Gupta Deepak, Soskin Vitaly, Marjanovic Milos, Amhaz Hassan, Mazumdar Ashish
Middle East J Anaesthesiol. 2016 Feb;23(4):385-400.
Measuring non-invasive blood pressure (NIBP) in less than one minute intervals (STAT NIBP measurements) is not always feasible. Therefore, large number of undetectable hypotension episodes can only be recognized with continuous beat to beat monitoring of blood pressure, for example, by continuous non-invasive arterial pressure monitor (CNAP).
The purpose of the current study was to investigate whether CNAP correlates well with conventional intermittent oscillometric NIBP during elective cesarean sections under subarachnoid blockade (SAB) and whether CNAP based patient management results in improved immediate maternal vasopressor requirements and improved immediate fetal/neonatal outcomes compared with NIBP based patient management.
The CNAP finger cuff together with the CNAP arm cuff were placed on the same arm which also had the peripheral intravenous access.. On the contralateral arm the conventional NIBP arm cuff was placed. Study Group: The patients were managed by the anesthesia provider based on the CNAP monitor readings. Control Group: The patients were managed by the anesthesia provider based on the NIBP monitor readings. Results: The CNAP-based treatment (study) group had a statistically significant lower use of oxytocin and lower estimated blood loss than the NIBP-based treatment (control) group. The differences in incidences of vasopressors use and peri-operative nausea vomiting between study group and control group did not reach statistical significance. CNAP readings were more likely to be in systolic hypotensive phases (<l00mmHg) and diastolic hypertensive phases (>80mmHg) as compared to NIBP readings.
Continuous non-invasive arterial pressure (CNAP) device may ONLY act as an adjunct to recognize fluctuating blood pressures during elective cesarean section under subarachnoid blockade (SAB).
以小于1分钟的间隔测量无创血压（STAT NIBP测量）并非总是可行的。因此，大量无法检测到的低血压发作只能通过连续逐搏监测血压来识别，例如通过连续无创动脉压监测仪（CNAP）。
本研究的目的是调查在蛛网膜下腔阻滞（SAB）下进行择期剖宫产时，CNAP与传统间歇性示波法无创血压是否具有良好的相关性，以及与基于无创血压的患者管理相比，基于CNAP的患者管理是否能改善产妇即刻血管升压药的需求，并改善胎儿/新生儿的即刻结局。
将CNAP手指袖带和CNAP手臂袖带放置在同一侧手臂上，该侧手臂同时有外周静脉通路。在对侧手臂上放置传统的无创血压手臂袖带。研究组：麻醉医生根据CNAP监测读数对患者进行管理。对照组：麻醉医生根据无创血压监测读数对患者进行管理。结果：与基于无创血压的治疗（对照）组相比，基于CNAP的治疗（研究）组催产素的使用量和估计失血量在统计学上显著更低。研究组和对照组在血管升压药使用发生率和围手术期恶心呕吐方面的差异未达到统计学意义。与无创血压读数相比，CNAP读数更可能处于收缩期低血压阶段（<100mmHg）和舒张期高血压阶段（>80mmHg）。
在蛛网膜下腔阻滞（SAB）下进行择期剖宫产时，连续无创动脉压（CNAP）装置可能仅作为一种辅助手段来识别波动的血压。
