title: Validation of non-invasive arterial pressure monitoring during carotid endarterectomy.
abstract: BACKGROUND
  Patients undergoing carotid endarterectomy require strict arterial blood pressure (BP) control to maintain adequate cerebral perfusion. In this study we tested whether non-invasive beat-to-beat Nexfin finger BP (BPfin) can replace invasive beat-to-beat radial artery BP (BPrad) in this setting.
  
  
  METHODS
  In 25 consecutive patients (median age 71 yr) scheduled for carotid endarterectomy and receiving general anaesthesia, BPfin and BPrad were monitored simultaneously and ipsilaterally during the 30-min period surrounding carotid artery cross-clamping. Validation was guided by the standard set by the Association for the Advancement of Medical Instrumentation (AAMI), which considers a BP monitor adequate when bias (precision) is <5 (8) mm Hg, respectively.
  
  
  RESULTS
  BPfin vs BPrad bias (precision) was -3.3 (10.8), 6.1 (5.7) and 3.5 (5.2) mm Hg for systolic, diastolic, and mean BP, respectively. One subject was excluded due to a poor quality BP curve. In another subject, mean BPfin overestimated mean BPrad by 13.5 mm Hg.
  
  
  CONCLUSIONS
  Mean BPfin could be considered as an alternative for mean BPrad during a carotid endarterectomy, based on the AAMI criteria. In 23 of 24 patients, the use of mean BPfin would not lead to decisions to adjust mean BPrad values outside the predefined BP threshold.
  
  
  BACKGROUND
  NCT01451294.
authors.affiliation: Department of Anaesthesiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: J F
authors.initials: JF
authors.lastname: Heusdens
authors.affiliation: Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: Lof
authors.affiliation: Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: C W A
authors.initials: CW
authors.lastname: Pennekamp
authors.affiliation: Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: J C
authors.initials: JC
authors.lastname: Specken-Welleweerd
authors.affiliation: Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: G J
authors.initials: GJ
authors.lastname: de Borst
authors.affiliation: Department of Anaesthesiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: W A
authors.initials: WA
authors.lastname: van Klei
authors.affiliation: Department of Anaesthesiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: L
authors.initials: L
authors.lastname: van Wolfswinkel
authors.affiliation: Department of Anaesthesiology, University Medical Center Utrecht, Utrecht, The Netherlands Department of Anaesthesiology, H 1-158, Academic Medical Center Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands r.v.immink@amc.uva.nl.
authors.forename: R V
authors.initials: RV
authors.lastname: Immink
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D062186:Arterial Pressure / Q000502:physiology*; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic
keywords: Nexfin; carotid endarterectomy; measurement techniques, arterial pressure; non-invasive continuous arterial pressure measurement