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Noninvasive measurement of arterial blood pressure in patients with continuous-flow left ventricular assist devices: a systematic review

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Abstract

Accurate mean blood pressure determination is essential to prevent adverse events in patients with continuous-flow left ventricular assist devices (CFLVAD). We sought to evaluate the accuracy of noninvasive methods of blood pressure measurement compared with invasive intra-arterial recordings in patients with CFLVAD. 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 that compared an intra-arterial and noninvasive blood pressure measurement were included. Electronic search of scientific literature identified 5968 articles. After deduplication, screening of titles and abstracts, full-text review, and excluding incorrect populations and comparator, a total of 12 studies with 502 participants were included, of those 402 participants who had intra-arterial blood pressure measurement. Doppler mean arterial blood pressure showed a very high correlation with mean intra-arterial blood pressure (r = 0.97, r = 0.87) in low pulsatility situations. When the pulsatility was not evaluated, the correlation was high moderate (r = 0.63, r = 0.741). In low pulsatility situations, the correlation was moderate to high moderate (r = 0.42 to r = 0.65). Oscillometer automatic blood pressure cuff showed a moderate to very high correlation with intra-arterial mean arterial blood pressure (r = 0.42, r = 0.86) but also could be low in the context of low pulsatility associated with inconsistent success in noninvasive measurement (r = 0.25). Studies correlating intra-arterial with noninvasive techniques were performed in the context of routine clinical care using fluid-filled catheters. The degree of correlation between both methods is at least moderate.

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Authors and Affiliations

  1. Department of Internal Medicine, Division of Cardiovascular Diseases, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA

    Paulino A. Alvarez, Rakesh Ponnapureddy, Dinesh Voruganti, Ernesto Ruiz Duque & Alexandros Briasoulis

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  1. Paulino A. Alvarez
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Alvarez, P.A., Ponnapureddy, R., Voruganti, D. et al. Noninvasive measurement of arterial blood pressure in patients with continuous-flow left ventricular assist devices: a systematic review. Heart Fail Rev 26, 47–55 (2021). https://doi.org/10.1007/s10741-020-10006-4

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