Precision and accuracy of a new device (CNAP™) for continuous non-invasive arterial pressure monitoring: assessment during general anaesthesia

Jeleazcov, Christian; Krajinovic, Ljubica; Münster, Tino; Birkholz, Torsten; Fried, Roland; Schüttler, J.; Fechner, J.

doi:10.1093/bja/aeq143

Cited by 157 publications

(123 citation statements)

References 23 publications

(17 reference statements)

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“…This has important implications, as CNAP is more likely than NIBP to leave the anaesthetist without blood pressure readings for a significant period (> 2 min). One reason for the increased recalibration rate in CNAP was that this study involved awake patients with voluntary upper limb movement, whereas the previous accuracy study was conducted under general anaesthesia [7]. The invasive arterial blood pressure vs CNAP defined a fast change in arterial pressure as a change of blood pressure of 20 mmHg, within a 3-min period, and concluded that both devices found a similar incidence of this change [7].…”

Section: Discussionmentioning

confidence: 98%

“…One reason for the increased recalibration rate in CNAP was that this study involved awake patients with voluntary upper limb movement, whereas the previous accuracy study was conducted under general anaesthesia [7]. The invasive arterial blood pressure vs CNAP defined a fast change in arterial pressure as a change of blood pressure of 20 mmHg, within a 3-min period, and concluded that both devices found a similar incidence of this change [7]. However, during caesarean section, the blood pressure may change by considerably more than 20 mmHg from the baseline within a time period of < 3 min.…”

Section: Discussionmentioning

confidence: 99%

“…In this situation, the anaesthetist has the choice of attempting to restart the device or resuming conventional NIBP monitoring. The time between starting the CNAP monitor and it displaying the first reading was 4 min, making it unsuitable for urgent cases [7].…”

Section: Discussionmentioning

confidence: 99%

“…The primary aim of the study was not to test CNAP's accuracy as this has been tested in a larger clinical trial [7]. The European Society of Hypertension (ESH) has developed a protocol for the validation of new blood pressure measuring devices in adults [11].…”

Section: Discussionmentioning

confidence: 99%

“…The most rigorous clinical trial of CNAP compared it with invasive arterial blood pressure in 88 patients undergoing elective cardiac, abdominal or neurosurgery [7]. More than 920 000 pairs of CNAP and invasive arterial blood pressure were recorded.…”

mentioning

confidence: 99%

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Ability of non‐invasive intermittent blood pressure monitoring and a continuous non‐invasive arterial pressure monitor (CNAP^™) to provide new readings in each 1‐min interval during elective caesarean section under spinal anaesthesia

et al. 2012

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SummaryWe compared the ability of automated non-invasive intermittent oscillometric blood pressure monitoring with a new device, CNAP TM (continuous non-invasive arterial pressure) to provide a new blood pressure reading in each 1-min interval between spinal anaesthesia and delivery during caesarean section. We also compared the accuracy of continuous non-invasive arterial pressure readings with non-invasive blood pressure measurements before spinal anaesthesia. Fiftynine women participated. The non-invasive and continuous non-invasive monitors displayed new blood pressure readings in a mean of 82% (11%) and 83% (13%) (p = 0.97) of the one-minute intervals between spinal anaesthesia and delivery, respectively. Continuous non-invasive arterial pressure was more likely to fail on two or more consecutive minutes (p = 0.001). From the pre-spinal readings, the mean bias, defined as non-invasive -continuous non-invasive arterial pressure, and limits of agreement (±2SD mean bias) for systolic, diastolic and mean blood pressure respectively were +1.3 (±26.0), )2.9 (±21.8) and +2.6 (±20.4) mmHg. The new monitor has disadvantages compared with conventional non-invasive intermittent blood pressure monitoring.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Ability of non‐invasive intermittent blood pressure monitoring and a continuous non‐invasive arterial pressure monitor (CNAP^™) to provide new readings in each 1‐min interval during elective caesarean section under spinal anaesthesia

et al. 2012

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Continuous noninvasive monitoring of arterial pressure using the vascular unloading technique in comparison to the invasive gold standard in elderly comorbid patients: A prospective observational study

Klose¹,

Lorenzen²,

Berndt³

et al. 2020

Health Science Reports

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Background and Aims: Elderly patients aged ≥65 years represent a growing population in the perioperative field, particularly orthopedic and vascular surgery. The higher degree of age-related or comorbid-dependent vascular alterations renders these patients at risk for hemodynamic complications and likely denote a possible limitation for modern, non-invasive arterial pressure monitoring devices. The aim was to compare vascular unloading technique-derived to invasive measurements of systolic (SAP), diastolic (DAP), and mean arterial pressure (MAP) in elderly perioperative patients. Methods: This prospective observational study included patients aged ≥65 years scheduled for orthopedic and patients ≥50 years with peripheral artery disease Fontaine stage ≥ II scheduled for vascular surgery, respectively. Invasive radial artery and non-invasive finger-cuff (Nexfin system) arterial pressures were recorded before and after induction of general anesthesia and during surgery. Correlation, Bland-Altman, and concordance analyses were performed. Measurements of arterial pressure were also compared during intraoperative hypotension (MAP <70 mm Hg) and hypertension (MAP >105 mm Hg). Results: Sixty patients with orthopedic (N = 25, mean (SD) age 77 (5) years) and vascular surgery (N = 35, age 69 [10] years) were enrolled. Seven hundred data pairs of all patients were analysed and pooled bias and percentage error were: SAP:

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Regulation and Approval of Continuous Non-invasive Blood-Pressure Monitoring Devices

Tamura

2019

IFMBE Proceedings

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Precision and accuracy of a new device (CNAP™) for continuous non-invasive arterial pressure monitoring: assessment during general anaesthesia

Abstract: CNAP provides real-time estimates of arterial pressure comparable with those generated by an invasive intra-arterial catheter system during general anaesthesia.

Cited by 157 publications

References 23 publications

Ability of non‐invasive intermittent blood pressure monitoring and a continuous non‐invasive arterial pressure monitor (CNAP^™) to provide new readings in each 1‐min interval during elective caesarean section under spinal anaesthesia

Ability of non‐invasive intermittent blood pressure monitoring and a continuous non‐invasive arterial pressure monitor (CNAP^™) to provide new readings in each 1‐min interval during elective caesarean section under spinal anaesthesia

Continuous noninvasive monitoring of arterial pressure using the vascular unloading technique in comparison to the invasive gold standard in elderly comorbid patients: A prospective observational study

Regulation and Approval of Continuous Non-invasive Blood-Pressure Monitoring Devices

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Precision and accuracy of a new device (CNAP™) for continuous non-invasive arterial pressure monitoring: assessment during general anaesthesia

Abstract: CNAP provides real-time estimates of arterial pressure comparable with those generated by an invasive intra-arterial catheter system during general anaesthesia.

Cited by 157 publications

References 23 publications

Ability of non‐invasive intermittent blood pressure monitoring and a continuous non‐invasive arterial pressure monitor (CNAP™) to provide new readings in each 1‐min interval during elective caesarean section under spinal anaesthesia

Ability of non‐invasive intermittent blood pressure monitoring and a continuous non‐invasive arterial pressure monitor (CNAP™) to provide new readings in each 1‐min interval during elective caesarean section under spinal anaesthesia

Continuous noninvasive monitoring of arterial pressure using the vascular unloading technique in comparison to the invasive gold standard in elderly comorbid patients: A prospective observational study

Regulation and Approval of Continuous Non-invasive Blood-Pressure Monitoring Devices

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Product

Resources

About

Ability of non‐invasive intermittent blood pressure monitoring and a continuous non‐invasive arterial pressure monitor (CNAP^™) to provide new readings in each 1‐min interval during elective caesarean section under spinal anaesthesia

Ability of non‐invasive intermittent blood pressure monitoring and a continuous non‐invasive arterial pressure monitor (CNAP^™) to provide new readings in each 1‐min interval during elective caesarean section under spinal anaesthesia