Continuous non-invasive blood pressure monitoring: reliability of Finapres device during the Valsalva manoeuvre

Abstract
Because of the inherent risks of intra-arterial blood pressure monitoring a new non-invasive device, Finapres, which measures blood pressure continuously in the finger, was evaluated in 14 hypertensive and one normotensive subject. Brachial intra-arterial and finger pressures were compared during a control period and a subsequent Valsalva manoeuvre. Visually, blood pressures measured by Finapres faithfully reproduced the intra-arterial recordings in all subjects. From each pressure signal beat to beat systolic, diastolic, and mean blood pressure values and their differences were obtained and the time course of the response and its characteristic features were analysed. During the control period the Finapres measurements were lower than intra-arterial systolic, mean, and diastolic pressures (mean(SD) 1(9.6), 9(6.8), and 4(6.1) mmHg respectively). During the response to the Valsalva manoeuvre the brachial-finger pressure differences showed limited deviation from those during the control period; median differences were at most 6 mmHg occurring late during the intrathoracic strain period and 7 mmHg during the post-release blood pressure overshoot. In general, the Finapres device reproduced intra-arterial patterns faithfully. This device appears to offer a reliable alternative to intra-arterial blood pressure monitoring.