title: Non-invasive blood pressure and cardiac index measurements using the Finapres Portapres in an emergency department triage setting.
abstract: Emergency department (ED) patients are triaged to determine the urgency of care. The Finapres Portapres (FP) measures blood pressure (BP) and cardiac output (CO) non-invasively, and may be of added value in early detection of patients at risk for hemodynamic compromise.
  
  
  OBJECTIVE
  Compare non-invasive BP measurements using FP and standard automated sphygmomanometry. Compare FP cardiac index (CI), CO corrected for body surface area, of normotensive patients, to chart-based physician estimate of shock, to discover if there is additional value in CI measurements in triage.
  
  
  METHODS
  ED Patients requiring BP measurement in triage were included. Systolic (SBP) and diastolic (DBP) BP were measured using both devices during a two minutes measurement. Two physicians independently judged probability of shock, defined as estimated CI ≤2.5 L min(-1) m(-2), based on chart review, three weeks after ED visit.
  
  
  RESULTS
  Of a total of 112 patients 97 patients were included. Pearson's correlation coefficient was 0.50 for SBP, 0.53 for DBP, with a Blant-Altman mean bias of 11.3 (upper limit 65.3, lower limit -42.8) and 7.7 (39.2, -23.7) for SBP and DBP respectively. In normotensive patients, the group with low FP CI measurements had significantly more cases with physician-estimated shock, compared to the normal to high measurements (P = .036).
  
  
  CONCLUSIONS
  When used as a triage device in the emergency department setting, non-invasive BP measurements using FP do not correlate well with automated sphygmomanometry. However, this study does indicate that use of the FP device in triage may aid physicians to recognize patients in early phases of shock.
authors.affiliation: Department of emergency medicine, Erasmus University Medical Center, Rotterdam, The Netherlands. y.vanderdoes@erasmusmc.nl
authors.forename: Yuri
authors.initials: Y
authors.lastname: van der Does
authors.forename: Lex M
authors.initials: LM
authors.lastname: van Loon
authors.forename: Jelmer
authors.initials: J
authors.lastname: Alsma
authors.forename: Annebel
authors.initials: A
authors.lastname: Govers
authors.forename: Benno
authors.initials: B
authors.lastname: Lansdorp
authors.forename: Pleunie P M
authors.initials: PP
authors.lastname: Rood
authors.forename: Stephanie C E
authors.initials: SC
authors.lastname: Schuit
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001795:Blood Pressure Determination / Q000295:instrumentation*; D002302:Cardiac Output; D004636:Emergency Service, Hospital; D005260:Female; D006334:Heart Function Tests / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012769:Shock / Q000175:diagnosis*; D019722:Sphygmomanometers; D014218:Triage / Q000379:methods*; D055815:Young Adult