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Continuous optical blood pressure measurement in the perioperative setting

Authors:

Abstract

Background and Goal of Study: Obtaining accurate continuous blood pressure (BP) monitoring is mandatory in critically-ill, anesthetized patients or during complex surgical procedures. The gold standard for continuous BP measurement invasive arterial catheter- is complex and associated with morbidity. To allow non-invasive beat-to-beat BP measurement, we used a commercially available pulse oximeter probe and analyzed its signals in order to assess performance of optically acquired signals transformed into continuous BP values. The aim of the study is to prove the accuracy of the optical non-invasive blood pressure device compared to the invasive arterial measurement. Materials and Methods: We included and obtained informed consent from 40 patients aged more than 18 years and scheduled for an elective surgery necessitating general anesthesia and invasive BP monitoring at CHUV- University Hospital of Lausanne. An arterial catheter was inserted in a radial artery. The fingertip device was placed on the contralateral side. Both signals were recorded at induction of general anesthesia and compared. The signal obtained through the fingertip device was analyzed based on published pulse wave analysis algorithms, and a patient-dependent calibration procedure. Results and Discussion: We provide here the preliminary results from the first 8 patients when estimating diastolic BP from optical signals. Data analysis on the remaining 32 patients is underway. During anesthesia induction, large changes of diastolic BP were measured by the radial catheter (average diastolic BP change of 62 mmHg ± 30 mmHg).
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General Anaesthesiology
526
Continuous optical blood pressure measurement
in the perioperative setting
Monitoring,arterial pressure, Arterial pressure,measurement
Y. A. Ghamri1, A. Axis1, F. Braun2, N. Pierrel1, J. Solà2, P. Schoettker1
1CHUV - Lausanne (Switzerland), 2CSEM - Neuchâtel (Switzerland)
Background and Goal of Study:
Obtaining accurate continuous blood pressure (BP) monitoring is mandatory in critically-ill, anesthetized
patients or during complex surgical procedures. The gold standard for continuous BP measurement-
invasive arterial catheter- is complex and associated with morbidity.
To allow non-invasive beat-to-beat BP measurement, we used a commercially available pulse oximeter
probe and analyzed its signals in order to assess performance of optically acquired signals transformed into
continuous BP values.
The aim of the study is to prove the accuracy of the optical non-invasive blood pressure device compared to
the invasive arterial measurement.
Materials and Methods:
We included and obtained informed consent from 40 patients aged more than 18 years and scheduled for
an elective surgery necessitating general anesthesia and invasive BP monitoring at CHUV- University
Hospital of Lausanne. An arterial catheter was inserted in a radial artery. The fingertip device was placed
on the contralateral side. Both signals were recorded at induction of general anesthesia and compared.
The signal obtained through the fingertip device was analyzed based on published pulse wave analysis
algorithms, and a patient-dependent calibration procedure.
Results and Discussion:
We provide here the preliminary results from the first 8 patients when estimating diastolic BP from optical
signals. Data analysis on the remaining 32 patients is underway.
During anesthesia induction, large changes of diastolic BP were measured by the radial catheter (average
diastolic BP change of 62 mmHg ± 30 mmHg).
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Overall, the measured mean error for diastolic BP was of 2.1 mmHg (95% confidence interval (CI) between
-2.6 and 6.9 mmHg), and the measured standard deviation of the error for diastolic BP was of 9.6 mmHg
(95% CI between 1.1 mmHg and 18 mmHg). For such a simple optical measurement setup, and given the
large BP variabilities observed in the study, these performances are already very close to the exigent
ISO81060-2 requirements.
Conclusion:
Our results demonstrate feasibility of estimating BP changes in the operating room through an algorithm-
based signal analysis acquired through a commercially available pulse oximeter. Further studies are
needed but this research validates a promising track towards non-invasive continuous monitoring of BP.
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