blood pressure measurements (Mean discrepancy 0.10 mm Hg). Continuous noninvasive finger blood pressure measurement showed an overall mean bias of 0.10 mm Hg compared to invasive monitoring, with 95% of measurements differing by ≤10 mm Hg.