The Ability of Pulse Pressure Variations Obtained with CNAP™ Device to Predict Fluid Responsiveness in the Operating Room

Abstract

A value of ΔPP(CNAP) >11% has a sensitivity of at least 62% in predicting preload-dependent responders to VE in mechanically ventilated patients during general anesthesia.

Assessment of volume responsiveness during mechanical ventilation: recent advances

“…Some recent studies have investigated non-invasive estimations of stroke volume, such as the non-invasive arterial pulse pressure estimated by the volume-clamp method [15,16] or the amplitude of the plethysmographic waveform [17]. All these non-invasive methods still require confirmatory studies, but they may be of great interest for the perioperative management of low-risk surgical patients, when there is no need for an invasive monitoring device.…”

Noninvasive continuous beat-to-beat radial artery pressure via TL-200 applanation tonometry

“…The Finapres has recently demonstrated efficacy (ROC area 0.81) for noninvasive fluid responsiveness testing with 250 ml colloid increments during hepatic resection cases. The CNAP showed even higher ROC area (0.942) with 500 ml colloid increments during vascular surgery cases [15,16].…”

CNAP® does not reliably detect minimal or maximal arterial blood pressures during induction of anaesthesia and tracheal intubation

“…Unfortunately, they did not show concordance results, but they concluded that continuous non‐invasive monitoring using CNAP led to detect a significantly higher number of hypotensive episodes . The ability of CNAP to predict fluid responsiveness has also been studied in several studies with consistent results, suggesting excellent ability of the device to predict this . Those results suggest that CNAP is probably a valuable tool more to assess AP semi‐quantitatively and to detect hypotension or response to fluid expansion than to precisely measure AP.…”