Comparison of Femoral Arterial Blood Pressure With Radial Arterial Blood Pressure and Noninvasive Upper Arm Blood Pressure in the Reperfusion Period During Liver Transplantation

Shin, B.S.; Kim, G.S.; Ko, Justin Sangwook; Gwak, Mi Sook; Yang, Moon Sik; Kim, C.S.; Hahm, Tae Soo; Lee, S.-K.

doi:10.1016/j.transproceed.2007.02.075

Cited by 21 publications

(20 citation statements)

References 6 publications

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“…33 There are specific clinical situations, such as continuous infusion of vasopressors, sepsis, or liver transplantation, in which radial systolic and mean pressures may significantly underestimate central arterial pressures and may lead to increased use of vasopressors. [34][35][36][37][38] For these reasons, a technical approach to capture close to central arterial pressures is highly desirable in critical clinical conditions.…”

Section: Discussionmentioning

confidence: 99%

Clinical Evaluation of a High-fidelity Upper Arm Cuff to Measure Arterial Blood Pressure during Noncardiac Surgery

et al. 2020

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Background In most patients having noncardiac surgery, blood pressure is measured with the oscillometric upper arm cuff method. Although the method is noninvasive and practical, it is known to overestimate intraarterial pressure in hypotension and to underestimate it in hypertension. A high-fidelity upper arm cuff incorporating a hydraulic sensor pad was recently developed. The aim of the present study was to investigate whether noninvasive blood pressure measurements with the new high-fidelity cuff correspond to invasive measurements with a femoral artery catheter, especially at low blood pressure. Methods Simultaneous measurements of blood pressure recorded from a femoral arterial catheter and from the high-fidelity upper arm cuff were compared in 110 patients having major abdominal surgery or neurosurgery. Results 550 pairs of blood pressure measurements (5 pairs per patient) were considered for analysis. For mean arterial pressure measurements, the average bias was 0 mmHg, and the precision was 3 mmHg. The Pearson correlation coefficient was 0.96 (P < 0.0001; 95% CI, 0.96 to 0.97), and the percentage error was 9%. Error grid analysis showed that the proportions of mean arterial pressure measurements done with the high-fidelity cuff method were 98.4% in zone A (no risk), 1.6% in zone B (low risk) and 0% in zones C, D, and E (moderate, significant, and dangerous risk, respectively). The high-fidelity cuff method detected mean arterial pressure values less than 65 mmHg with a sensitivity of 84% (95% CI, 74 to 92%) and a specificity of 97% (95% CI, 95% to 98%). To detect changes in mean arterial pressure of more than 5 mmHg, the concordance rate between the two methods was 99.7%. Comparable accuracy and precision were observed for systolic and diastolic blood pressure measurements. Conclusions The new high-fidelity upper arm cuff method met the current international standards in terms of accuracy and precision. It was also very accurate to track changes in blood pressure and reliably detect severe hypotension during noncardiac surgery. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

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Section: Discussionmentioning

confidence: 99%

Clinical Evaluation of a High-fidelity Upper Arm Cuff to Measure Arterial Blood Pressure during Noncardiac Surgery

et al. 2020

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“…These results are consistent with an earlier study by Dorman et al (11), where a proportion Central-peripheral MAP differences are not uncommon and have been repeatedly demonstrated in surgical patients undergoing cardiopulmonary bypass and liver transplantation. However, the responsible mechanisms are poorly understood (5,6,10,12). A similar phenomenon may occur in patients with septic shock, especially in those receiving high-dose NE therapy.…”

Section: Discussionmentioning

confidence: 99%

Radial to Femoral Arterial Blood Pressure Differences in Septic Shock Patients Receiving High-Dose Norepinephrine Therapy

Kim¹,

Jun

Huh

et al. 2013

Shock

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“…Under conditions of extreme splanchnic vasodilation and systemic hypotension with concomitant vasopressor administration, a peripheral artery site may not accurately reflect aortic pressure. It is possible that recording from the femoral artery would have yielded different results 28. It should be noted that the manufacturers of both devices state that a peripheral arterial line is adequate, and thus using only a radial arterial line has become common clinical practice 29, 30…”

Section: Discussionmentioning

confidence: 99%

Comparison of calibrated and uncalibrated arterial pressure-based cardiac output monitors during orthotopic liver transplantation

et al. 2010

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Arterial pressure-based cardiac output monitors (APCOs) are increasingly used as alternatives to thermodilution. Validation of these evolving technologies in high-risk surgery is still ongoing. In liver transplantation, FloTrac-Vigileo (Edwards Lifesciences) has limited correlation with thermodilution, whereas LiDCO Plus (LiDCO Ltd.) has not been tested intraoperatively. Our goal was to directly compare the 2 proprietary APCO algorithms as alternatives to pulmonary artery catheter thermodilution in orthotopic liver transplantation (OLT). The cardiac index (CI) was measured simultaneously in 20 OLT patients at prospectively defined surgical landmarks with the LiDCO Plus monitor (CI L ) and the FloTrac-Vigileo monitor (CI V ). LiDCO Plus was calibrated according to the manufacturer's instructions. FloTrac-Vigileo did not require calibration. The reference CI was derived from pulmonary artery catheter intermittent thermodilution (CI TD ). CI V -CI TD bias ranged from À1.38 (95% confidence interval ¼ À2.02 to À0.75 L/minute/m 2 , P ¼ 0.02) to À2.51 L/minute/m 2 (95% confidence interval ¼ À3.36 to À1.65 L/minute/m 2 , P < 0.001), and CI L -CI TD bias ranged from À0.65 (95% confidence interval ¼ À1.29 to À0.01 L/minute/ m 2 , P ¼ 0.047) to À1.48 L/minute/m 2 (95% confidence interval ¼ À2.37 to À0.60 L/minute/m 2 , P < 0.01). For both APCOs, bias to CI TD was correlated with the systemic vascular resistance index, with a stronger dependence for FloTrac-Vigileo. The capability of the APCOs for tracking changes in CI TD was assessed with a 4-quadrant plot for directional changes and with receiver operating characteristic curves for specificity and sensitivity. The performance of both APCOs was poor in detecting increases and fair in detecting decreases in CI TD . In conclusion, the calibrated and uncalibrated APCOs perform differently during OLT. Although the calibrated APCO is less influenced by changes in the systemic vascular resistance, neither device can be used interchangeably with thermodilution to monitor cardiac output during liver transplantation. Liver Transpl 16:773-782,

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Comparison of Femoral Arterial Blood Pressure With Radial Arterial Blood Pressure and Noninvasive Upper Arm Blood Pressure in the Reperfusion Period During Liver Transplantation

Cited by 21 publications

References 6 publications

Clinical Evaluation of a High-fidelity Upper Arm Cuff to Measure Arterial Blood Pressure during Noncardiac Surgery

Clinical Evaluation of a High-fidelity Upper Arm Cuff to Measure Arterial Blood Pressure during Noncardiac Surgery

Radial to Femoral Arterial Blood Pressure Differences in Septic Shock Patients Receiving High-Dose Norepinephrine Therapy

Comparison of calibrated and uncalibrated arterial pressure-based cardiac output monitors during orthotopic liver transplantation

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