title: Accuracy of continuous noninvasive arterial pressure monitoring in living-liver donors during transplantation.
abstract: OBJECTIVE
  Hemodynamic monitoring is vital during liver transplant surgeries because distinct hemodynamic changes are expected. The continuous noninvasive arterial pressure (CNAP) monitor is a noninvasive device for continuous arterial pressure measurement by a tonometric method. This study compared continuous noninvasive arterial pressure monitoring with invasive direct arterial pressure monitoring in living-liver donors during transplant.
  
  
  METHODS
  There were 40 patients analyzed while undergoing hepatic lobectomy for liver transplant. Invasive pressure monitoring was established at the radial artery and continuous noninvasive arterial pressure monitoring using a finger sensor was recorded simultaneously from the contralateral arm. Systolic, diastolic, and mean arterial pressures from the 2 methods were compared. Correlation between the 2 methods was calculated.
  
  
  RESULTS
  A total of 5433 simultaneous measurements were obtained. For systolic arterial blood pressure, 55% continuous noninvasive arterial pressure measurements were within 10% direct arterial measurement; the correlation was 0.479, continuous noninvasive arterial pressure bias was -0.3 mm Hg, and limits of agreement were 32.0 mm Hg. For diastolic arterial blood pressure, 50% continuous noninvasive arterial pressure measurements were within 10% direct arterial measurement; the correlation was 0.630, continuous noninvasive arterial pressure bias was -0.4 mm Hg, and limits of agreement were 21.1 mm Hg. For mean arterial blood pressure, 60% continuous noninvasive arterial pressure measurements were within 10% direct arterial measurement; the correlation was 0.692, continuous noninvasive arterial pressure bias was +0.4 mm Hg, and limits of agreement were 20.8 mm Hg.
  
  
  CONCLUSIONS
  The 2 monitoring techniques did not show acceptable agreement. Our results suggest that continuous noninvasive arterial pressure monitoring is not equivalent to invasive arterial pressure monitoring in donors during living-donor liver transplant.
authors.affiliation: From the Department of Anesthesiology, Baskent University Faculty of Medicine, Ankara, Turkey.
authors.forename: Coskun
authors.initials: C
authors.lastname: Araz
authors.forename: Pinar
authors.initials: P
authors.lastname: Zeyneloglu
authors.forename: Arash
authors.initials: A
authors.lastname: Pirat
authors.forename: Nukhet
authors.initials: N
authors.lastname: Veziroglu
authors.forename: Aynur
authors.initials: A
authors.lastname: Camkiran Firat
authors.forename: Gulnaz
authors.initials: G
authors.lastname: Arslan
mesh_terms: D000328:Adult; D062186:Arterial Pressure; D015924:Blood Pressure Monitors; D002406:Catheterization, Peripheral / Q000295:instrumentation; D005260:Female; D005385:Fingers / Q000098:blood supply*; D006498:Hepatectomy / Q000009:adverse effects; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D019520:Living Donors; D008297:Male; D008365:Manometry; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000295:instrumentation / Q000379:methods*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D014160:Transducers, Pressure; D016896:Treatment Outcome; D062666:Vascular Access Devices; D055815:Young Adult