Noninvasive measurement of arterial blood pressure in patients with continuous-flow left ventricular assist devices: a systematic review

Álvarez, Paulino; Ponnapureddy, Rakesh; Voruganti, Dinesh; Duque, Ernesto Ruiz; Briasoulis, Αlexandros

doi:10.1007/s10741-020-10006-4

Cited by 7 publications

(9 citation statements)

References 36 publications

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“…They proposed an algorithm with Doppler and automatic blood pressure measurements after reviewing different noninvasive blood devices in multiple studies. Alvarez et al focused mainly on the correlation coefficient of the techniques with the A‐line 30 . We chose to compare the results directly with a shared validity standard, the mean difference with the A‐line as reference, in combination with the acceptance criteria of the AAMI.…”

Section: Discussionmentioning

confidence: 99%

“…Alvarez et al focused mainly on the correlation coefficient of the techniques with the A‐line. 30 We chose to compare the results directly with a shared validity standard, the mean difference with the A‐line as reference, in combination with the acceptance criteria of the AAMI. In addition, a technical background was provided to offer understanding of each technique and therefore a better insight into the potential of each technique.…”

Section: Discussionmentioning

confidence: 99%

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Validity and success rate of noninvasive mean arterial blood pressure measurements in cf‐LVAD patients: A technical review

et al. 2022

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Validity and success rate of noninvasive mean arterial blood pressure measurements in cf‐LVAD patients: A technical review

et al. 2022

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“…Alvarez et al 2 presented a systematic review about the non-invasive methods of BP measurement in patients with CFLVADs. The authors highlighted four major categories of the methods: Doppler-based measurement, oscillometric automated measurement, pulse oximeter-based measurement, and other non-invasive techniques.…”

Section: Introductionmentioning

confidence: 99%

Automatic non-invasive blood pressure measurement in left ventricular assist device patients with a photoplethysmography assisted device

et al. 2023

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Introduction: Non-invasive measurement of blood pressure in patients with a left ventricular assist device (LVAD) is challenging due to the mechanical properties of these circulatory support devices. Keeping blood pressure in a target range is crucial to reduce the risk of LVAD complications. As current assessment methods require trained personnel resulting in infrequent monitoring, devices for home-based measurements are sorely needed. Objectives: In this paper, we report a measurement method and a custom-made monitoring device based on photoplethysmography (PPG) enabling automated measurement of the mean arterial pressure (MAP) of patients with LVAD. Methods: The method and the device were tested on 21 adult patients with LVAD, and the estimated MAP values were compared to MAP values measured simultaneously by a human expert applying the commonly used Doppler-based method. Results: Results of the proposed method showed highly significant correlation with Doppler-based MAP values ( R = 0.85 for inflation, p < 0.001; R = 0.96 for deflation, p<0.001). The mean difference of the proposed method to the Doppler-based MAP values was 1.48 ± 5.43 mmHg for inflation and −0.19 ± 2.71 mmHg for deflation. Conclusion: The results demonstrate that the proposed method is a promising direction to achieve accurate, automated, non-invasive BP measurement, applicable in home health monitoring for patients with LVAD.

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“…Blood pressure (BP) optimization is critical in the clinical management of patients with left ventricular assist devices (LVADs), 1–3 but accurate BP measurement presents a significant challenge 4,5 . An indwelling arterial catheter remains the gold standard but is invasive and often infeasible.…”

Section: Introductionmentioning

confidence: 99%

“…Blood pressure (BP) optimization is critical in the clinical management of patients with left ventricular assist devices (LVADs), [1][2][3] but accurate BP measurement presents a significant challenge. 4,5 An indwelling arterial catheter remains the gold standard but is invasive and often infeasible. Brachial artery Doppler is commonly used as a noninvasive estimate of BP in LVAD patients 4,5 but is labor-intensive and impractical when high-frequency (or continuous) measurements are required.…”

Section: Introductionmentioning

confidence: 99%

Noninvasive finger plethysmography for continuous blood pressure monitoring in patients with left ventricular assist device

et al. 2023

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BackgroundAccurate blood pressure (BP) measurement remains challenging in patients with HeartMate 3™ left ventricular assist devices (HM3 LVADs). The Finapres® NOVA is a promising non‐invasive continuous BP monitor that uses the volume clamp method via a finger cuff, so here we aimed to validate the instrument in HM3 patients.MethodsIn a single‐center cohort, BP was monitored in 15 patients within 72 h following HM3 implantation. A radial artery catheter quantified arterial blood pressure (ABP), while the NOVA measured finger arterial pressure (fiAP) and reconstructed brachial artery pressure (reBAP). Waveforms were recorded for 10 min, and mean values were calculated in 15‐s intervals.ResutsfiAP and ABP were moderately correlated during both the first (ICC 0.61, p = 0.04) and final measurements (ICC 0.66, p = 0.03). reBAP and ABP were strongly correlated during both the first (ICC 0.81, p = 0.002) and final measurements (ICC 0.83, p = 0.001). Both NOVA‐derived values may underestimate low BP values while overestimating relatively high BP values. The reBAP was within 5 mm Hg of the ABP in 40% of patients (and within 10 mm Hg in 67%).ConclusionsThis pilot represents the first evidence in support of the Finapres® NOVA for non‐invasive BP measurement in select patients with HM3 LVADs. The instrument may provide useful data during BP medication adjustments or pump titration, but despite the correlation between the non‐invasive reBAP and invasive ABP, individual‐level inaccuracy may be clinically meaningful. Further investigation is needed to clarify these limitations and optimize accuracy before widespread adoption in this unique patient population.

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Noninvasive measurement of arterial blood pressure in patients with continuous-flow left ventricular assist devices: a systematic review

Cited by 7 publications

References 36 publications

Validity and success rate of noninvasive mean arterial blood pressure measurements in cf‐LVAD patients: A technical review

Validity and success rate of noninvasive mean arterial blood pressure measurements in cf‐LVAD patients: A technical review

Automatic non-invasive blood pressure measurement in left ventricular assist device patients with a photoplethysmography assisted device

Noninvasive finger plethysmography for continuous blood pressure monitoring in patients with left ventricular assist device

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