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Non-invasive measurement of pulse pressure variation and systolic pressure variation using a finger cuff corresponds with intra-arterial measurement. 2011

B Lansdorp, and D Ouweneel, and A de Keijzer, and J G van der Hoeven, and J Lemson, and P Pickkers
MIRA-Institute for Biomedical Technology and Technical Medicine, University of Twente, PO Box 217, 7500 AE Enschede, The Netherlands. b.lansdorp@utwente.nl

BACKGROUND Pulse pressure variation (PPV) and systolic pressure variation (SPV) are reliable predictors of fluid responsiveness in patients undergoing controlled mechanical ventilation. Currently, PPV and SPV are measured invasively and it is unknown if an arterial pressure (AP) signal obtained with a finger cuff can be used as an alternative. The aim of this study was to validate PPV and SPV measured using a finger cuff. METHODS Patients receiving mechanical ventilation under sedation after cardiac artery bypass graft (CABG) surgery were included after arrival on the intensive care unit. AP was measured invasively in the radial artery and non-invasively using the finger cuff of the Nexfin™ monitor. I.V. fluid challenges were administered according to clinical need. The mean value of PPV and SVV was calculated before and after administration of a fluid challenge. Agreement of the calculated PPV and SPV from both methods was assessed using the Bland-Altman analysis. RESULTS Nineteen patients were included and 28 volume challenges were analysed. Correlation between the two methods for PPV and SPV [mean (sd)=6.9 (4.3)% and 5.3 (2.6)%, respectively] was r=0.96 (P<0.0001) and r=0.95 (P<0.0001), respectively. The mean bias was -0.95% for PPV and -0.22% for SPV. Limits of agreement were -4.3% and 2.4% for PPV and -2.2% and 1.7% for SPV. The correlation between changes in PPV and SPV as a result of volume expansion measured by the two different methods was r=0.88 (P<0.0001) and r=0.87 (P<0.0001), respectively. CONCLUSIONS In patients receiving controlled mechanical ventilation after CABG, PPV and SPV can be measured reliably non-invasively using the inflatable finger cuff of the Nexfin™ monitor.

UI MeSH Term Description Entries
D007262 Infusions, Intravenous The long-term (minutes to hours) administration of a fluid into the vein through venipuncture, either by letting the fluid flow by gravity or by pumping it. Drip Infusions,Intravenous Drip,Intravenous Infusions,Drip Infusion,Drip, Intravenous,Infusion, Drip,Infusion, Intravenous,Infusions, Drip,Intravenous Infusion
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D008991 Monitoring, Physiologic The continuous measurement of physiological processes, blood pressure, heart rate, renal output, reflexes, respiration, etc., in a patient or experimental animal; includes pharmacologic monitoring, the measurement of administered drugs or their metabolites in the blood, tissues, or urine. Patient Monitoring,Monitoring, Physiological,Physiologic Monitoring,Monitoring, Patient,Physiological Monitoring
D011184 Postoperative Period The period following a surgical operation. Period, Postoperative,Periods, Postoperative,Postoperative Periods
D011674 Pulse The rhythmical expansion and contraction of an ARTERY produced by waves of pressure caused by the ejection of BLOOD from the left ventricle of the HEART as it contracts. Pulses
D012015 Reference Standards A basis of value established for the measure of quantity, weight, extent or quality, e.g. weight standards, standard solutions, methods, techniques, and procedures used in diagnosis and therapy. Standard Preparations,Standards, Reference,Preparations, Standard,Standardization,Standards,Preparation, Standard,Reference Standard,Standard Preparation,Standard, Reference
D012039 Regional Blood Flow The flow of BLOOD through or around an organ or region of the body. Blood Flow, Regional,Blood Flows, Regional,Flow, Regional Blood,Flows, Regional Blood,Regional Blood Flows
D001794 Blood Pressure PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS. Systolic Pressure,Diastolic Pressure,Pulse Pressure,Pressure, Blood,Pressure, Diastolic,Pressure, Pulse,Pressure, Systolic,Pressures, Systolic
D001916 Brachial Artery The continuation of the axillary artery; it branches into the radial and ulnar arteries. Arteries, Brachial,Artery, Brachial,Brachial Arteries

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