J Clin Monit Comput - Impact of non invasive and beat-to-beat arterial pressure monitoring on intraoperative hemodynamic management.

Tópicos

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Resumo

The Nexfin device allows for non-invasive beat-to-beat blood pressure monitoring (BP(NXF)). Perioperative hypotension and hypertension have been shown to be associated with poor clinical outcomes. The goal of the present study was to assess the ability of this device to decrease the duration of significant intraoperative hypo- or hypertension compared to standard BP monitoring by cuff (BP(CUFF)). We studied25 patients (ASA I-III) undergoing either abdominal or orthopedic surgery. BP(CUFF) was monitored every 5?min from the introduction of anesthesia, while BP(NXF) was monitored continuously on the opposite arm. When systolic BP(NXF) (SBP(NXF)) decreased or increased more than 20% relative to baseline SBP(NXF), a standard BP(CUFF) measurement was taken to compare values. In addition, the time interval between the 20% change in SBP(NXF) and the next scheduled standard SBP(CUFF) measurement was recorded for each event. The mean length of surgery was 3.0???0.3?h. Patients presented with 11???4 episodes of hypotension and 12???4 episodes of hypertension during the surgery. If BP(CUFF) had been used, this would have resulted in 21???7?min of hypotension and 20???10?min of hypertension. If hemodynamic changes seen by SBP(NXF) were appropriately treated, an average of 7???1?min/h of hypotension time, 7???2?min/h of hypertension time and 14???3?min per hour of hypo- or hypertension time may have been identified. The Nexfin BP has the potential to decrease the time of hypotension and hypertension compared to conventional intermittent BP(CUFF) monitoring. Therefore, this device has the potential to positively impact clinical outcomes.

Resumo Limpo

nexfin devic allow noninvas beattobeat blood pressur monitor bpnxf periop hypotens hypertens shown associ poor clinic outcom goal present studi assess abil devic decreas durat signific intraop hypo hypertens compar standard bp monitor cuff bpcuff studi patient asa iiii undergo either abdomin orthoped surgeri bpcuff monitor everi min introduct anesthesia bpnxf monitor continu opposit arm systol bpnxf sbpnxf decreas increas relat baselin sbpnxf standard bpcuff measur taken compar valu addit time interv chang sbpnxf next schedul standard sbpcuff measur record event mean length surgeri h patient present episod hypotens episod hypertens surgeri bpcuff use result min hypotens min hypertens hemodynam chang seen sbpnxf appropri treat averag minh hypotens time minh hypertens time min per hour hypo hypertens time may identifi nexfin bp potenti decreas time hypotens hypertens compar convent intermitt bpcuff monitor therefor devic potenti posit impact clinic outcom

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