Continuous noninvasive arterial blood pressure monitoring using the vascular unloading technology during complex gastrointestinal endoscopy: a prospective observational study
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Continuous noninvasive arterial blood pressure monitoring using the vascular unloading technology during complex gastrointestinal endoscopy: a prospective observational study. / Nicklas, Julia Y; Beckmann, David; Killat, Jasper; Petzoldt, Martin; Reuter, Daniel A; Rösch, Thomas; Saugel, Bernd.
in: J CLIN MONIT COMPUT, Jahrgang 33, Nr. 1, 02.2019, S. 25-30.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Continuous noninvasive arterial blood pressure monitoring using the vascular unloading technology during complex gastrointestinal endoscopy: a prospective observational study
AU - Nicklas, Julia Y
AU - Beckmann, David
AU - Killat, Jasper
AU - Petzoldt, Martin
AU - Reuter, Daniel A
AU - Rösch, Thomas
AU - Saugel, Bernd
PY - 2019/2
Y1 - 2019/2
N2 - The innovative vascular unloading technology (VUT) allows continuous noninvasive arterial blood pressure (AP) monitoring. We aimed to investigate whether the VUT enables AP changes to be detected earlier compared with intermittent AP monitoring in patients undergoing gastrointestinal endoscopy. In this prospective observational study, we recorded continuous AP measurements with the VUT (CNAP system; CNSystems Medizintechnik AG, Graz, Austria) and intermittent AP measurements with upper arm cuff oscillometry in 90 patients undergoing complex gastrointestinal endoscopy (Department of Interventional Endoscopy at the University Medical Center Hamburg-Eppendorf, Hamburg, Germany). A "hypotensive phase" was defined as a time period of at least 30 s during which ≥ 50% of the VUT-AP values were in a predefined range of hypotension, i.e., AP value a) ≥ 10% below the last oscillometric value and b) ≤ 65 mmHg for mean AP or ≤ 90 mmHg for systolic AP. In the 5-min-interval between two oscillometric measurements, one or more hypotensive phases were detected in 26 patients (29%) for mean AP and in 27 patients (30%) for systolic AP. Hypotensive phases had a mean duration of 195 ± 99 s for mean AP and 197 ± 97 s for systolic AP with a mean procedure duration of 36 (± 21) min. Continuous noninvasive AP monitoring using the VUT enables hypotensive phases to be detected earlier compared with intermittent AP monitoring during complex gastrointestinal endoscopy. These hypotensive phases may be missed or only belatedly recognized with intermittent AP monitoring. Continuous noninvasive AP measurement facilitates detecting hemodynamic instability more rapidly and therefore may improve patient safety.
AB - The innovative vascular unloading technology (VUT) allows continuous noninvasive arterial blood pressure (AP) monitoring. We aimed to investigate whether the VUT enables AP changes to be detected earlier compared with intermittent AP monitoring in patients undergoing gastrointestinal endoscopy. In this prospective observational study, we recorded continuous AP measurements with the VUT (CNAP system; CNSystems Medizintechnik AG, Graz, Austria) and intermittent AP measurements with upper arm cuff oscillometry in 90 patients undergoing complex gastrointestinal endoscopy (Department of Interventional Endoscopy at the University Medical Center Hamburg-Eppendorf, Hamburg, Germany). A "hypotensive phase" was defined as a time period of at least 30 s during which ≥ 50% of the VUT-AP values were in a predefined range of hypotension, i.e., AP value a) ≥ 10% below the last oscillometric value and b) ≤ 65 mmHg for mean AP or ≤ 90 mmHg for systolic AP. In the 5-min-interval between two oscillometric measurements, one or more hypotensive phases were detected in 26 patients (29%) for mean AP and in 27 patients (30%) for systolic AP. Hypotensive phases had a mean duration of 195 ± 99 s for mean AP and 197 ± 97 s for systolic AP with a mean procedure duration of 36 (± 21) min. Continuous noninvasive AP monitoring using the VUT enables hypotensive phases to be detected earlier compared with intermittent AP monitoring during complex gastrointestinal endoscopy. These hypotensive phases may be missed or only belatedly recognized with intermittent AP monitoring. Continuous noninvasive AP measurement facilitates detecting hemodynamic instability more rapidly and therefore may improve patient safety.
KW - Journal Article
U2 - 10.1007/s10877-018-0131-6
DO - 10.1007/s10877-018-0131-6
M3 - SCORING: Journal article
C2 - 29556885
VL - 33
SP - 25
EP - 30
JO - J CLIN MONIT COMPUT
JF - J CLIN MONIT COMPUT
SN - 1387-1307
IS - 1
ER -