Continuous blood pressure monitoring via non-invasive radial artery applanation tonometry and invasive arterial catheter demonstrates good agreement in patients undergoing colon carcinoma surgery

J Clin Monit Comput. 2017 Dec;31(6):1189-1195. doi: 10.1007/s10877-016-9967-9. Epub 2016 Dec 20.

Abstract

Purpose: Radial artery applanation tonometry (RAAT) has been developed and utilized for continuous arterial pressure monitoring. However, evidence is lacking to clinically verify the RAAT technology and identify appropriate patient groups before routine clinical use. This study aims to evaluate the RAAT technology by comparing systolic blood pressure (SBP), mean blood pressure (MBP) and diastolic blood pressure (DBP) values in patients undergoing colon carcinoma surgery.

Methods: Blood Pressure (BP) values obtained via RAAT (TL-300, Tensys Medical Inc., San Diego, CA, USA) and conventional arterial catheterization from 30 colon carcinoma surgical patients were collected and compared via Bland-Atman method, linear regression and 4-quadrant plot concordance analysis.

Results: For SBPs, MBPs and DBPs, means of the differences (±standard deviation; 95% limits of agreement) were -0.9 (±7.6; -15.7 to 13.9) mmHg, 3.1 (±6.5; -9.6 to 15.8) mmHg and 4.3 (±7.4; -10.3 to 18.8) mmHg, respectively. Linear regression coefficients of determination were 0.8706 for SBPs, 0.8353 for MBPs and 0.6858 for DBPs. Four-quadrant concordance correlation coefficients were 0.8740, 0.8522 and 0.7108 for SBPs, MBPs and DBPs, respectively.

Conclusions: A highly selected patient collective undergoing colon carcinoma surgery was studied. BP measurements obtained via the TL-300 had clinically acceptable agreement with that acquired invasively using an arterial catheter. For use in clinical routine, it is necessary to take measures for improvement regarding movement artifacts and dilution of noise. A large sample size of patients under various conditions is also needed to further evaluate the RAAT technology before clinically routine use.

Keywords: Arterial catheter; Arterial pressure measurement; Blood pressure monitoring; Colon carcinoma surgery; Radial artery applanation tonometry.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arterial Pressure
  • Blood Pressure
  • Blood Pressure Determination / methods*
  • Carcinoma / surgery*
  • Catheterization, Peripheral
  • Colonic Neoplasms / surgery*
  • Critical Care / methods
  • Digestive System Surgical Procedures
  • Female
  • Humans
  • Intensive Care Units
  • Male
  • Manometry / methods
  • Middle Aged
  • Monitoring, Intraoperative / methods*
  • Monitoring, Physiologic / methods*
  • Radial Artery / physiology*
  • Regression Analysis
  • Signal Processing, Computer-Assisted