• Ivar N Omenås, Christian Tronstad, and Leiv Arne Rosseland.
• Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.
• BMC Anesthesiol. 2020 Jun 27; 20 (1): 157.

BackgroundIn women presenting for caesarean section under spinal anesthesia, continuous measurement of circulatory aspects, such as blood pressure and cardiac output, is often needed. At present, invasive techniques are used almost exclusively. Reliable non-invasive monitoring would be welcome, as it could be safer, less uncomfortable, and quick and easy to apply. We aimed to evaluate whether a non-invasive, finger plethysmographic device, the ccNexFin monitor, can replace invasively measured blood pressure in the radial artery, and whether cardiac output measurements from this device can be used interchangeably with measurements from the mini-invasive LiDCO monitor currently in use at our institution.MethodsSimultaneous invasive measurements were compared to ccNexFin in 23 healthy women during elective caesarean section under spinal anesthesia. We used Bland Altman statistics to assess agreement, and polar plot methodology to judge trending abilities with pre-defined limits.ResultsMean arterial and systolic pressures showed biases (invasive - ccNexFin) of - 4.3 and 12.2 mmHg, with limits of agreement of - 15.9 - 7.4 and - 11.1 - 35.6, respectively. The ccNexFin trending abilities were within the suggested limits for mean pressure but insufficient for systolic pressure compared to invasive measurements. Cardiac output had a small bias of 0.2 L/min, but wide limits of agreement of - 2.6 - 3.0. The ccNexFin trending abilities compared to the invasive estimated values (LiDCO) were unsatisfactory.ConclusionsWe consider the ccNexFin monitor to have sufficient accuracy in measuring mean arterial pressure. The limits of agreement for systolic measurements were wider, and the trending ability compared to invasive measurements was outside the recommended limit. The ccNexFin is not reliable for cardiac output measurements or trend in pregnant women for caesarean delivery under spinal anesthesia.Trial RegistrationRegistered May 23, 2013, at ClinicalTrials.gov under number NCT01861132 .

22 keywords...

hide…