<scp>CNAP</scp><sup>®</sup> does not reliably detect minimal or maximal arterial blood pressures during induction of anaesthesia and tracheal intubation

Gayat, Étienne; Mongardon, Nicolas; Tuil, Olivier; Sievert, K.; Chazot, Thierry; Liu, N.; Fischler, Marc

doi:10.1111/aas.12028

Cited by 25 publications

(13 citation statements)

References 15 publications

(21 reference statements)

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“…deep hypotension following anesthesia induction etc.). The trending ability remained unaffected by these inaccuracies [ 24 , 25 ]. In addition, as pointed out by Hahn [ 22 ], the device uses the oscillometric cuff as a reference, making it equivalent to contemporary practice in the studied population.…”

Section: Discussionmentioning

confidence: 99%

Fluid management guided by a continuous non-invasive arterial pressure device is associated with decreased postoperative morbidity after total knee and hip replacement

et al. 2015

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BackgroundThe use of goal directed fluid protocols in intermediate risk patients undergoing hip or knee replacement was studied in few trials using invasive monitoring. For this reason we have implemented two different fluid management protocols, both based on a novel totally non-invasive arterial pressure monitoring device and compared them to the standard (no-protocol) treatment applied before the transition in our academic institution.MethodsThree treatment groups were compared in this prospective study: the observational (CONTROL, N = 40) group before adoption of fluid protocols and two randomized groups after the transition to protocol fluid management with the use of the continuous non-invasive blood pressure monitoring (CNAP®) device. In the PRESSURE group (N = 40) standard variables were used for restrictive fluid therapy. Goal directed fluid therapy using pulse pressure variation was used in the GDFT arm (N = 40). The influence on the rate of postoperative complications, on the hospital length of stay and other parameters was assessed.ResultsBoth protocols were associated with decreased fluid administration and maintained hemodynamic stability. Reduced rate of postoperative infection and organ complications (22 (55 %) vs. 33 (83 %) patients; p = 0.016; relative risk 0.67 (0.49–0.91)) was observed in the GDFT group compared to CONTROL. Lower number of patients receiving transfusion (4 (10 %) in GDFT vs. 17 (43 %) in CONTROL; p = 0.005) might contribute to this observation. No significant differences were observed in other end-points.ConclusionIn our study, the use of the fluid protocol based on pulse pressure variation assessed using continuous non-invasive arterial pressure measurement seems to be associated with a reduction in postoperative complications and transfusion needs as compared to standard no-protocol treatment.Trial registrationACTRN12612001014842Electronic supplementary materialThe online version of this article (doi:10.1186/s12871-015-0131-8) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Fluid management guided by a continuous non-invasive arterial pressure device is associated with decreased postoperative morbidity after total knee and hip replacement

et al. 2015

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“…[6][7][8] Regarding the accuracy of blood pressure recordings in comparison to continuous invasive measurements, the results are conflicting. [9][10][11] With respect to PPV CNAP , Monnet and colleagues 12 were able to show that PPV was valuable in predicting FR in critically ill patients on the ICU; however, the values were calculated offline. Recently, a 'grey zone' approach has been introduced in order to assess more clearly the inconclusive values of dynamic variables around a defined cut-off value, helping to optimize fluid resuscitation on the basis of dynamic variables.…”

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confidence: 99%

Non-invasive assessment of fluid responsiveness using CNAP™ technology is interchangeable with invasive arterial measurements during major open abdominal surgery

Renner

Gruenewald

Hill

et al. 2017

British Journal of Anaesthesia

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“…3,15 However, Gayat and associates showed that CNAP rapidly reflected changes in blood pressure but failed to be in concordance with arterial pressure measurements. 16 Ilies and associates showed in another study that measurements obtained by CNAP at different stages of anesthesia were unreliable. 12 In our study, CNAP was used in living donors during liver transplant for liver transplant.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Continuous Noninvasive Arterial Pressure Monitoring in Living-Liver Donors During Transplantation

Araz¹,

Zeyneloğlu²,

Pirat³

et al. 2015

Exp Clin Transplant

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CNAP^® does not reliably detect minimal or maximal arterial blood pressures during induction of anaesthesia and tracheal intubation

Abstract: The CNAP monitor could detect acute change in AP within a reasonable time lag. Precision of its measurements is not satisfactory, and therefore, it could only serve as a clue to the occurrence of changes in AP.

Cited by 25 publications

References 15 publications

Fluid management guided by a continuous non-invasive arterial pressure device is associated with decreased postoperative morbidity after total knee and hip replacement

Fluid management guided by a continuous non-invasive arterial pressure device is associated with decreased postoperative morbidity after total knee and hip replacement

Non-invasive assessment of fluid responsiveness using CNAP™ technology is interchangeable with invasive arterial measurements during major open abdominal surgery

Accuracy of Continuous Noninvasive Arterial Pressure Monitoring in Living-Liver Donors During Transplantation

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CNAP® does not reliably detect minimal or maximal arterial blood pressures during induction of anaesthesia and tracheal intubation

Abstract: The CNAP monitor could detect acute change in AP within a reasonable time lag. Precision of its measurements is not satisfactory, and therefore, it could only serve as a clue to the occurrence of changes in AP.

Cited by 25 publications

References 15 publications

Fluid management guided by a continuous non-invasive arterial pressure device is associated with decreased postoperative morbidity after total knee and hip replacement

Fluid management guided by a continuous non-invasive arterial pressure device is associated with decreased postoperative morbidity after total knee and hip replacement

Non-invasive assessment of fluid responsiveness using CNAP™ technology is interchangeable with invasive arterial measurements during major open abdominal surgery

Accuracy of Continuous Noninvasive Arterial Pressure Monitoring in Living-Liver Donors During Transplantation

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CNAP^® does not reliably detect minimal or maximal arterial blood pressures during induction of anaesthesia and tracheal intubation