Noninvasive Hemodynamic Measurements During Neurosurgical Procedures in Sitting Position
- 1 July 2017
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Neurosurgical Anesthesiology
- Vol. 29 (3), 251-257
- https://doi.org/10.1097/ana.0000000000000300
Abstract
Neurosurgical procedures in sitting position need advanced cardiovascular monitoring. Transesophageal echocardiography (TEE) to measure cardiac output (CO)/cardiac index (CI) and stroke volume (SV), and invasive arterial blood pressure measurements for systolic (ABPsys), diastolic (ABPdiast) and mean arterial pressure (MAP) are established monitoring technologies for these kind of procedures. A noninvasive device for continuous monitoring of blood pressure and CO based on a modified Penaz technique (volume-clamp method) was introduced recently. In the present study the noninvasive blood pressure measurements were compared with invasive arterial blood pressure monitoring, and the noninvasive CO monitoring to TEE measurements.Measurements of blood pressure and CO were performed in 35 patients before/after giving a fluid bolus and a change from supine to sitting position, start of surgery, and repositioning from sitting to supine at the end of surgery. Data pairs from the noninvasive device (Nexfin HD) versus arterial line measurements (ABPsys, ABPdiast, MAP) and versus TEE (CO, CI, SV) were compared using Bland-Altman analysis and percentage error.All parameters compared (CO, CI, SV, ABPsys, ABPdiast, MAP) showed a large bias and wide limits of agreement. Percentage error was above 30% for all parameters except ABPsys.The noninvasive device based on a modified Penaz technique cannot replace arterial blood pressure monitoring or TEE in anesthetized patients undergoing neurosurgery in sitting position.Keywords
This publication has 32 references indexed in Scilit:
- Non-invasive continuous arterial pressure monitoring with Nexfin® does not sufficiently replace invasive measurements in critically ill patientsBritish Journal of Anaesthesia, 2013
- Stroke volume‐directed administration of hydroxyethyl starch or Ringer's acetate in sitting position during craniotomyActa Anaesthesiologica Scandinavica, 2013
- Assessment of changes in cardiac index and fluid responsiveness: a comparison of Nexfin and transpulmonary thermodilutionActa Anaesthesiologica Scandinavica, 2013
- Comparison of noninvasive continuous arterial waveform analysis (Nexfin) with transthoracic Doppler echocardiography for monitoring of cardiac outputJournal of Clinical Anesthesia, 2012
- Noninvasive Continuous Arterial Blood Pressure Monitoring with Nexfin®Anesthesiology, 2012
- 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
- Pulse contour cardiac output derived from non‐invasive arterial pressure in cardiovascular diseaseAnaesthesia, 2010
- Nexfin Noninvasive Continuous Blood Pressure Validated Against Riva-Rocci/KorotkoffAmerican Journal of Hypertension, 2009
- Transoesophageal echocardiography is unreliable for cardiac output assessment after cardiac surgery compared with thermodilution*Anaesthesia, 2004
- STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENTThe Lancet, 1986