Journal of Clinical Monitoring

, Volume 7, Issue 2, pp 161–167 | Cite as

Comparative accuracies of a finger blood pressure monitor and an oscillometric blood pressure monitor

  • Richard H. Epstein
  • Suzanne Huffnagle
  • Richard R. Bartkowski
Original Articles

Abstract

A noninvasive blood pressure monitor (Finapres) that uses the methodology of Peňaz to continuously display the arterial waveform from the finger has been introduced recently. The Finapres monitor overestimated systolic pressure by 5.8±11.9 mm Hg, while the Dinamap monitor underestimated systolic pressure by −6.9±9.2 mm Hg (P=0.003). Dinamap mean and diastolic pressure biases were less than 2 mm Hg, while the Finapres biases for these variables were significantly greater (7.7±10.0 and 8.2±9.8 mm Hg, respectively). There was no difference in systolic or mean pressure precision between the two devices (approximately 10 mm Hg), but the diastolic precision of the Dinamap unit was superior to that of the Finapres. While in most patients the Finapres monitor provided continuous blood pressure data equivalent to the data from the radial artery, marked bias (>15 mm Hg) was exhibited in 2 patients for all three pressure variables. Despite this bias, blood pressure changes were tracked closely in these 2 patients. We conclude that, in its current form, the Finapres monitor cannot be relied upon independently to accurately measure blood pressure in patients undergoing general anesthesia. Since the Dinamap monitor measures mean pressure reliably and accurately, we suggest that mean blood pressure values between the Finapres and Dinamap monitors be compared to guide one in interpreting Finapres data.

Key words

Monitoring: blood pressure Equipment: monitors, blood pressure Measurement techniques: blood pressure Anesthesia, general 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Peňaz J. Photoelectric measurement of blood pressure, volume and flow in the finger. In: Digest of the 10th International Conference on Medical and Biological Engineering. Dresden, 1973:104Google Scholar
  2. 2.
    Boehmer RD. Continuous, real-time, noninvasive monitor of blood pressure: Peňaz methodology applied to the finger. J Clin Monit 1987;3:282–287PubMedGoogle Scholar
  3. 3.
    Epstein RH, Kaplan SK, Leighton BL, et al. Evaluation of a continuous noninvasive blood pressure monitor in obstetric patients undergoing spinal anesthesia. J Clin Monit 1989;5:157–163PubMedCrossRefGoogle Scholar
  4. 4.
    Hipkins SF, Rutten AJ, Runciman WB. Experimental analysis of catheter-manometer systems in vitro and in vivo. Anesthesiology 1989;71:893–906PubMedCrossRefGoogle Scholar
  5. 5.
    Sheiner LB, Beal SL. Some suggestions for measuring predictive performance. J Pharmacokinet Biopharm 1981;9:503–512PubMedCrossRefGoogle Scholar
  6. 6.
    Loubser PG. Comparison of intra-arterial and automated oscillometric blood pressure measurement methods in postoperative hypertensive patients. Med Instrum 1986;20:255–259PubMedGoogle Scholar
  7. 7.
    Manolio TA, Fishel SC, Beattie C, et al. Am J Hypertens 1988;1:161S-167SPubMedGoogle Scholar
  8. 8.
    Yelderman M, Ream AK. Indirect measurement of mean blood pressure in the anesthetized patient. Anesthesiology 1979;50:253–256PubMedCrossRefGoogle Scholar
  9. 9.
    Parati G, Casadei R, Groppelli A, et al. Comparison of finger and intra-arterial blood pressure monitoring at rest and during laboratory testing. Hypertension 1989;13:647–655PubMedGoogle Scholar
  10. 10.
    Dorlas JC, Mijboer JA, Butijn WT, et al. Effects of peripheral vasoconstriction on the blood pressure in the finger, measured continuously by a new noninvasive method (the Finapres). Anesthesiology 1985;62:342–345PubMedCrossRefGoogle Scholar
  11. 11.
    Molhoek GP, Wessling KH, Settels JJM, et al. Evaluation of the Peňaz servo-plethysmo-manometer for the continuous non-invasive measurement of finger blood pressure. Basic Res Cardiol 1984;79:598–609PubMedCrossRefGoogle Scholar
  12. 12.
    Bruner JMR, Krenis LJ, Kunsman JM, Sherman AP. Comparison of direct and indirect methods of measuring arterial blood pressure. Med Instrum 1981;15:11–21PubMedGoogle Scholar
  13. 13.
    O'Rourke MF, Blazek JV, Morreels CL, Krovets LJ. Pressure wave transmission along the human aorta: changes with age and degenerative disease. Circ Res 1968;23:567–579PubMedGoogle Scholar
  14. 14.
    Hamilton WF, Dow P. An experimental study of the standing waves in the pulse propagated through the aorta. Am J Physiol 1939;125:48–59Google Scholar
  15. 15.
    Gorback MS, Quill TS, Block EC, Graubert DA. Oscillometric blood pressure determination from the adult thumb using an infant cuff. Anesth Analg 1989;69:668–670PubMedGoogle Scholar
  16. 16.
    Kurki TS, Sanford TJ, Smith NT, et al. Effects of radial artery cannulation on the function of finger blood pressure and pulse oximeter monitors. Anesthesiology 1988;69:778–782PubMedCrossRefGoogle Scholar
  17. 17.
    Critikon, Inc. Operation manual: Dinamap adult/pediatric and neonatal vital signs monitor (models 1846 SX and 1846 SX/P). Tampa, FL: Critkon, Inc, 1985:26Google Scholar

Copyright information

© Little, Brown and Company 1991

Authors and Affiliations

  • Richard H. Epstein
    • 1
  • Suzanne Huffnagle
    • 1
  • Richard R. Bartkowski
    • 1
  1. 1.Dept of AnesthesiologyThomas Jefferson University, Suite 6275, New HospitalPhiladelphia

Personalised recommendations