Janelle Gregory M, Gravenstein Nikolaus
Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida, USA.
Anesth Analg. 2006 Feb;102(2):484-90. doi: 10.1213/01.ane.0000194873.52453.bd.
Continuous beat-to-beat arterial blood pressure (BP) monitoring with a simultaneous arterial waveform display is typically achieved with an invasive arterial catheter. We evaluated a noninvasive device, the T-Line Tensymeter, that provides a calibrated arterial pressure waveform from which continuous BP measurements and heart rate may be computed by either a bedside host monitor or the tensymeter device itself. In 25 patients given general anesthesia, we measured systolic, mean, and diastolic BPs via the tensymeter and compared these measurements with those obtained from the contralateral radial artery catheter. Data were analyzed using the Bland Altman test to determine agreement between the two systems. The mean +/- sd bias and precision (mm Hg) were as follows: 1.7 +/- 7.0 and 5.7 +/- 4.4 for systolic BP; 2.3 +/- 6.9 and 5.7 +/- 4.5 for diastolic BP; and 1.7 +/- 5.3 and 4.0 +/- 4.8 for mean BP. Noninvasive pressures from the tensymeter-produced arterial waveform agreed with simultaneous contralateral BPs measured from arterial catheters within an acceptable clinical range for a limited population of surgical patients studied over a systolic arterial BP range from 41 to 189 mm Hg without significant temporal performance degradation. The tensymeter may enable physicians to circumvent arterial cannulation in certain circumstances (such as with low- or intermediate-risk procedures) on patients when beat-to-beat BP measurement is desirable.
通过有创动脉导管通常可实现连续逐搏动脉血压(BP)监测及同步动脉波形显示。我们评估了一种无创设备——T-Line张力计,它能提供校准后的动脉压力波形,床边主机监测仪或张力计设备本身均可据此计算连续血压测量值和心率。在25例接受全身麻醉的患者中,我们通过张力计测量收缩压、平均压和舒张压,并将这些测量值与对侧桡动脉导管测得的值进行比较。使用Bland Altman检验分析数据,以确定两个系统之间的一致性。收缩压、舒张压和平均压的平均±标准差偏差及精密度(mmHg)如下:收缩压为1.7±7.0和5.7±4.4;舒张压为2.3±6.9和5.7±4.5;平均压为1.7±5.3和4.0±4.8。在41至189 mmHg的收缩压范围内,对于有限数量的接受手术的患者,在没有明显时间性能下降的情况下,张力计产生的动脉波形的无创压力与通过动脉导管同时测量的对侧血压在可接受的临床范围内相符。在某些情况下(如低风险或中等风险手术),当需要逐搏血压测量时,张力计可能使医生避免对患者进行动脉插管。