Clinical validation of a continuous non-invasive haemodynamic monitor (CNAP™ 500) during general anaesthesia

Hahn, Reinhard; Rinösl, Harald; Neuner, M.; Kettner, Stephan C.

doi:10.1093/bja/aer499

Cited by 66 publications

(44 citation statements)

References 14 publications

(15 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Their study results showed that the standard deviation of the difference between the two devices was approximately ± 12 mmHg at the mode (75 mmHg MAP). 95 While these authors did not calculate the limits of agreement, a rough estimate that does not take into account repeated measures suggests that the confidence intervals of standard NIBP are worse than those reported in a number of volume-clamp studies [e.g., Martina (Nexfin), 96 Weiss (Nexfin), 97 Jeleazcov (CNAP), 98 Jagadeesh (CNAP), 99 Dewhirst (CNAP), 100 Tobias (CNAP), 101 and Ilies (CNAP)] 102 but similar to those in other volume-clamp studies [Biais (CNAP), 103 Hahn (CNAP), 104 McCarthy 2012 (CNAP), 105 and Schramm (CNAP)]. 106 At the extremes (significantly above or below a MAP of 75 mmHg), when accurate measurement of blood pressure is increasingly important, NIBP performance deteriorated.…”

Section: Clinical Contextsupporting

confidence: 68%

Advances in photoplethysmography: beyond arterial oxygen saturation

Bartels

Thiele

2015

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Purpose Photoplethysmography permits continuous measurement of heart rate and peripheral oxygen saturation and has been widely used to inform clinical decisions. Recently, a myriad of noninvasive hemodynamic monitoring devices using this same technology have been increasingly available. This narrative review aims to summarize the principles that form the basis for the function of these devices as well as to comment on trials evaluating their accuracy and clinical application. Principal findings Advanced monitoring devices extend photoplethysmography technology beyond measuring oxygen concentration and heart rate. Quantification of respiratory variation of the photoplethysmographic waveform reflects respiratory variation of the arterial pressure waveform and can be used to gauge volume responsiveness. Both the volume-clamp and physiocal techniques are extensions of conventional photoplethysmography and permit continuous measurement of finger arterial blood pressure. Finger arterial pressure waveforms can subsequently inform estimations of cardiac output. Conclusions Although respiratory variations of the plethysmographic waveform correlate only modestly with the arterial blood pressure waveform, fluid responsiveness can be relatively consistently assessed using both approaches. Continuous blood pressure measurements obtained using the volume-clamp technique may be as accurate as conventional brachial noninvasive blood pressure measurements. Most importantly, clinical comparative effectiveness studies are still needed in order to determine if these technologies can be translated into improvement of relevant patient outcomes. RésuméObjectif La photopléthysmographie permet la mesure continue de la fréquence cardiaque et de la saturation en oxygène périphérique, et elle est largement utilisée pour les prises de décisions cliniques. Depuis peu, un très grand nombre de dispositifs non invasifs de surveillance hémodynamique utilisant la même technologie envahit le marché. Cette synthèse narrative vise à résumer les principes à la base du fonctionnement de ces dispositifs et à commenter les essais évaluant leur exactitude ainsi que leurs applications cliniques. Constatations principales Les dispositifs de surveillance avancée étendent la technologie de photopléthysmographie au-delà de la mesure de la concentration en oxygène et de la fréquence cardiaque. La quantification de la variation respiratoire du tracé photopléthysmographique reflète la variation respiratoire du tracé de pression artérielle et peut servir à jauger la réactivité au volume. Les deux techniques de compression volumique (volume-clamp) au doigt et la technique physiocal sont des prolongements de Author contributions Karsten Bartels wrote approximately 50% of the manuscript and critically edited the remainder. Robert H. Thiele wrote approximately 50% of the manuscript and critically edited the remainder.

show abstract

Section: Clinical Contextsupporting

confidence: 68%

Advances in photoplethysmography: beyond arterial oxygen saturation

Bartels

Thiele

2015

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

show abstract

“…In critically ill patients, continuous monitoring of hemodynamic parameters (especially monitoring of basic vital parameters like heart rate and blood pressure [BP]) is required. Different methods for continuous noninvasive BP monitoring have been described [1][2][3][4][5][6][7][8][9]. Among others, there are BP monitoring systems providing a continuous BP waveform based on photoplethysmography [1][2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

“…Different methods for continuous noninvasive BP monitoring have been described [1][2][3][4][5][6][7][8][9]. Among others, there are BP monitoring systems providing a continuous BP waveform based on photoplethysmography [1][2][3][4][5]. In addition, the applanation tonometry method with a sensor placed over the radial artery has been demonstrated to be able to provide a BP waveform and BP values in a noninvasive and continuous manner [6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the radial artery applanation tonometry technology for continuous noninvasive blood pressure monitoring compared with central aortic blood pressure measurements in patients with multiple organ dysfunction syndrome

Meidert¹,

Huber²,

Hapfelmeier³

et al. 2013

Journal of Critical Care

View full text Add to dashboard Cite

“…The non‐acceptable accuracy of the Task Force Monitor in estimating SBP is not in accordance with other studies (Hahn et al ., ; Ilies et al ., ). We acknowledge that our adjustment of adding 16 mmHg and subtracting 4 mmHg from the Task Force Monitor's measurements of SBP and DBP, respectively, might have distorted the estimations.…”

Section: Discussionmentioning

confidence: 99%

Validation of non‐invasive haemodynamic methods in patients with liver disease: the Finometer and the Task Force Monitor

Brittain

Busk

Möller

2017

Clin Physio Funct Imaging

View full text Add to dashboard Cite

Patients with advanced cirrhosis often present a hyperdynamic circulation characterized by a decrease in systolic and diastolic blood pressure (SBP and DBP), and an increase in heart rate (HR) and cardiac output (CO). Accurate assessment of the altered circulation can be performed invasively; however, due to the disadvantages of this approach, non-invasive methods are warranted. The purpose of this study was to compare continuous non-invasive measurements of haemodynamic variables by the Finometer and the Task Force Monitor with simultaneous invasive measurements. In 25 patients with cirrhosis, SBP, DBP and HR were measured non-invasively and by femoral artery catheterization. CO was measured non-invasively and by indicator dilution technique. The non-invasive pressure monitoring was considered acceptable with a bias (accuracy) and a SD (precision) not exceeding 5 and 8 mmHg, respectively, as recommended by the Association for the Advancement of Medical Instrumentation. The accuracy and precision of the Finometer and the Task Force Monitor were as follows: SBP: -3·6 ± 17·9 and -8·9 ± 17·5 mmHg, respectively; DBP: 4·2 ± 9·6 and 1·9 ± 8·6 mmHg, respectively; HR: 2·0 ± 6·9 and 2·2 ± 6·2 bpm, respectively; and CO: 0·1 ± 1·6 and -1·0 ± 2·0 L min , respectively. The study demonstrates that the overall performances of the Finometer and the Task Force Monitor in estimating absolute values of SBP, DBP, HR and CO in patients with cirrhosis are not equivalent to the gold standard, but may have an acceptable performance with repeated measurements.

show abstract

Clinical validation of a continuous non-invasive haemodynamic monitor (CNAP™ 500) during general anaesthesia

Abstract: The new CNAP monitor showed an agreement with the IAP that is promising but did not match our predefined criteria.

Cited by 66 publications

References 14 publications

Advances in photoplethysmography: beyond arterial oxygen saturation

Advances in photoplethysmography: beyond arterial oxygen saturation

Evaluation of the radial artery applanation tonometry technology for continuous noninvasive blood pressure monitoring compared with central aortic blood pressure measurements in patients with multiple organ dysfunction syndrome

Validation of non‐invasive haemodynamic methods in patients with liver disease: the Finometer and the Task Force Monitor

Contact Info

Product

Resources

About