Accuracy of Non-Invasive Measurement of Mean Arterial Blood Pressure in Patients with Continuous Flow Left Ventricular Assist Devices: A Systematic Review

Abstract

To determine the accuracy of non-invasive blood mean blood pressure (MAP) assessment in patients with continuous flow left ventricular assist devices. Systematic electronic search was performed on four online databases (PubMed, Scopus, Embase, and Web of Knowledge) for the terms "Blood Pressure" AND ("Heart-Assist Devices" OR "Left ventricular Assist Devices"). Only studies where a non-invasive blood pressure measurement was compared with intra-arterial blood pressure recording were included. A total of 12 studies with 502 participants were included, of those 402 had intra-arterial blood pressure measurement. The median number of participants per study was 30.5 (range: 5-154). The mean age of participants was 53 years old and 77% were male. All were single center prospective studies and intra-arterial blood pressure recordings were performed in the context of routine medical care in the Intensive Care Unit. Characteristics of the included studies are shown in figure 1. Intra-arterial recording was obtained using fluid filled catheter in all studies. Statements regarding the leveling and calibration of transducer 6 (50%) studies. Simultaneous recording occurred in 4 (30%) studies. The correlations between non-invasive and intra-arterial recordings are shown in Figure 2 CONCLUSION: Standardization of quality of signal acquisition and assessment of pulsatility was variable among studies. Non-invasive MAP has variable accuracy and this may adversely influence patients outcomes.