Level of agreement between Nexfin non-invasive arterial pressure with invasive arterial pressure measurements in children
- 1 October 2012
- journal article
- research article
- Published by Elsevier BV in British Journal of Anaesthesia
- Vol. 109 (4), 609-615
- https://doi.org/10.1093/bja/aes295
Abstract
We compared Nexfin non-invasive arterial pressure measurements using a novel small finger cuff with intra-arterial pressure in the paediatric setting in order to establish the level of agreement between both methods. The study included 41 children aged 2-16 yr admitted for surgery or paediatric intensive care with an intra-arterial catheter as part of standard monitoring. Values of systolic (SAP), diastolic (DAP), and mean arterial pressure (MAP) were obtained simultaneously from the intra-arterial catheter and the non-invasive Nexfin monitor. Data were analysed using intra-class correlation (ICC) coefficients and the Bland-Altman analysis. A non-invasive arterial pressure signal was obtained in the majority of patients. The reproducibility of arterial pressure measurements over time by both non-invasive and invasive techniques was high, with ICC coefficients ranging from 0.94 to 0.98. The Bland-Altman analysis for SAP, DAP, and MAP revealed a bias with 95% limits of agreement of -13.5 (-39.7; +12.8), -0.2 (-12.8; +13.2), and -2.6 (-17.7; +12.5) mm Hg, respectively. Linear regression suggested a weak correlation of SAP and the bias between intra-arterial and Nexfin SAP measurements (intercept 4.9 mm Hg, β -0.29; P=0.01). Nexfin non-invasive arterial pressure measurements are feasible in paediatric patients. Nexfin accurately reflects the intra-arterial MAP and DAP curves, but seems to underestimate SAP compared with intra-arterial pressure. These results suggest that Nexfin may be used in low-to-moderate risk children without severe systemic hypotension, who require beat-to-beat haemodynamic monitoring but do not have an indication for invasive measurements.Keywords
Funding Information
- epartment of Anaesthesiology, VU University Medical Centre
This publication has 15 references indexed in Scilit:
- Application of Nexfin noninvasive beat-to-beat arterial blood pressure monitoring in autonomic function testingBlood Pressure Monitoring, 2011
- Pulse contour cardiac output derived from non‐invasive arterial pressure in cardiovascular diseaseAnaesthesia, 2010
- Continuous non-invasive finger arterial pressure monitoring reflects intra-arterial pressure changes in children undergoing cardiac surgeryBritish Journal of Anaesthesia, 2010
- The Reliability of Continuous Noninvasive Finger Blood Pressure Measurement in Critically Ill ChildrenAnesthesia & Analgesia, 2009
- Nexfin Noninvasive Continuous Blood Pressure Validated Against Riva-Rocci/KorotkoffAmerican Journal of Hypertension, 2009
- Feasibility of Noninvasive Continuous Finger Arterial Blood Pressure Measurements in Very Young Children, Aged 0–4 YearsPediatric Research, 2008
- Noninvasive Assessment of Blood Pressure Variability in Preterm InfantsPediatric Research, 2004
- Assessment of Short-Term Blood Pressure Variability in Anesthetized Children: A Comparative Study Between Intraarterial and Finger Blood PressureJournal of Clinical Monitoring and Computing, 1999
- Feasibility of using finger arterial pressure in neonatesArchives of Disease in Childhood: Fetal & Neonatal, 1997
- Comparison of intraarterial with continuous noninvasive blood pressure measurement in postoperative pediatric patientsJournal of Clinical Monitoring and Computing, 1994