J Clin Monit Comput - Continuous non-invasive monitoring improves blood pressure stability in upright position: randomized controlled trial.

Tópicos

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Resumo

Intermittent blood pressure (BP) monitoring is the standard-of-care during low and intermediate risk anaesthesia, yet it could lead to delayed recognition of BP fluctuations. Perioperative hypotension is known to be associated with postoperative complications. Continuous, non-invasive methods for BP monitoring have been developed recently. We have tested a novel non-invasive, continuous monitor (using the volume clamp method) to assist with maintaining BP in safe ranges for patients undergoing surgery in a beach chair position. Forty adult patients undergoing thyroid gland surgery in an upright position were included in this prospective randomised controlled trial. Patients were equally allocated to the group with continuous monitoring of BP using the CNAP? Monitor and to the control group managed using an intermittent oscillometric BP cuff. The absolute and proportional time spent outside the range of ?20% of the target BP along with other hemodynamic and clinical parameters were evaluated. The continuous monitoring decreased the anaesthesia time spent below -20% pressure range [absolute: 12 min (4-20) vs. 27 min (16-34); p=0.001; relative to procedure length: 14% (7-20) vs. 33.5% (17.5-53); p=0.003]. No significant differences were observed in postoperative morbidity or in hospital length of stay. Continuous non-invasive BP monitoring via the CNAP? Monitor allows for better BP management in patients undergoing surgery in a beach chair position. In our randomised trial the time spent in hypotension was significantly shorter using continuous monitoring.

Resumo Limpo

intermitt blood pressur bp monitor standardofcar low intermedi risk anaesthesia yet lead delay recognit bp fluctuat periop hypotens known associ postop complic continu noninvas method bp monitor develop recent test novel noninvas continu monitor use volum clamp method assist maintain bp safe rang patient undergo surgeri beach chair posit forti adult patient undergo thyroid gland surgeri upright posit includ prospect randomis control trial patient equal alloc group continu monitor bp use cnap monitor control group manag use intermitt oscillometr bp cuff absolut proport time spent outsid rang target bp along hemodynam clinic paramet evalu continu monitor decreas anaesthesia time spent pressur rang absolut min vs min p relat procedur length vs p signific differ observ postop morbid hospit length stay continu noninvas bp monitor via cnap monitor allow better bp manag patient undergo surgeri beach chair posit randomis trial time spent hypotens signific shorter use continu monitor

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