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CNAP ® does not reliably detect minimal or maximal arterial blood pressures during induction of anaesthesia and tracheal intubation
Author(s) -
GAYAT E.,
MONGARDON N.,
TUIL O.,
SIEVERT K.,
CHAZOT T.,
LIU N.,
FISCHLER M.
Publication year - 2013
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.12028
Subject(s) - medicine , interquartile range , anesthesia , confidence interval , tracheal intubation , intubation , nadir , intraclass correlation , general anaesthesia , rocuronium , surgery , cardiology , clinical psychology , satellite , engineering , aerospace engineering , psychometrics
Background CNAP ® provides continuous non‐invasive arterial pressure ( AP ) monitoring. We assessed its ability to detect minimal and maximal APs during induction of general anaesthesia and tracheal intubation. Methods Fifty‐two patients undergoing surgery under general anaesthesia were enrolled. Invasive pressure monitoring was established at the radial artery, and CNAP monitoring using a finger sensor recording was begun before induction. Statistical analysis was conducted with the B land– A ltman method for comparison of repeated measures and intraclass correlation coefficient ( ICC ). Results Patients’ median age was 67 years [interquartile range (59–76)], median American Society of Anesthesiologists score was 3 [interquartile range (2–3)]. Bias was 5 and −7 mm H g for peak and nadir systolic AP ( SAP ), with upper and lower limits of agreement of (42:−32) and (27;−42), respectively. The corresponding ICC values were 0.74 [95% confidence interval ( CI ) = 0.57–0.84] and 0.60 (95% CI = 0.44–0.73). Time lags to reach these values were 7.5 s (95% CI = −10.0 to 60.0) for the highest SAP and 10 s (95% CI = −12.5 to 72.5) for the lowest SAP . Bias, lower and upper limits of agreement for diastolic, and mean AP were −14 (−36 to 9) and −12 (−37 to 13) for the nadir value and −7 (−29 to 15) and −2 (−28 to 25) for the peak value. Conclusions The CNAP monitor could detect acute change in AP within a reasonable time lag. Precision of its measurements is not satisfactory, and therefore, it could only serve as a clue to the occurrence of changes in AP .