Noninvasive continuous blood pressure measurement during anaesthesia: A clinical evaluation of a method commonly used in measuring devices

Abstract

The objective of the study was assess the utility during anaesthesia of noninvasive continuous blood pressure measurement techniques which use intermittent oscillometric blood pressure measurement for their calibration. The assessment was performed by comparing noninvasive blood pressure with intra-arterial blood pressure. The noninvasive blood pressure measurement device used for evaluation was the NCAT N-500 which uses tonometry for its continuous measurements. Fifteen patients were studied. In 10 patients the intra-arterial blood pressure curve (IBP) was recorded from the radial artery (radial artery group), and in 5 patients it was recorded from the brachial artery (brachial artery group). In all patients the oscillometrically calibrated tonometric blood pressure (OTBP) was recorded from the other arm. To discriminate between calibration dependent measurement error and tonometric measurement error, the OTBP signal was recalibrated against the IBP signal to get the intra-arterial calibrated tonometric pressure curve (ITBP). OTBP-IBP reflected the overall measurement error, ITBP-IBP the error of the tonometric measurement, and OTBP-ITBP the calibration dependent measurement error. According to criteria formulated in the discussion the accuracy and agreement of the ITBP-IBP measurements were clinical acceptable. Accuracy and agreement of OTBP-IBP and of OTBP-ITBP were not clinical acceptable. Correlation of dynamic behavior was lower for OTBP than for ITBP. A significant effect of site difference between calibration measurements and continuous measurements was not found. It is concluded that the approach of continuous noninvasive blood pressure measurement based on the combination of two different measurement methods, in which the continuous method is calibrated by the oscillometric method, lead to clinical unacceptable accuracy and agreement in the patient group studied.