Assessing the eligibility of a non-invasive continuous blood pressure measurement technique for application during total intravenous anaesthesia

作者：Huhle Robert^*; Siegert Joachim; Wonka Fred; Schindler Christoph; de Abreu Marcelo Gama; Koch Thea; Morgenstern Ute; Theilen Herman

来源：Biomedical Engineering-Biomedizinische Technik, 2016, 61(3): 369-379.

DOI：10.1515/bmt-2015-0001

• blood pressure
• CNAP
• continuous non-invasive blood pressure monitoring
• hypertension
• invasive blood pressure
• perioperative anaesthesia
• reference standards

Objective: To assess the eligibility for replacement of invasive blood pressure as measured "within" the arterial vessel (IBP) with non-invasive continuous arterial blood pressure (cNIP) monitoring during total intravenous anaesthesia (TIVA), the ability of cNiP to track fast blood pressure changes needs to be quantified. A new method of statistical data analysis is developed for this purpose.
Methods: In a pilot study on patients undergoing neurosurgical anaesthesia, mean arterial pressure MAP(IBP) measured with IBP was compared to MAP(CNP) measured by the CNAP Monitor 500 in ten patients (age: 63 +/- 13 a). Correlation analysis of changes of device differences Delta eMAP=Delta MAP(CNP)-Delta MAP(IBP) with changes of MAP(IBP) (Delta MAP(IBP)) during intervals of vasoactivity was conducted. An innovative technique, of linear trend analysis (LTA) applied to two signals, is described to perform this analysis without a priori knowledge of intervals of vasoactivity.
Results: Analysis of Delta eMAP during vasoactivity revealed that Delta MAP(CNP) systematically underestimated Delta MAP(IBP) by 37%. This was confirmed in the complete data set using LTA technique showing a systematic, yet patient specific, underestimation in tracking Delta MAP(IBP) (16...120%).
Conclusion: The proposed LTA technique is able to detect systematic errors in tracking short-term blood pressure changes otherwise masked by established analysis. LTA may thus be a useful tool to assess the eligibility of cNIP to replace IBP during TIVA.

• 出版日期2016-6