title: Comparison of continuous non-invasive finger arterial pressure monitoring with conventional intermittent automated arm arterial pressure measurement in patients under general anaesthesia.
abstract: BACKGROUND
  For a majority of patients undergoing anaesthesia for general surgery, mean arterial pressure (MAP) is only measured intermittently by arm cuff oscillometry (MAPiNIAP). In contrast, the Nexfin(®) device provides continuous non-invasive measurement of MAP (MAPcNIAP) using a finger cuff. We explored the agreement of MAPcNIAP and MAPiNIAP with the gold standard: continuous invasive MAP measurement by placement of a radial artery catheter (MAPinvasive).
  
  
  METHODS
  In a total of 120 patients undergoing elective general surgery and clinically requiring MAPinvasive measurement, MAPiNIAP and MAPcNIAP were measured in a 30 min time period at an arbitrary moment during surgery with stable haemodynamics. MAPiNIAP was measured every 5 min.
  
  
  RESULTS
  Data from 112 patients were analysed. Compared with MAPinvasive, modified Bland-Altman analysis revealed a bias (sd) of 2 (9) mm Hg for MAPcNIAP and -2 (12) mm Hg for MAPiNIAP. Percentage errors for MAPcNIAP and MAPiNIAP were 22% and 32%, respectively.
  
  
  CONCLUSIONS
  In a haemodynamically stable phase in patients undergoing general anaesthesia, the agreement with invasive MAP of continuous non-invasive measurement using a finger cuff was not inferior to the agreement of intermittent arm cuff oscillometry. Continuous measurements using a finger cuff can interchangeably be used as an alternative for intermittent arm cuff oscillometry in haemodynamically stable patients, with the advantage of beat-to-beat haemodynamic monitoring.
  
  
  BACKGROUND
  NCT 01362335 (clinicaltrials.gov).
authors.affiliation: Department of Anesthesiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, PO Box 30 001, 9700 RB Groningen, The Netherlands.
authors.forename: J J
authors.initials: JJ
authors.lastname: Vos
authors.affiliation: Department of Anesthesiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, PO Box 30 001, 9700 RB Groningen, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Poterman
authors.affiliation: Department of Anesthesiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, PO Box 30 001, 9700 RB Groningen, The Netherlands.
authors.forename: E A Q
authors.initials: EA
authors.lastname: Mooyaart
authors.affiliation: Department of Anesthesiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, PO Box 30 001, 9700 RB Groningen, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Weening
authors.affiliation: Department of Anesthesiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, PO Box 30 001, 9700 RB Groningen, The Netherlands.
authors.forename: M M R F
authors.initials: MM
authors.lastname: Struys
authors.affiliation: Department of Anesthesiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, PO Box 30 001, 9700 RB Groningen, The Netherlands.
authors.forename: T W L
authors.initials: TW
authors.lastname: Scheeren
authors.affiliation: Department of Anesthesiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, PO Box 30 001, 9700 RB Groningen, The Netherlands a.kalmar@umcg.nl.
authors.forename: A F
authors.initials: AF
authors.lastname: Kalmar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General / Q000379:methods*; D001795:Blood Pressure Determination / Q000295:instrumentation / Q000379:methods; D015924:Blood Pressure Monitors; D005385:Fingers / Q000098:blood supply; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000295:instrumentation / Q000379:methods*; D009991:Oscillometry / Q000379:methods; D017534:Radial Artery / Q000502:physiology; D015203:Reproducibility of Results; D055815:Young Adult
keywords: NIAP; Nexfin; non-invasive arterial pressure; volume clamp