Limits...
Continuous non-invasive arterial pressure technique improves patient monitoring during interventional endoscopy.

Siebig S, Rockmann F, Sabel K, Zuber-Jerger I, Dierkes C, Brünnler T, Wrede CE - Int J Med Sci (2009)

Bottom Line: Based on the first NIBP value in an interval between two NIBP measurements, BP values determined by CNAP showed a maximum increase of 30.8+/-21.7% and a maximum decrease of 22.4+/-28.3% (mean of all intervals).Conventional intermittent blood pressure monitoring of patients receiving sedating agents failed to detect fast changes in BP.The new technique CNAP improved the detection of rapid BP changes, and may contribute to a better patient safety for those undergoing interventional procedures.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine I, University of Regensburg, Regensburg, Germany. Sylvia.siebig@klinik.uni-r.de

ABSTRACT

Introduction: Close monitoring of arterial blood pressure (BP) is a central part of cardiovascular surveillance of patients at risk for hypotension. Therefore, patients undergoing diagnostic and therapeutic procedures with the use of sedating agents are monitored by discontinuous non-invasive BP measurement (NIBP). Continuous non-invasive BP monitoring based on vascular unloading technique (CNAP, CN Systems, Graz) may improve patient safety in those settings. We investigated if this new technique improved monitoring of patients undergoing interventional endoscopy.

Methods: 40 patients undergoing interventional endoscopy between April and December 2007 were prospectively studied with CNAP(R) in addition to standard monitoring (NIBP, ECG and oxygen saturation). All monitoring values were extracted from the surveillance network at one-second intervals, and clinical parameters were documented. The variance of CNAP values were calculated for every interval between two NIBP measurements.

Results: 2660 minutes of monitoring were recorded (mean 60.1+/-34.4 min/patient). All patients were analgosedated with midazolam and pethidine, and 24/40 had propofol infusion (mean 90.9+/-70.3 mg). The mean arterial pressure for CNAP was 102.4+/-21.2 mmHg and 106.8+/-24.8 mmHg for NIBP. Based on the first NIBP value in an interval between two NIBP measurements, BP values determined by CNAP showed a maximum increase of 30.8+/-21.7% and a maximum decrease of 22.4+/-28.3% (mean of all intervals).

Discussion: Conventional intermittent blood pressure monitoring of patients receiving sedating agents failed to detect fast changes in BP. The new technique CNAP improved the detection of rapid BP changes, and may contribute to a better patient safety for those undergoing interventional procedures.

Show MeSH

Related in: MedlinePlus

Illustration of the "tolerated" fluctuation of 10% or 20% respectively, based on the initial NIBP value. The percentage of measurements within this corridor is shown bellow.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC2631161&req=5

Figure 3: Illustration of the "tolerated" fluctuation of 10% or 20% respectively, based on the initial NIBP value. The percentage of measurements within this corridor is shown bellow.

Mentions: Most physicians using NIBP monitoring during procedural sedation are conscious of the fact that arterial pressure values may differ between two NIBP measurements. We assumed that a fluctuation of 10% or 20% of the initial NIBP value can be safely tolerated, depending on the initial value (figure 3). In our investigation, 45.12% of all mean CNAP® values were beyond this “tolerable” interval of 10%, and 15.80% of the values were even beyond the 20% range.


Continuous non-invasive arterial pressure technique improves patient monitoring during interventional endoscopy.

Siebig S, Rockmann F, Sabel K, Zuber-Jerger I, Dierkes C, Brünnler T, Wrede CE - Int J Med Sci (2009)

Illustration of the "tolerated" fluctuation of 10% or 20% respectively, based on the initial NIBP value. The percentage of measurements within this corridor is shown bellow.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2631161&req=5

Figure 3: Illustration of the "tolerated" fluctuation of 10% or 20% respectively, based on the initial NIBP value. The percentage of measurements within this corridor is shown bellow.
Mentions: Most physicians using NIBP monitoring during procedural sedation are conscious of the fact that arterial pressure values may differ between two NIBP measurements. We assumed that a fluctuation of 10% or 20% of the initial NIBP value can be safely tolerated, depending on the initial value (figure 3). In our investigation, 45.12% of all mean CNAP® values were beyond this “tolerable” interval of 10%, and 15.80% of the values were even beyond the 20% range.

Bottom Line: Based on the first NIBP value in an interval between two NIBP measurements, BP values determined by CNAP showed a maximum increase of 30.8+/-21.7% and a maximum decrease of 22.4+/-28.3% (mean of all intervals).Conventional intermittent blood pressure monitoring of patients receiving sedating agents failed to detect fast changes in BP.The new technique CNAP improved the detection of rapid BP changes, and may contribute to a better patient safety for those undergoing interventional procedures.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine I, University of Regensburg, Regensburg, Germany. Sylvia.siebig@klinik.uni-r.de

ABSTRACT

Introduction: Close monitoring of arterial blood pressure (BP) is a central part of cardiovascular surveillance of patients at risk for hypotension. Therefore, patients undergoing diagnostic and therapeutic procedures with the use of sedating agents are monitored by discontinuous non-invasive BP measurement (NIBP). Continuous non-invasive BP monitoring based on vascular unloading technique (CNAP, CN Systems, Graz) may improve patient safety in those settings. We investigated if this new technique improved monitoring of patients undergoing interventional endoscopy.

Methods: 40 patients undergoing interventional endoscopy between April and December 2007 were prospectively studied with CNAP(R) in addition to standard monitoring (NIBP, ECG and oxygen saturation). All monitoring values were extracted from the surveillance network at one-second intervals, and clinical parameters were documented. The variance of CNAP values were calculated for every interval between two NIBP measurements.

Results: 2660 minutes of monitoring were recorded (mean 60.1+/-34.4 min/patient). All patients were analgosedated with midazolam and pethidine, and 24/40 had propofol infusion (mean 90.9+/-70.3 mg). The mean arterial pressure for CNAP was 102.4+/-21.2 mmHg and 106.8+/-24.8 mmHg for NIBP. Based on the first NIBP value in an interval between two NIBP measurements, BP values determined by CNAP showed a maximum increase of 30.8+/-21.7% and a maximum decrease of 22.4+/-28.3% (mean of all intervals).

Discussion: Conventional intermittent blood pressure monitoring of patients receiving sedating agents failed to detect fast changes in BP. The new technique CNAP improved the detection of rapid BP changes, and may contribute to a better patient safety for those undergoing interventional procedures.

Show MeSH
Related in: MedlinePlus