Estimation of central arterial pressure from the radial artery in patients undergoing invasive neuroradiological procedures

Abstract

Backgrounds Central arterial pressure can be derived from analysis of the peripheral artery waveform. The aim of this study was to compare central arterial pressures measured from an intra-aortic catheter with peripheral radial arterial pressures and with central arterial pressures estimated from the peripheral pressure wave using a pressure recording analytical method (PRAM). Methods We studied 21 patients undergoing digital subtraction cerebral angiography under local or general anesthesia and equipped with a radial arterial catheter. A second catheter was placed in the ascending aorta for central pressure wave acquisition. Central (AO) and peripheral (RA) arterial waveforms were recorded simultaneously by PRAM for 90–180 s. During an off-line analysis, AO pressures were reconstructed (AO rec ) from the RA trace using a mathematical model obtained by multi-linear regression analysis. The AO rec values obtained by PRAM were compared with the true central pressure value obtained from the catheter placed in the ascending aorta. Results Systolic, diastolic and mean pressures ranged from 79 to 180 mmHg, 47 to 102 mmHg, and 58 to 128 mmHg, respectively, for AO, and 83 to 174 mmHg, 47 to 107 mmHg, and 60 to 129 mmHg, respectively, for RA. The correlation coefficients between AO and RA were 0.86 (p < 0.01), 0.83 (p < 0.01) and 0.86 (p < 0.01) for systolic, diastolic and mean pressures, respectively, and the mean differences − 0.3 mmHg, 2.4 mmHg and 1.5 mmHg. The correlation coefficients between AO and AO rec were 0.92 (p < 0.001), 0.87 (p < 0.001) and 0.92 (p < 0.001), for systolic, diastolic and mean pressures, respectively, and the mean differences 0.01 mmHg, 1.8 mmHg and 1.2 mmHg. Conclusions PRAM can provide reliable estimates of central arterial pressure. Electronic supplementary material The online version of this article (10.1186/s12871-019-0844-1) contains supplementary material, which is available to authorized users.

Accuracy of Noninvasive Blood Pressure Versus Central Aortic Pressure in Patients Supported on Left Ventricular Assist Device Therapy

“…Although NIBP measurement provides a reliable estimate of AoP across the cohort on average, these data suggest that low NIBP-MAPs underestimated true invasive values and high NIBP-MAPs overestimated true invasive values-the latter finding previously shown 4 and overall findings similar to peripheral and central pressures in nonLVAD patients. 6 e135 Indeed, there was a statistically significant difference in NIBP-MAP values and AoP-MAP values when stratified by the mean NIBP-MAP such that AoP was higher at low NIBP values (<81 mm Hg) and lower at high NIBP values (≥81 mm Hg). Furthermore, the significant outliers and the suboptimal negative predictive value of 74% to rule out central aortic hypertension can pose a challenge to clinical management.…”

“…Although NIBP measurement provides a reliable estimate of AoP across the cohort on average, these data suggest that low NIBP-MAPs underestimated true invasive values and high NIBP-MAPs overestimated true invasive values—the latter finding previously shown 4 and overall findings similar to peripheral and central pressures in nonLVAD patients. 6…”