Department of Anesthesiology, Wakayama Medical University School of Medicine, Kimiidera 811-1, Wakayama, 641-8509, Japan.
BMC Anesthesiol. 2020 Jul 20;20(1):176. doi: 10.1186/s12871-020-01091-x.
Since blood pressure tends to be unstable during induction of anesthesia in patients undergoing cardiovascular surgery, an artery catheter is often inserted before induction to continuously monitor arterial pressure during induction of anesthesia. ClearSight System™ enables noninvasive continuous measurement of beat-to-beat arterial pressure via a single finger cuff without pain using photoplethysmographic technology. If ClearSight System™ can replace intra-arterial pressure measurement, blood pressure could be easily and noninvasively assessed. However, the validity of ClearSight System™ during induction of anesthesia in patients undergoing cardiovascular surgery has not been evaluated. The aim of this study was to compare blood pressure measured by ClearSight System™ with intra-arterial pressure during induction of anesthesia for cardiovascular surgery.
This study was registered retrospectively. Data during induction of anesthesia for elective cardiovascular surgery were obtained for patients in whom noninvasive arterial pressure was measured by ClearSight System™ (APcs) and invasive radial arterial pressure (APrad) was measured simultaneously. According to the widely used criteria formulated by international standards from the Association for the Advancement of Medical Instrumentation, the acceptable bias and precision for arterial pressure measurements were fixed at < 5 mmHg and 8 mmHg, respectively.
Data for 18 patients were analyzed. For 3068 analyzed paired measurements, values of APcs vs APrad bias (precision) were 13.2 (17.5), - 9.1 (7.3) and - 3.9 (7.8) mmHg for systolic, diastolic, and mean arterial pressures, respectively.
Mean arterial pressure measured by ClearSight System™ could be considered as an alternative for mean radial arterial pressure during induction of anesthesia for elective cardiovascular surgery.
由于心血管手术患者在麻醉诱导期间血压往往不稳定，因此通常在诱导前插入动脉导管，以便在麻醉诱导期间连续监测动脉压。ClearSight System™ 采用光体积描记技术，通过单个手指袖带无创连续测量每搏动脉压，无需疼痛。如果 ClearSight System™ 可以替代动脉内压测量，那么血压就可以轻松无创地进行评估。然而，ClearSight System™ 在心血管手术患者麻醉诱导期间的有效性尚未得到评估。本研究的目的是比较心血管手术麻醉诱导期间通过 ClearSight System™ 测量的血压与动脉内压。
本研究为回顾性注册研究。对同时测量非侵入性动脉压（APcs）和有创桡动脉压（APrad）的择期心血管手术患者的麻醉诱导期间的数据进行了研究。根据国际医疗器械促进协会制定的广泛使用标准，动脉压测量的可接受偏差和精度分别固定在<5mmHg 和 8mmHg。
对 18 例患者的数据进行了分析。在 3068 次分析的配对测量中，APcs 与 APrad 的收缩压（精度）、舒张压（精度）和平均动脉压（精度）的差值（精度）分别为 13.2mmHg（17.5mmHg）、-9.1mmHg（7.3mmHg）和-3.9mmHg（7.8mmHg）。
在择期心血管手术麻醉诱导期间，ClearSight System™ 测量的平均动脉压可考虑替代桡动脉平均压。
