-
Anesthesia and analgesia · Jul 2013
Clinical TrialThe accuracy and responsiveness of continuous noninvasive arterial pressure during rapid ventricular pacing for transcatheter aortic valve replacement.
- Christoph Schramm, Anja Huber, and Konstanze Plaschke.
- Department of Anesthesiology, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany. konstanze.plaschke@med.uni-heidelberg.de
- Anesth. Analg.. 2013 Jul 1;117(1):76-82.
BackgroundThe accuracy of measurement of the continuous noninvasive arterial blood pressure (CNAP) technique is unknown during sudden cardiocirculatory arrest.MethodsIn 33 patients undergoing elective transfemoral aortic valve implantation procedures under analgesic sedation, invasive arterial blood pressure (IAP) was compared with a CNAP device during episodes of severe hypotension (functional cardiocirculatory arrests by rapid pacing) and the remaining time without severe hypotension. Systolic, diastolic, and mean pairs of blood pressure measurements were extracted for both groups and were analyzed by Bland-Altman plots. The responsiveness of the CNAP technique was assessed in the various phases of severe hypotension concerning time and amplitude of changes.ResultsOverall CNAP accuracy (bias), calculated by subtracting IAP from CNAP, was -6.3 ± 18.9, 7.4 ± 10.5, and 4.0 ± 11.3 mm Hg (mean ± SD, systolic, diastolic, and mean). Bias increased during episodes of severe hypotension to 11.8 ± 14.5, 13.8 ± 12.4, and 12.9 ± 12.4 mm Hg. The percentage of agreements (95% confidence interval) between the blood pressure pairs with a difference ≤15 mm Hg was 58.5% (57.9-58.6), 75.8% (75.5-76.0), 82.2% (81.9-82.4; systolic, diastolic, mean) for all data and 56.4% (54.2-58.9; P = 0.71), 53.2%* (51.1-56.0), and 57.4%* (56.3-59.1; *P < 0.001) during rapid pacing. The responsiveness of mean CNAP and mean IAP did not differ significantly during the various phases of rapid pacing.ConclusionsThe stand-alone CNAP monitor (model 500at, software V3.5) accurately and rapidly measures the changes of blood pressure that occur during sudden development of cardiocirculatory arrest and recovery to baseline blood pressures. CNAP monitors the duration of the arrest.
Notes
Knowledge, pearl, summary or comment to share?You can also include formatting, links, images and footnotes in your notes
- Simple formatting can be added to notes, such as
*italics*
,_underline_
or**bold**
. - Superscript can be denoted by
<sup>text</sup>
and subscript<sub>text</sub>
. - Numbered or bulleted lists can be created using either numbered lines
1. 2. 3.
, hyphens-
or asterisks*
. - Links can be included with:
[my link to pubmed](http://pubmed.com)
- Images can be included with:
![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
- For footnotes use
[^1](This is a footnote.)
inline. - Or use an inline reference
[^1]
to refer to a longer footnote elseweher in the document[^1]: This is a long footnote.
.