Measurement error risk for finger-cuff blood pressure after aortic valve replacement are aortic valve area index and heart rate; FloTrac vs ClearSight

Abstract

Purpose: The accuracy of ClearSightTM blood pressure measurements in patients with postaortic valve replacement may be inaccurate compared to intra-arterial pressure, the clinical risk of measurement discrepancy remains uncertain. This study aimed to determine the factors associated with errors in measurement. Methods: From October 2020 to November 2021, we collected 881 pairs of intra-arterial/ClearSight blood pressure measurements from 30 adults who underwent transcatheter aortic valve replacement. The agreement of ClearSight blood pressure with intra-arterial pressure was compared, and the clinical risk was evaluated by classifying measurement errors into zones A (no risk) to E (dangerous risk) using error grid analysis. Results: The bias and precision of ClearSight measurement were −4.88 ± 15.46 (mmHg) for systolic, 4.73 ± 8.95 (mmHg) for the mean and 9.53 ± 9.01 (mmHg) for the diastolic blood pressure. The proportions of measurement pairs in zones A were 88.0% for systolic BP and 71.2% for mean BP, respectively. Logistic regression analysis revealed that the risk of measurement error being outside zone A was heart rate [odds ratio, 1.24; 95% confidence interval, 1.15 to 1.35; p<0.001] for systolic and mean blood pressure, and aortic valve area index < 1.0 (cm2. m−2) [odds ratio, 1.62; 95% confidence interval, 1.21 to 2.16; p=0.02] for mean blood pressure.Conclusion: These findings could help to identify patients of unsuitable for ClearSight blood pressure measurement. Our results demonstrate that the small aortic valve area index and low cardiac index are risk factors for measurement error.

Arterial blood pressure monitoring using three different technologies during neuro radiological procedure: a prospective, monocentric, observational study

“…In the operating room, some studies have shown reliable measures between the Nex n and invasive measurement with acceptable agreement for ABP ( There are only few studies that investigated 'clinical concordance' of non-invasive ABP measurement (Bugarini et al 2021;Kho et al 2022;Yahagi et al 2022).…”