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Radial artery applanation tonometry for continuous noninvasive arterial blood pressure monitoring in the cardiac intensive care unit

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Abstract

Background

Hemodynamic monitoring plays a pivotal role in the treatment of patients in the cardiac intensive care unit (CICU). The innovative radial artery applanation tonometry technology allows for continuous noninvasive arterial blood pressure (AP) measurement. By closing the gap between continuous invasive AP monitoring (arterial catheter) and intermittent noninvasive AP monitoring (oscillometry) this technology might improve CICU patient monitoring. We therefore aimed to evaluate the measurement performance of radial artery applanation tonometry in comparison with a radial arterial catheter in CICU patients.

Methods

In this prospective method comparison study, we simultaneously recorded AP noninvasively with radial artery applanation tonometry (T-line 200pro device; Tensys Medical Inc., San Diego, CA, USA) and invasively with an arterial catheter (criterion standard) in 30 patients treated in the CICU of a German university hospital. We statistically analyzed 7,304 averaged 10-beat epochs of measurements of mean AP, systolic AP, and diastolic AP by using Bland–Altman analysis for repeated measurements.

Results

Our study revealed a mean difference ± standard deviation (95 % limits of agreement; percentage error) between radial artery applanation tonometry and the criterion standard method (radial arterial catheter) of +2 ± 6 mmHg (−10 to +14 mmHg; 17 %) for mean AP, −6 ± 11 mmHg (−28 to +15 mmHg; 20 %) for systolic AP, and +4 ± 7 mmHg (−9 to +17 mmHg; 23 %) for diastolic AP.

Conclusions

In CICU patients, continuous noninvasive measurement of AP using radial artery applanation tonometry is feasible. The technology showed reasonable accuracy and precision in comparison with radial arterial catheter-derived AP values.

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Acknowledgments

Tensys Medical Inc. (San Diego, CA, USA) provided the technical equipment for recording and extraction of arterial blood pressure measurements using radial arterial applanation tonometry.

Conflict of interest

BS, ASM, and JYW received unrestricted research grants from Tensys Medical Inc. (San Diego, CA, USA). For all other authors there is no conflict of interest to disclose.

Author information

Author notes

  1. Agnes S. Meidert

    Present address: Clinic of Anesthesiology, Ludwig-Maximilians-University Munich, Marchioninistraße 15, 81377, Munich, Germany

  2. Julia Y. Wagner & Bernd Saugel

    Present address: Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany

Authors and Affiliations

  1. I. Medizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Strasse 22, 81675, Munich, Germany

    Nicolas Langwieser, Christian Bradaric, Tareq Ibrahim & Karl-Ludwig Laugwitz

  2. II. Medizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Strasse 22, 81675, Munich, Germany

    Luisa Prechtl, Agnes S. Meidert, Roland M. Schmid & Bernd Saugel

  3. Institut für Medizinische Statistik und Epidemiologie, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Strasse 22, 81675, Munich, Germany

    Alexander Hapfelmeier

  4. DZKH (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany

    Karl-Ludwig Laugwitz

  5. III. Medizinische Klinik, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Strasse 22, 81675, Munich, Germany

    Julia Y. Wagner

Authors
  1. Nicolas Langwieser
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  2. Luisa Prechtl
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  7. Karl-Ludwig Laugwitz
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  8. Roland M. Schmid
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  9. Julia Y. Wagner
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  10. Bernd Saugel
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Corresponding author

Correspondence to Bernd Saugel.

Additional information

N. Langwieser and L. Prechtl contributed equally to the study.

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Langwieser, N., Prechtl, L., Meidert, A.S. et al. Radial artery applanation tonometry for continuous noninvasive arterial blood pressure monitoring in the cardiac intensive care unit. Clin Res Cardiol 104, 518–524 (2015). https://doi.org/10.1007/s00392-015-0816-5

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  • DOI: https://doi.org/10.1007/s00392-015-0816-5

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