Department of Pediatric Critical Care Nemours/AI duPont Hospital For Children.
Department of Biomedical Research, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware.
Blood Press Monit. 2020 Oct;25(5):278-284. doi: 10.1097/MBP.0000000000000458.
This study evaluates the accuracy of continuous blood pressure monitoring using pulse contour technology with the ClearSight monitoring device, a noninvasive alternative to placing an invasive arterial line, in pediatric patients.
Children younger than 18 years admitted to a pediatric ICU, who required an arterial line, and fit into the ClearSight finger cuff were included. Blood pressure measurement for systolic, diastolic, and mean arterial pressures (MAP) obtained by the ClearSight device were compared with those obtained with the intra-arterial catheter as well as automated cuff measurements using the mixed-effects model. Analysis was conducted for entire cohort, and measurements obtained with and without vasopressor use.
There were 213 measurements from 10 patients. There was a statistically significant difference in systolic blood pressure when comparing arterial line and ClearSight systolic and diastolic measurements between the two methods (P < 0.001). There was no statistical difference between arterial MAP and ClearSight MAP (P = 0.957). Results were similar when ClearSight measurements were compared with automated cuff measurements. Both the vasopressor use and nonvasopressor use groups showed a statistically significant difference between arterial and ClearSight measurements for systolic and diastolic pressures, but not for the MAP.
Measurements of MAP obtained by the ClearSight device were almost identical to those obtained by the intra-arterial catheter. Although there was a difference in systolic blood pressures between the two methods, in those patients receiving inotropic support, the difference was within the range of what is considered acceptable in validating blood pressure devices.
本研究评估了使用脉搏轮廓技术的 ClearSight 监护仪进行连续血压监测的准确性，该监护仪是非侵入性的，可替代放置侵入性动脉导管，适用于儿科患者。
纳入需要动脉导管且适合 ClearSight 指套的 18 岁以下儿科 ICU 患者。使用 ClearSight 设备测量收缩压、舒张压和平均动脉压（MAP），并与动脉内导管和自动袖带测量值进行比较，采用混合效应模型进行分析。对整个队列以及使用和不使用血管加压药的测量值进行了分析。
共有 10 名患者的 213 次测量值。在比较两种方法的动脉压和 ClearSight 收缩压和舒张压测量值时，收缩压存在统计学差异（P < 0.001）。动脉 MAP 和 ClearSight MAP 之间无统计学差异（P = 0.957）。当将 ClearSight 测量值与自动袖带测量值进行比较时，结果相似。在使用和不使用血管加压药的两组中，动脉和 ClearSight 测量值的收缩压和舒张压均存在统计学差异，但 MAP 无统计学差异。
ClearSight 设备测量的 MAP 值与动脉内导管测量值几乎相同。虽然两种方法的收缩压存在差异，但在接受正性肌力支持的患者中，这种差异在验证血压设备时被认为是可接受的范围内。
