Brain circulation · 2025
Nexfin versus conventional oscillometric cuff for blood pressure monitoring during neuro-endovascular procedures.
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Chen Huanwen, Njonkou-Tchoquessi Rosy Linda, Colasurdo Marco, Cobb Christopher J, Payabvash Seyedmehdi, Malhotra Ajay, Gandhi Dheeraj
Аннотация
BACKGROUND: Nexfin, a noninvasive blood pressure (BP) monitoring system, can provide continuous real-time measurements of BP, which can be useful for patients with acute neurological injury who require urgent neuroendovascular interventions. While Nexfin has shown promising reliability for other clinical scenarios, its performance has not been demonstrated during neuroendovascular procedures for patients with neurological injury.
METHODS: This was a single-center retrospective study. Consecutive patients who underwent neuro-endovascular procedures with Nexfin BP monitoring were identified at a single institution. Mean arterial pressure (MAP) and systolic BP (SBP) from Nexfin, conventional oscillometric cuff, and arterial line were recorded every 5 to 15 min Concordance between measurement modalities was assessed. Nexfin's ability to detect the significant drops in BP (MAP decrease of 10 or more or SBP decrease of 20 or more) on the arterial line was also assessed and compared with cuff.
RESULTS: A total of 620 blood measurements (264 Nexfin, 197 cuff, and 159 arterial line) from 33 patients who underwent neuro-endovascular procedures were collected. Overall, Nexfin measurements correlated well with the arterial line measurements for MAP (Pearson's R = 0.74, P < 0.001) and SBP (Pearson's R = 0.67, P < 0.001). Overall, Nexfin performed similarly to cuff in estimating arterial line measurements; however, Nexfin was more sensitive for detecting MAP drops than conventional cuff (70.6% vs. 50.0%), while maintaining similar specificity (92.8% vs. 91.1%). This culminated in higher positive predictive value (60.0% vs. 50.0%), negative predictive value (95.4% vs. 91.1%), and F1-score (0.65 vs. 0.50). Similar results were seen for detecting SBP drops, where Nexfin also outperformed cuff.
CONCLUSIONS: For patients undergoing neuro-endovascular treatments, Nexfin performed as well as conventional cuffs in estimating intraoperative BP measurements from arterial lines, and it was more sensitive than cuffs in detecting intraprocedural relative hypotension without compromising specificity.
METHODS: This was a single-center retrospective study. Consecutive patients who underwent neuro-endovascular procedures with Nexfin BP monitoring were identified at a single institution. Mean arterial pressure (MAP) and systolic BP (SBP) from Nexfin, conventional oscillometric cuff, and arterial line were recorded every 5 to 15 min Concordance between measurement modalities was assessed. Nexfin's ability to detect the significant drops in BP (MAP decrease of 10 or more or SBP decrease of 20 or more) on the arterial line was also assessed and compared with cuff.
RESULTS: A total of 620 blood measurements (264 Nexfin, 197 cuff, and 159 arterial line) from 33 patients who underwent neuro-endovascular procedures were collected. Overall, Nexfin measurements correlated well with the arterial line measurements for MAP (Pearson's R = 0.74, P < 0.001) and SBP (Pearson's R = 0.67, P < 0.001). Overall, Nexfin performed similarly to cuff in estimating arterial line measurements; however, Nexfin was more sensitive for detecting MAP drops than conventional cuff (70.6% vs. 50.0%), while maintaining similar specificity (92.8% vs. 91.1%). This culminated in higher positive predictive value (60.0% vs. 50.0%), negative predictive value (95.4% vs. 91.1%), and F1-score (0.65 vs. 0.50). Similar results were seen for detecting SBP drops, where Nexfin also outperformed cuff.
CONCLUSIONS: For patients undergoing neuro-endovascular treatments, Nexfin performed as well as conventional cuffs in estimating intraoperative BP measurements from arterial lines, and it was more sensitive than cuffs in detecting intraprocedural relative hypotension without compromising specificity.