Ameloot Koen, Palmers Pieter-Jan, Malbrain Manu L N G
aDepartment of Cardiology bDepartment of Intensive Care, University Hospitals Leuven, Leuven cDepartment of Intensive Care dDepartment of High Care Burn Unit, Ziekenhuis Netwerk Antwerpen, ZNA Stuivenberg, Antwerp, Belgium.
Curr Opin Crit Care. 2015 Jun;21(3):232-9. doi: 10.1097/MCC.0000000000000198.
The present review aims to summarize literature on the accuracy of the finger cuff method to measure cardiac output (CO) and blood pressure, its ability to track hemodynamic changes, and to predict fluid responsiveness.
Finger cuff is an easy-to-use hemodynamic monitoring technique. Different devices are currently available, which provide continuous arterial blood pressure (Finapress), whereas only ClearSight (previously known as Nexfin; BMEYE) provides an estimate of CO. In most studies, the criteria for clinical interchangeability (for CO) were not met, when compared with the currently used invasive monitoring systems such as uncalibrated CO via a radial artery line, and calibrated CO either via a pulmonary artery catheter or a femoral artery catheter connected to the PiCCO (Pulsion Medical Systems) or VolumeView (Edwards Lifesciences) devices. In particular, ClearSight obtained CO seems to be less accurate in patients with a low CO. However, in most patients, ClearSight is able to track hemodynamic changes induced by a fluid challenge or passive leg raising test. We will discuss in this review the relevant literature with regard to validation of the finger cuff technique for both arterial blood pressure and CO.
The finger cuff method provides a reasonable estimate of CO and blood pressure, which does not meet the criteria for clinical interchangeability with the currently used invasive devices.
本综述旨在总结关于手指袖带法测量心输出量(CO)和血压的准确性、跟踪血流动力学变化的能力以及预测液体反应性的文献。
手指袖带是一种易于使用的血流动力学监测技术。目前有不同的设备,其中一些可提供连续动脉血压(Finapress),而只有ClearSight(以前称为Nexfin;BMEYE)可提供心输出量的估计值。在大多数研究中,与目前使用的侵入性监测系统(如通过桡动脉导管测量的未校准心输出量,以及通过连接到PiCCO(Pulsion Medical Systems)或VolumeView(Edwards Lifesciences)设备的肺动脉导管或股动脉导管测量的校准心输出量)相比,(手指袖带法测量心输出量)未达到临床互换性标准。特别是,ClearSight测得的心输出量在低心输出量患者中似乎不太准确。然而,在大多数患者中,ClearSight能够跟踪由液体负荷试验或被动抬腿试验引起的血流动力学变化。我们将在本综述中讨论有关手指袖带技术用于动脉血压和心输出量验证的相关文献。
手指袖带法可提供心输出量和血压的合理估计值,但不符合与目前使用的侵入性设备进行临床互换的标准。