title: Radial artery applanation tonometry for continuous noninvasive arterial blood pressure monitoring in the cardiac intensive care unit.
abstract: BACKGROUND
  Hemodynamic monitoring plays a pivotal role in the treatment of patients in the cardiac intensive care unit (CICU). The innovative radial artery applanation tonometry technology allows for continuous noninvasive arterial blood pressure (AP) measurement. By closing the gap between continuous invasive AP monitoring (arterial catheter) and intermittent noninvasive AP monitoring (oscillometry) this technology might improve CICU patient monitoring. We therefore aimed to evaluate the measurement performance of radial artery applanation tonometry in comparison with a radial arterial catheter in CICU patients.
  
  
  METHODS
  In this prospective method comparison study, we simultaneously recorded AP noninvasively with radial artery applanation tonometry (T-line 200 pro device; Tensys Medical Inc., San Diego, CA, USA) and invasively with an arterial catheter (criterion standard) in 30 patients treated in the CICU of a German university hospital. We statistically analyzed 7,304 averaged 10-beat epochs of measurements of mean AP, systolic AP, and diastolic AP by using Bland-Altman analysis for repeated measurements.
  
  
  RESULTS
  Our study revealed a mean difference ± standard deviation (95% limits of agreement; percentage error) between radial artery applanation tonometry and the criterion standard method (radial arterial catheter) of +2 ± 6 mmHg (-10 to +14 mmHg; 17%) for mean AP, -6 ± 11 mmHg (-28 to +15 mmHg; 20%) for systolic AP, and +4 ± 7 mmHg (-9 to +17 mmHg; 23%) for diastolic AP.
  
  
  CONCLUSIONS
  In CICU patients, continuous noninvasive measurement of AP using radial artery applanation tonometry is feasible. The technology showed reasonable accuracy and precision in comparison with radial arterial catheter-derived AP values.
authors.affiliation: I. Medizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Strasse 22, 81675, Munich, Germany.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Langwieser
authors.forename: Luisa
authors.initials: L
authors.lastname: Prechtl
authors.forename: Agnes S
authors.initials: AS
authors.lastname: Meidert
authors.forename: Alexander
authors.initials: A
authors.lastname: Hapfelmeier
authors.forename: Christian
authors.initials: C
authors.lastname: Bradaric
authors.forename: Tareq
authors.initials: T
authors.lastname: Ibrahim
authors.forename: Karl-Ludwig
authors.initials: KL
authors.lastname: Laugwitz
authors.forename: Roland M
authors.initials: RM
authors.lastname: Schmid
authors.forename: Julia Y
authors.initials: JY
authors.lastname: Wagner
authors.forename: Bernd
authors.initials: B
authors.lastname: Saugel
mesh_terms: D000368:Aged; D062186:Arterial Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005858:Germany; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008365:Manometry / Q000379:methods*; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D011446:Prospective Studies; D017534:Radial Artery