title: Precision and accuracy of a new device (CNAPTM) for continuous non-invasive arterial pressure monitoring: assessment during general anaesthesia.
abstract: BACKGROUND
  Continuous non-invasive arterial pressure measured with CNAP (CNAP) has been shown to be superior to intermittent oscillometric measurements during procedural sedation and spinal anaesthesia. We assessed the performance of CNAP during general anaesthesia by analysis of agreement with invasive measurements of arterial pressure (AP).
  
  
  METHODS
  Eighty-eight patients undergoing elective abdominal surgery, cardio-, or neurosurgery were included in the study. Systolic, diastolic, and mean AP measured by an intra-arterial catheter in the radial artery (IAP) were compared with those obtained by CNAP from the same arm. Data were analysed to determine the precision (i.e. measurement error) and accuracy (i.e. systematic error) of beat-to-beat CNAP values with respect to IAP. Also, we compared the frequency of fast changes in AP (FCAP) and hypotension (IOH) by both methods.
  
  
  RESULTS
  CNAP precision of 4.5, 3.1, and 3.2 mm Hg (systolic, diastolic, and mean AP, respectively) was not significantly different from IAP precision, and CNAP accuracy was +6.7, -5.6, and -1.6 mm Hg. The frequency of AP pairs having a difference within the calculated limits of agreement was 81%, 64%, and 76% for systolic, diastolic, and mean AP, respectively. The calculated limits of agreement were +/-17.6, +/-11.4, and +/-12.0 mm, Hg, respectively. CNAP and IAP detected simultaneously to 82.1% FCAP and to 84.6% IOH.
  
  
  CONCLUSIONS
  CNAP provides real-time estimates of arterial pressure comparable with those generated by an invasive intra-arterial catheter system during general anaesthesia.
authors.affiliation: Department of Anesthesiology, University of Erlangen-Nuremberg, Erlangen, Germany. christian.jeleazcov@kfa.imed.uni-erlangen.de
authors.forename: C
authors.initials: C
authors.lastname: Jeleazcov
authors.forename: L
authors.initials: L
authors.lastname: Krajinovic
authors.forename: T
authors.initials: T
authors.lastname: Münster
authors.forename: T
authors.initials: T
authors.lastname: Birkholz
authors.forename: R
authors.initials: R
authors.lastname: Fried
authors.forename: J
authors.initials: J
authors.lastname: Schüttler
authors.forename: J
authors.initials: J
authors.lastname: Fechner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000295:instrumentation / Q000379:methods; D015924:Blood Pressure Monitors; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000295:instrumentation* / Q000379:methods; D009991:Oscillometry / Q000379:methods; D011446:Prospective Studies; D017534:Radial Artery / Q000502:physiology; D015203:Reproducibility of Results; D012815:Signal Processing, Computer-Assisted