Cua Clifford L, Thomas Kristi, Zurakowski David, Laussen Peter C
Departments of Cardiology and Orthopaedic Surgery, Children's Hospital Boston, Boston, Massachusetts.
Anesth Analg. 2005 May;100(5):1289-1294. doi: 10.1213/01.ANE.0000149591.67207.05.
The Vasotrac is a device that provides near-continuous and noninvasive arterial blood pressure monitoring and may be an alternative to direct intraarterial measurement. It has been evaluated in adult patients, but minimal information is available for pediatric patients. We evaluated agreement between measurements of arterial blood pressure and heart rate obtained from the Vasotrac versus an arterial catheter in a pediatric population. Children undergoing corrective cardiac surgery were enrolled. Simultaneous arterial blood pressure measurements were obtained postoperatively from the Vasotrac unit and an arterial catheter. Bland-Altman plots were constructed to assess agreement. Paired correlation analysis, bias, and precision calculations were performed. Sixteen patients, mean age 10.1 +/- 2.3 yr and weight 34.6 +/- 11.9 kg, were enrolled. Four-thousand-one- hundred- two paired measurements were obtained. Arterial blood pressures measured noninvasively correlated with catheter measurements with Pearson r values of 0.90, 0.80, and 0.91 for systolic, diastolic, and mean arterial blood pressures, respectively (all P < 0.001). There was excellent agreement between arterial blood pressure measurement methods. Absolute mean differences based on mixed-model regression with 95% confidence intervals were 4.0 mm Hg (3.0-5.0 mm Hg), 4.3 mm Hg (3.1-5.5 mm Hg), and 3.5 mm Hg (2.5-4.0 mm Hg) for systolic blood pressure, diastolic blood pressure, and mean blood pressure, respectively. Arterial blood pressure measurements obtained from the Vasotrac agreed well with invasive arterial monitoring in pediatric patients.
Vasotrac是一种可提供近乎连续的无创动脉血压监测的设备，可能是直接动脉内测量的替代方法。它已在成年患者中进行了评估，但关于儿科患者的信息极少。我们评估了在儿科人群中，通过Vasotrac获得的动脉血压和心率测量值与通过动脉导管获得的测量值之间的一致性。纳入了接受心脏矫正手术的儿童。术后同时从Vasotrac装置和动脉导管获取动脉血压测量值。构建Bland-Altman图以评估一致性。进行了配对相关性分析、偏差和精密度计算。共纳入16例患者，平均年龄10.1±2.3岁，体重34.6±11.9 kg。获得了4102对测量值。无创测量的动脉血压与导管测量值相关，收缩压、舒张压和平均动脉血压的Pearson r值分别为0.90、0.80和0.91（均P<0.001）。两种动脉血压测量方法之间具有极好的一致性。基于混合模型回归并带有95%置信区间的绝对平均差异，收缩压、舒张压和平均血压分别为4.0 mmHg（3.0 - 5.0 mmHg）、4.3 mmHg（3.1 - 5.5 mmHg）和3.5 mmHg（2.5 - 4.0 mmHg）。在儿科患者中，通过Vasotrac获得的动脉血压测量值与有创动脉监测结果吻合良好。
