Use of the Nexfin™ device to detect acute arterial pressure variations during anaesthesia induction.
BACKGROUND
Standard non-invasive arterial pressure (AP) measurements are discontinuous. By providing non-invasive beat-to-beat AP measurements, Nexfin™ might limit duration of intraoperative hypotension and hypertension. We assessed the ability of Nexfin™ to detect AP variations by comparing its trending ability with invasive AP monitoring.


METHODS
Thirty-one subjects undergoing elective surgery under general anaesthesia were included. During induction, simultaneous pairs of AP measurements were collected every 5 s from the Nexfin™ finger sensor and a homolateral radial artery catheter. Magnitude and time lags of AP variations from baseline to nadir and peak were calculated for both methods. Concordance analysis was performed by the Bland-Altman method (for comparison of repeated measures when appropriate).


RESULTS
Nexfin™ detected 100% of AP changes with the median delays of 0 s (-13 to 7) and 0 s (-5 to 12) for nadir and peak, respectively. Bias [limits of agreement (LOA)] of systolic AP (SAP) variations was -0.5 mm Hg (-31.2 to 30.2) and -9.4 mm Hg (-31.3 to 12.6) from baseline to nadir and from baseline to peak, respectively. For 3479 analysed paired measurements, bias was -3.8 and -8.8 mm Hg for SAP and diastolic AP, with LOA of (-36.0 to 28.5) and (-29.8 to 12.3), respectively.


CONCLUSIONS
Nexfin™ detects AP variations accurately and can be a useful warning device during anaesthesia. However, it is not interchangeable with invasive monitoring, given the large LOA between the two measurements.


BACKGROUND
NCT01658631.
Department of Anaesthesia, Hôpital Foch, University Versailles Saint-Quentin en Yvelines, 92151 Suresnes, France.
E
E
Weiss
Department of Anaesthesia and Intensive Care, Hôpital Lariboisière, University Paris Diderot, 75010 Paris, France.
E
E
Gayat
Department of Anaesthesia, Hôpital Foch, University Versailles Saint-Quentin en Yvelines, 92151 Suresnes, France.
V
V
Dumans-Nizard
Department of Anaesthesia, Hôpital Foch, University Versailles Saint-Quentin en Yvelines, 92151 Suresnes, France.
M
M
Le Guen
Department of Anaesthesia, Hôpital Foch, University Versailles Saint-Quentin en Yvelines, 92151 Suresnes, France m.fischler@hopital-foch.org.
M
M
Fischler
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General / Q000379:methods*; D001794:Blood Pressure / Q000502:physiology; 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; D011446:Prospective Studies; D017534:Radial Artery / Q000502:physiology; D015203:Reproducibility of Results; D055815:Young Adult
anaesthesiology; arterial pressure monitors; monitoring, intraoperative