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Continuous blood pressure monitoring via non-invasive radial artery applanation tonometry and invasive arterial catheter demonstrates good agreement in patients undergoing colon carcinoma surgery

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Abstract

Purpose

Radial artery applanation tonometry (RAAT) has been developed and utilized for continuous arterial pressure monitoring. However, evidence is lacking to clinically verify the RAAT technology and identify appropriate patient groups before routine clinical use. This study aims to evaluate the RAAT technology by comparing systolic blood pressure (SBP), mean blood pressure (MBP) and diastolic blood pressure (DBP) values in patients undergoing colon carcinoma surgery.

Methods

Blood Pressure (BP) values obtained via RAAT (TL-300, Tensys Medical Inc., San Diego, CA, USA) and conventional arterial catheterization from 30 colon carcinoma surgical patients were collected and compared via Bland-Atman method, linear regression and 4-quadrant plot concordance analysis.

Results

For SBPs, MBPs and DBPs, means of the differences (±standard deviation; 95% limits of agreement) were −0.9 (±7.6; −15.7 to 13.9) mmHg, 3.1 (±6.5; −9.6 to 15.8) mmHg and 4.3 (±7.4; −10.3 to 18.8) mmHg, respectively. Linear regression coefficients of determination were 0.8706 for SBPs, 0.8353 for MBPs and 0.6858 for DBPs. Four-quadrant concordance correlation coefficients were 0.8740, 0.8522 and 0.7108 for SBPs, MBPs and DBPs, respectively.

Conclusions

A highly selected patient collective undergoing colon carcinoma surgery was studied. BP measurements obtained via the TL-300 had clinically acceptable agreement with that acquired invasively using an arterial catheter. For use in clinical routine, it is necessary to take measures for improvement regarding movement artifacts and dilution of noise. A large sample size of patients under various conditions is also needed to further evaluate the RAAT technology before clinically routine use.

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References

  1. Saugel B, Dueck R, Wagner JY Measurement of blood pressure. Best Pract Res Clin Anaesthesiol, 2014;309–322. doi:10.1016/j.bpa.2014.08.001.

    PubMed  Google Scholar 

  2. Scheer B, Perel A, Pfeiffer UJ. Clinical review: complications and risk factors of peripheral arterial catheters used for haemodynamic monitoring in anaesthesia and intensive care medicine. Crit Care. 2002;6:198–204.

    Article  Google Scholar 

  3. Adji A, Hirata K, O’Rourke MF. Clinical use of indices determined noninvasively from the radial and carotid pressure waveforms. Blood Press Monit. 2006;11(4):215–21. doi:10.1097/01.mbp.0000218001.50333.b7.

    Article  PubMed  Google Scholar 

  4. Nelson MR, Stepanek J, Cevette M, Covalciuc M, Hurst T, Jamil Tajik A. Noninvasive measurement of central vascular pressures with arterial tonometry: clinical revival of the pulse pressure waveform? Mayo Clin Proc. 2010;85(5):460–72. doi:10.4065/mcp.2009.0336.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Sharman JE, Stowasser M, Fassett RG, Marwick TH, Franklin SS. Central blood pressure measurement may improve risk stratification. J Hum Hypertens. 2008;22:838–44. doi:10.1038/jhh.2008.71.

    Article  PubMed  Google Scholar 

  6. McEniery CM, Yasmin, McDonnell B et al. Central pressure: variability and impact of cardiovascular risk factors: the Anglo-Cardiff Collaborative Trial II. Hypertension 2008;51(6): 1476–1482. doi:10.1161/HYPERTENSIONAHA.107.105445.

    Article  CAS  PubMed  Google Scholar 

  7. Meidert AS, Huber W, Hapfelmeier A, et al. Evaluation of the radial artery applanation tonometry technology for continuous noninvasive blood pressure monitoring compared with central aortic blood pressure measurements in patients with multiple organ dysfunction syndrome. J Crit Care. 2013;28(6):908–12. doi:10.1016/j.jcrc.2013.06.012.

    Article  PubMed  Google Scholar 

  8. Meidert AS, Huber W, Müller JN, et al. Radial artery applanation tonometry for continuous non-invasive arterial pressure monitoring in intensive care unit patients: comparison with invasively assessed radial arterial pressure. Br J Anaesth. 2014;112(3):521–8. doi:10.1093/bja/aet400.

    Article  CAS  PubMed  Google Scholar 

  9. Janelle GM, Nikolaus G. An accuracy evaluation of the T-Line Tensymeter (continuous noninvasive blood pressure management device) versus conventional invasive radial artery monitoring in surgical patients. Anesth Analg. 2006;102(2):484–90. doi:10.1213/01.ane.0000194873.52453.bd.

    Article  PubMed  Google Scholar 

  10. Lin WQ, Wu HH, Su CS, et al. Comparison of continuous noninvasive blood pressure monitoring by TL-300 with standard invasive blood pressure measurement in patients undergoing elective neurosurgery. J Neurosurg Anesthesiol. 2015. doi:10.1097/ANA.0000000000000245.

    Google Scholar 

  11. Saugel B, Meidert AS, Hapfelmeier A, Eyer F, Schmid RM, Huber W. Non-invasive continuous arterial pressure measurement based on radial artery tonometry in the intensive care unit: a method comparison study using the T-Line TL-200pro device. Br J Anaesth. 2013;111(2):185–90. doi:10.1093/bja/aet025.

    Article  CAS  PubMed  Google Scholar 

  12. Saugel B, Fassio F, Hapfelmeier A, Meidert AS, Schmid RM, Huber W. The T-Line TL-200 system for continuous non-invasive blood pressure measurement in medical intensive care unit patients. Intensive Care Med. 2012;38(9):1471–7. doi:10.1007/s00134-012-2617-x.

    Article  PubMed  Google Scholar 

  13. Dueck R, Goedje O, Clopton P. Noninvasive continuous beat-to-beat radial artery pressure via TL-200 applanation tonometry. J Clin Monit Comput. 2012;26(2):75–83. doi:10.1007/s10877-012-9336-2.

    Article  PubMed  Google Scholar 

  14. Ilies C, BauerM, Berg P et al (2012) Investigation of the agreement of a continuous non-invasive arterial pressure device in comparison with invasive radial artery measurement. Br J Anaesth 108:202–210. doi:10.1093/bja/aer394.

    Article  CAS  PubMed  Google Scholar 

  15. Saugel B, Cecconi M, Wagner JY, Reuter DA. Noninvasive continuous cardiac output monitoring in perioperative and intensive care medicine. Br J Anaesth. 2015;114(4):562–75. doi:10.1093/bja/aeu447.

    Article  CAS  PubMed  Google Scholar 

  16. ANSI/AAMI SP10:2002 American national standard for manual, electronic, or automated sphygmomanometers. Association for the Advancement of Medical Instrumentation 2002.

  17. Szmuk P, Pivalizza E, Warters RD, Ezri T, Gebhard R. An evaluation of the T-Line Tensymeter continuous noninvasive blood pressure device during induced hypotension. Anaesthesia. 2008;63(3):307–12. doi:10.1111/j.1365-2044.2007.05369.x.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

This study was supported by Tensys Medical Inc. (San Diego, CA, USA). TL-300 system and disposable sensors were provided by Tensys Medical Inc. (San Diego, CA, USA). Thank Dr. Oliver Goedje for technical and statistical guidance. Thank Dr. Eric Daniels for manuscript proofreading.

Author contributions

Jing Sun: study design and conception, ethical application, analysis and interpretation of data, manuscript drafting and revising. Hanjian Chen: patient recruitment, data acquisition, theoretical support. Jun Zheng: study conception and design, ethical application, project coordinator. Bin Mao: study design, ethical application, and experimental platform preparation. Shengmei Zhu: patient recruitment, data acquisition, theoretical support. Jingyi Feng: study design and conception, data analysis and interpretation, manuscript revising. All authors approved the version of the manuscript for publication.

Funding

This study was supported by Tensys Medical Inc. (San Diego, CA, USA).

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Author notes

    Authors and Affiliations

    1. Department of Clinical Engineering, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China

      Jing Sun, Jun Zheng, Bin Mao & Jingyi Feng

    2. Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China

      Hanjian Chen & Shengmei Zhu

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    1. Jing Sun
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    Correspondence to Jingyi Feng.

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    Conflict of interest

    Tensys Medical Inc. (San Diego, CA, USA) provided TL-300 system and disposable sensors for this study. This company was not involved in study design and conception, data collection, analysis and interpretation of data, writing of the manuscript, or the decision to submit the manuscript for publication.

    Ethical approval

    All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethics Committee of the First Affiliated Hospital, School of Medicine, Zhejiang University (Ref: 2014/134).

    Informed consent

    Informed consent was obtained from all individual participants included in the study.

    Additional information

    Jing Sun and Hanjian Chen have contributed equally to this work.

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    Sun, J., Chen, H., Zheng, J. et al. Continuous blood pressure monitoring via non-invasive radial artery applanation tonometry and invasive arterial catheter demonstrates good agreement in patients undergoing colon carcinoma surgery. J Clin Monit Comput 31, 1189–1195 (2017). https://doi.org/10.1007/s10877-016-9967-9

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    • DOI: https://doi.org/10.1007/s10877-016-9967-9

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