The Use of Non-Invasive Continuous Blood Pressure Measuring (ClearSight®) during Central Neuraxial Anaesthesia for Caesarean Section—A Retrospective Validation Study

Abstract

The close monitoring of blood pressure during a caesarean section performed under central neuraxial anaesthesia should be the standard of safe anaesthesia. As classical oscillometric and invasive blood pressure measuring have intrinsic disadvantages, we investigated a novel, non-invasive technique for continuous blood pressure measuring. Methods: In this monocentric, retrospective data analysis, the reliability of continuous non-invasive blood pressure measuring using ClearSight® (Edwards Lifesciences Corporation) is validated in 31 women undergoing central neuraxial anaesthesia for caesarean section. In addition, patients and professionals evaluated ClearSight® through questioning. Results: 139 measurements from 11 patients were included in the final analysis. Employing Bland–Altman analyses, we identified a bias of −10.8 mmHg for systolic, of −0.45 mmHg for diastolic and of +0.68 mmHg for mean arterial blood pressure measurements. Pooling all paired measurements resulted in a Pearson correlation coefficient of 0.7 for systolic, of 0.67 for diastolic and of 0.75 for mean arterial blood pressure. Compensating the interindividual differences in linear regressions of the paired measurements provided improved correlation coefficients of 0.73 for systolic, of 0.9 for diastolic and of 0.89 for mean arterial blood pressure measurements. Discussion: Diastolic and mean arterial blood pressure are within an acceptable range of deviation from the reference method, according to the Association for the Advancement of Medical Instrumentation (AAMI) in the patient collective under study. Both patients and professionals prefer ClearSight® to oscillometric blood pressure measurement in regard of comfort and handling.

0.75% ropivacaine may be a suitable drug in pregnant women undergoing urgent cesarean delivery during labor analgesia period

“…The advantages of non-invasive hemodynamic monitoring during elective and urgent cesarean deliveries are becoming more and more clear [ 36 ]. Studies have shown that Continuous non-invasive hemodynamic monitoring allowed an early detection of maternal hypotension leading to a prompt treatment with satisfactory results considering neonatal well-being [ 37 , 38 ]. We did not use non-invasive hemodynamic monitoring in our trial.…”

Patent landscape review of non-invasive medical sensors for continuous monitoring of blood pressure and their validation in critical care practice

“…It was claimed that, when performing a caesarean section ( n = 31) under a central neuraxial anesthetic while using ClearSight, a non-invasive continuous blood pressure monitor, the difference between the diastolic and mean arterial blood pressure and the reference method is acceptable ( 35 ). Patients with severe aortic stenosis having elective transcatheter aortic valve replacement were monitored for mean blood pressure, systolic and diastolic blood pressure with the ClearSight device ( n = 20).…”

Finger cuff versus invasive and noninvasive arterial pressure measurement in pregnant patients with obesity

“…Acceptable agreement was demonstrated between the FC and NIBP measurements in pregnant participants with a median BMI less than 35 kg m −2 14–16 . In nonobese pregnant participants, Misugi et al reported acceptable agreement of the FC with INV for mean arterial pressure (MAP) only 17 .…”

“…12 Our team evaluated the FC in 30 nonpregnant patients with a median BMI of 50 kg m À2 reporting greater bias in systolic, mean, and diastolic pressures 13 than reported by Rogge et al 12 Acceptable agreement was demonstrated between the FC and NIBP measurements in pregnant participants with a median BMI less than 35 kg m À2 . [14][15][16] In nonobese pregnant participants, Misugi et al…”