I. Medizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Strasse 22, 81675, Munich, Germany.
Clin Res Cardiol. 2015 Jun;104(6):518-24. doi: 10.1007/s00392-015-0816-5. Epub 2015 Jan 25.
Hemodynamic monitoring plays a pivotal role in the treatment of patients in the cardiac intensive care unit (CICU). The innovative radial artery applanation tonometry technology allows for continuous noninvasive arterial blood pressure (AP) measurement. By closing the gap between continuous invasive AP monitoring (arterial catheter) and intermittent noninvasive AP monitoring (oscillometry) this technology might improve CICU patient monitoring. We therefore aimed to evaluate the measurement performance of radial artery applanation tonometry in comparison with a radial arterial catheter in CICU patients.
In this prospective method comparison study, we simultaneously recorded AP noninvasively with radial artery applanation tonometry (T-line 200 pro device; Tensys Medical Inc., San Diego, CA, USA) and invasively with an arterial catheter (criterion standard) in 30 patients treated in the CICU of a German university hospital. We statistically analyzed 7,304 averaged 10-beat epochs of measurements of mean AP, systolic AP, and diastolic AP by using Bland-Altman analysis for repeated measurements.
Our study revealed a mean difference ± standard deviation (95% limits of agreement; percentage error) between radial artery applanation tonometry and the criterion standard method (radial arterial catheter) of +2 ± 6 mmHg (-10 to +14 mmHg; 17%) for mean AP, -6 ± 11 mmHg (-28 to +15 mmHg; 20%) for systolic AP, and +4 ± 7 mmHg (-9 to +17 mmHg; 23%) for diastolic AP.
In CICU patients, continuous noninvasive measurement of AP using radial artery applanation tonometry is feasible. The technology showed reasonable accuracy and precision in comparison with radial arterial catheter-derived AP values.
血流动力学监测在心脏重症监护病房（CICU）患者的治疗中起着关键作用。创新的桡动脉平面张力测量技术可实现连续无创动脉血压（AP）测量。通过缩小连续有创 AP 监测（动脉导管）与间歇性无创 AP 监测（振荡法）之间的差距，该技术可能会改善 CICU 患者的监测。因此，我们旨在评估桡动脉平面张力测量技术与 CICU 患者桡动脉导管的测量性能。
在这项前瞻性方法比较研究中，我们同时使用桡动脉平面张力测量仪（T-line 200 pro 设备；Tensys Medical Inc.，圣地亚哥，CA，美国）无创记录 AP（T 线 200 pro 设备），并使用动脉导管（金标准）在德国一家大学医院的 CICU 中治疗的 30 名患者中进行有创记录。我们使用重复测量的 Bland-Altman 分析对 7304 个平均 10 个心跳的测量数据进行了平均 AP、收缩压 AP 和舒张压 AP 的统计分析。
我们的研究显示，桡动脉平面张力测量仪与金标准方法（动脉导管）之间的平均差异 ± 标准偏差（95% 一致性界限；%误差）为+2 ± 6 mmHg（-10 至+14 mmHg；17%），平均 AP 为-6 ± 11 mmHg（-28 至+15 mmHg；20%），收缩压 AP 为+4 ± 7 mmHg（-9 至+17 mmHg；23%），舒张压 AP。
在 CICU 患者中，使用桡动脉平面张力测量仪连续无创测量 AP 是可行的。该技术与桡动脉导管衍生的 AP 值相比，具有合理的准确性和精密度。
