Department of Anaesthesiology, Radboud University Nijmegen Medical Centre, Internal Postal Code 632, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
Br J Anaesth. 2010 Oct;105(4):493-500. doi: 10.1093/bja/aeq201. Epub 2010 Aug 6.
Continuous non-invasive measurement of finger arterial pressure (FAP) is a reliable technology in adults. FAP is measured with an inflatable cuff around the finger and simultaneously converted to a reconstructed brachial artery pressure waveform (reBAP) by the Nexfin™ device. We assessed the adequacy of a prototype device (Nexfin-paediatric), designed for a paediatric population, for detecting rapid arterial pressure changes in children during cardiac surgery.
Thirteen anaesthetized children with a median age of 11 months (2 months-7 yr) undergoing congenital cardiac surgery were included in the study. reBAP and intra-arterial pressure (IAP) were recorded simultaneously during the surgical procedure. To assess the accuracy of reBAP in tracking arterial pressure changes, the four largest IAP variations within a 5 min time interval were identified from each procedure. These variations were compared offline with reBAP during a 10 s control period before and a 10 s period after an arterial pressure change had occurred.
In 10 out of 13 children, a non-invasive arterial pressure recording could be obtained. Therefore, recordings from these 10 children were eligible for further analysis, resulting in 40 data points. The correlation coefficient between reBAP and IAP in tracking mean arterial pressure (MAP) changes was 0.98. reBAP followed changes in IAP with a mean bias for systolic, diastolic arterial pressure, and MAP of 0.0 mm Hg (sd 5.8), 0.1 (sd 2.8), and 0.19 (sd 2.7), respectively.
The prototype device closely follows arterial pressure changes in children. However, in a considerable number of attempts, obtaining a signal was time-consuming or unsuccessful. This technique seems promising but requires further technical development.
连续无创测量指动脉压（FAP）在成人中是一种可靠的技术。FAP 通过环绕手指的可充气袖带进行测量，并由 Nexfin™ 设备同时转换为重建的肱动脉压力波形（reBAP）。我们评估了一种专为儿科人群设计的原型设备（Nexfin-paediatric）在儿童心脏手术期间检测快速动脉压力变化的能力。
本研究纳入了 13 名接受先天性心脏手术的麻醉儿童，中位数年龄为 11 个月（2 个月至 7 岁）。在手术过程中同时记录 reBAP 和动脉内压（IAP）。为了评估 reBAP 跟踪动脉压力变化的准确性，从每个手术过程中确定了四个最大的 IAP 变化，持续时间为 5 分钟。这些变化在发生动脉压力变化之前和之后的 10 秒对照期内与 reBAP 离线比较。
在 13 名儿童中有 10 名获得了无创动脉压力记录。因此，这 10 名儿童的记录有资格进行进一步分析，共得到 40 个数据点。reBAP 在跟踪平均动脉压（MAP）变化方面与 IAP 的相关系数为 0.98。reBAP 跟随 IAP 变化，收缩压、舒张压和 MAP 的平均偏差分别为 0.0 毫米汞柱（标准差 5.8）、0.1（标准差 2.8）和 0.19（标准差 2.7）。
原型设备密切跟踪儿童的动脉压力变化。然而，在相当多的尝试中，获得信号既费时又不成功。该技术似乎很有前途，但需要进一步的技术开发。
