Use of non-invasive continuous blood pressure monitoring in prehospital settings; a feasibility study
PDF

Keywords

: blood pressure monitors
plethysmography
prehospital emergency care

How to Cite

MAURIN, O., Frattini, B., Jost, D., Boukhari, H., Duwat, A., Jouffroy, R., Hervault, N., Trichereau, J., Lefort, H., Travers, S., & Tourtier, J. (2019). Use of non-invasive continuous blood pressure monitoring in prehospital settings; a feasibility study. Mediterranean Journal of Emergency Medicine, (27), 10. Retrieved from https://mjemonline.com/index.php/mjem/article/view/111

Abstract

Objective: Non-invasive continuous blood pressure (NICBP) monitoring is an alternative to the standard non-invasive sporadic blood pressure monitoring. It allows measuring mean arterial blood pressure (MBP), systolic blood pressure (SBP), and diastolic blood pressure (DBP). Its results seem to have a good correlation with the values of invasive continuous blood pressure. The aim of our study was to assess the feasibility of using this device in a pre-hospital setting.

Methods: The measurements taken for adult patients who were treated by Advanced Life Support teams equipped with NICBP (Nexfin™) device from one to 20 August 2015 were analysed prospectively The main outcome parameter was the number of faulty BP measurements obtained by Nexfin™ on one arm compared to the BP cuff on the other arm.

Results: Nine patients were included. The mean age was 53 [40-61]. The number of faulty measurements was 1 for Nexfin™ and 10 for the cuff. There was a good correlation and concordance between the measurements recorded by Nexfin™ and cuff for SBP (77% vs 89%), DBP (70% vs 85%), and MBP (64% vs 82%) respectively.

Conclusion: Although its big size and the low battery life, NICBP monitoring seems to be a valuable option considering its good correlation with the conventional method.

PDF

References

Rossaint R, Bouillon B, Cerny V, Coats TJ, Duranteau J, Fernández- Mondéjar E, et al. The European guideline on management of major bleeding and coagulopathy following trauma: fourth edition. Crit Care 2016; 20:100.

Brain Trauma Foundation, American Association of Neurological Surgeons. Guidelines for the management of severe traumatic brain injury. Congress of Neurological Surgeons. J Neurotrauma. 2007; 24 Suppl 1:1-106.

Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA 2016; 315:801-10.

Moss RL. Vital signs records omissions on prehospital patient encounter forms. Prehospital Disaster Med 1993; 8:21-7.

Weiss E, Gayat E, Dumans-Nizard V, Le Guen M, Fischler M. Use of the NexfinTM device to detect acute arterial pressure variations during anaesthesia induction. Br J Anaesth 2014; 113:52-60.

Ameloot K, Van De Vijver K, Broch O, Van Regenmortel N, De Laet I, Schoonheydt K, et al. Nexfin noninvasive continuous hemodynamic monitoring: validation against continuous pulse contour and intermittent transpulmonary thermodilution derived cardiac output in critically ill patients. ScientificWorldJournal 2013; 2013:519080.

Fischer MO, Avram R, Cârjaliu I, Massetti M, Gérard JL, Hanouz JL, et al. Non-invasive continuous arterial pressure and cardiac index monitoring with Nexfin after cardiac surgery. Br J Anaesth 2012; 109:514-21.

Lima MV, Ochiai ME, Vieira K, Cardoso JN, Brancalhão EC, Puig R, et al. Continuous noninvasive hemodynamic monitoring in decompensated heart failure. Arq Bras Cardiol 2012; 99:843-7.

Martina JR, Westerhof BE, van Goudoever J, Cardoso JN, Brancalhão EC, Puig R, et al. Noninvasive continuous arterial blood pressure monitoring with Nexfin®. Anesthesiology 2012; 116:1092-103.

Broch O, Renner J, Gruenewald M, Meybohm P, Schöttler J, Caliebe A, et al. A comparison of the Nexfin® and transcardiopulmonary thermodilution to estimate cardiac output during coronary artery surgery. Anaesthesia 2012; 67:377-83.

Bogert LWJ, Wesseling KH, Schraa O, Van Lieshout EJ, D Mol BA, Van Goudoever J, et al. Pulse contour cardiac output derived from non-invasive arterial pressure in cardiovascular disease: Cardiac output derived from non-invasive arterial pressure. Anaesthesia 2010; 65:1119-25.

Hofhuizen C, Lansdorp B, van der Hoeven J, Scheffer GJ, Lemson J. Validation of noninvasive pulse contour cardiac output using finger arterial pressure in cardiac surgery patients requiring fluid therapy. J Crit Care 2014; 29:161-5.

Geeraerts T, Velly L, Abdennour L, Asehnoune K, Audibert G, Bouzat P, et al. Management of severe traumatic brain injury (first 24 hours). Anaesth Crit Care Pain Med 2018; 37:171-86.

Butcher I, Maas AI, Lu J, Marmarou A, Murray GD, Mushkudiani NA, et al. Prognostic value of admission blood pressure in traumatic brain injury: results from the IMPACT study. J Neurotrauma 2007; 24:294-302.

Brenner M, Stein DM, Hu PF, Aarabi B, Sheth K, Scalea TM. Traditional systolic blood pressure targets underestimate hypotension-induced secondary brain injury. J Trauma Acute Care Surg 2012; 72:1135-9.

Berry C, Ley EJ, Bukur M, Malinoski D, Margulies DR, Mirocha J, et al. Redefining hypotension in traumatic brain injury. Injury 2012; 43:1833-7.

Vos JJ, Poterman M, Mooyaart EA, Weening M, Struys MM, Scheeren TW, et al. Comparison of continuous non-invasive finger arterial pressure monitoring with conventional intermittent automated arm arterial pressure measurement in patients under general anaesthesia. Br J Anaesth 2014; 113:67-74.

Lakhal K, Martin M, Faiz S, Ehrmann S, Blanloeil Y, Asehnoune K, et al. The CNAPTM Finger cuff for non-invasive beat-to-beat montioring of arterial blood pressure: an evaluation in intensive care nit patients and a comparison with 2 intermittent devices. Anesth Analg 2016; 123:1126-35.