• Philippe Conter, Josef Briegel, Torsten Baehner, Alois Kreitmeier, Agnes S Meidert, Martin Tholl, Franz Schwimmbeck, Andreas Bauer, and Ulrich J Pfeiffer.
• Department of Anesthesiology, University Hospital, LMU Munich, Munich, Germany. Electronic address: philippe.conter@med.uni-muenchen.de.
• J. Cardiothorac. Vasc. Anesth. 2023 Aug 1; 37 (8): 138213891382-1389.

ObjectivesTo compare noninvasive pulse-pressure variation (PPV) measurements obtained from a new high-fidelity upper arm cuff using a hydraulic coupling technique to corresponding intraarterial PPV measurements.DesignThe authors used prospective multicenter comparison and development studies for the new high-fidelity upper arm cuff.SettingThe study was performed in the departments of Anesthesiology at the Ludwig-Maximilians-Universität München Hospital, the University Hospital of Bonn, and the RoMed Hospital in Rosenheim (all Germany).ParticipantsA total of 153 patients were enrolled, undergoing major abdominal surgery or neurosurgery with mechanical ventilation. For the evaluation of PPV, 1,467 paired measurements in 107 patients were available after exclusion due to predefined quality criteria.InterventionsSimultaneous measurements of PPV were performed from a reference femoral arterial catheter (PPVref) and the high-fidelity upper arm cuff (PPVcuff). The new device uses a semirigid conical shell. It incorporates a hydraulic sensor pad with a pressure transducer, leading to a tissue pressure-pulse contour with all characteristics of an arterial- pulse contour.Measurements And Main ResultsThe comparative analysis of the included measurements showed that PPVref and PPVcuff were closely correlated (r = 0.92). The mean of the differences between PPVref and PPVcuff was 0.1 ± 2.0%, with 95% limits of agreement between -4.1% and 3.9%. To track absolute changes in PPV >2%, the concordance rate between the 2 methods was 93%.ConclusionsThe new high-fidelity upper arm cuff method provided a clinically reliable estimate of PPV.Copyright © 2023 Elsevier Inc. All rights reserved.

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