Non-invasive continuous arterial pressure and cardiac index monitoring with Nexfin after cardiac surgery
Open Access
- 1 July 2012
- journal article
- research article
- Published by Elsevier BV in British Journal of Anaesthesia
- Vol. 109 (4), 514-521
- https://doi.org/10.1093/bja/aes215
Abstract
This observational study was designed to evaluate the reliability and precision of a new digital photoplethysmographic device (Nexfin, BMEYE B.V., Amsterdam, The Netherlands) for continuous and non-invasive assessment of arterial pressure and cardiac output. Fifty consecutive adult subjects were prospectively enrolled at admission to the intensive care unit after conventional cardiac surgery and investigated hourly from T0 to T4. Simultaneous comparative systolic, diastolic, and mean arterial pressures and cardiac index (CI) data points were collected from an invasive radial artery catheter, transpulmonary thermodilution catheter, and the Nexfin device. Correlations were determined by linear regression. The Bland–Altman analysis was used to compare bias, precision, and limits of agreement. Six (12%) subjects were excluded from the analysis because of the inability to obtain a reliable photoplethysmographic signal. No complications were observed. A significant relationship was found between absolute values of photoplethysmographic and radial systolic (r2=0.56, Pr2=0.61, Pr2=0.77, Pr2=0.33, P<0.001). Bias, precision, and limits of agreement between the mean photoplethysmographic and radial arterial pressures were 4.6 (95% confidence interval: 3.7–5.5), 6.5, and −17.3 to 8.1 mm Hg, respectively. The percentage error between transpulmonary thermodilution and the Nexfin for CI measurement was 50%. The Nexfin device is safe, convenient, and reliable in measuring continuous non-invasive arterial pressure but not interchangeable with transpulmonary thermodilution to monitor CI.Keywords
This publication has 29 references indexed in Scilit:
- A Systematic Review and Meta-Analysis on the Use of Preemptive Hemodynamic Intervention to Improve Postoperative Outcomes in Moderate and High-Risk Surgical PatientsAnesthesia & Analgesia, 2011
- Hemodynamic monitoring and management in patients undergoing high risk surgery: a survey among North American and European anesthesiologistsCritical Care, 2011
- Minimally Invasive Measurement of Cardiac Output during Surgery and Critical CareAnesthesiology, 2010
- Pitfalls in haemodynamic monitoring based on the arterial pressure waveformCritical Care, 2010
- Hemodynamic monitoring in shock and implications for managementIntensive Care Medicine, 2007
- Oscillometric brachial mean artery pressures are higher than intra‐radial mean artery pressures in intensive care unit patients receiving norepinephrineActa Anaesthesiologica Scandinavica, 2006
- Evidence-based review of the use of the pulmonary artery catheter: impact data and complicationsCritical Care, 2006
- Clinical review: Complications and risk factors of peripheral arterial catheters used for haemodynamic monitoring in anaesthesia and intensive care medicineCritical Care, 2002
- Models of brachial to finger pulse wave distortion and pressure decrementCardiovascular Research, 1997
- Effects of peripheral vasoconstriction on the measurement of blood pressure in a fingerCardiovascular Research, 1985