Non-invasive continuous arterial pressure and pulse pressure variation measured with Nexfin^®in patients following major upper abdominal surgery: a comparative study

Abstract

Summary We compared the accuracy and precision of the non‐invasive Nexfin® device for determining systolic, diastolic, mean arterial pressure and pulse pressure variation, with arterial blood pressure values measured from a radial artery catheter in 19 patients following upper abdominal surgery. Measurements were taken at baseline and following fluid loading. Pooled data results of the arterial blood pressures showed no difference between the two measurement modalities. Bland–Altman analysis of pulse pressure variation showed significant differences between values obtained from the radial artery catheter and Nexfin finger cuff technology (mean (SD) 1.49 (2.09)%, p < 0.001, coefficient of variation 24%, limits of agreement −2.71% to 5.69%). The effect of volume expansion on pulse pressure variation was identical between methods (concordance correlation coefficient 0.848). We consider the Nexfin monitor system to be acceptable for use in patients after major upper abdominal surgery without major cardiovascular compromise or haemodynamic support.

Validation of noninvasive continuous arterial pressure measurement by ClearSight System™ during induction of anesthesia for cardiovascular surgery

“…First, when we reviewed our preserved data from 18 patients before data analysis, the characteristics of patients were similar to those in previous prospective studies. The exclusion criteria in previous studies included peripheral arterial disease, preoperative atrial fibrillation, and obesity (> BMI 30) [4,7,15,16], and such patients were also not included in our study. Second, when data are collected from the anesthetic record, the time to intubate may not be accurate.…”

“…If ClearSight System™ can replace intra-arterial pressure measurement, blood pressure could be continuously, easily, and noninvasively assessed. Previous studies have shown that this device is reliable in pregnant women [2], children [3], and patients undergoing upper abdominal surgery [4]. On the other hand, it has been reported that it is not reliable in critically ill patients [5] and patients undergoing neurosurgery in a sitting position [6].…”

Pleth variability index or stroke volume optimization during open abdominal surgery: a randomized controlled trial

“…One meta-analysis reported the offline assessment of respiratory variation in pulse oximetry plethysmographic waveform amplitude (∆POP) for predicting fluid responsiveness to be comparable to that of PVI (AUC 0.89 vs 0.95), but this technique is as yet not available in real time [ 26 ]. Also, pulse pressure variation and stroke volume variation can now be obtained non-invasively using the Nexfin/Clearsight™ or the CNAP™ systems, but their capacity for predicting fluid responsiveness differs between studies [ 27 – 30 ]. The same applies to measurements of the variability of the diameter of the caval vein or other veins during positive pressure ventilation [ 31 ].…”

Non-invasive measurement of pulse pressure variation using a finger-cuff method in obese patients having laparoscopic bariatric surgery

“…Higher overall PPV values in our study may-in part-explain wider 95%-LoA between PPV Finger and PPV ART in the present study compared to previous studies [10,11]. Additionally, these studies used offline calculation with the same formula for both, PPV Finger and PPV ART [10,11], whereas we compared PPV Finger automatically calculated using the PPV Finger algorithm and PPV ART calculated by the patient monitor.…”