Validation of noninvasive continuous arterial pressure measurement by ClearSight System™ during induction of anesthesia for cardiovascular surgery

Abstract

Background: Since blood pressure tends to be unstable during induction of anesthesia in patients undergoing cardiovascular surgery, an artery catheter is often inserted before induction to continuously monitor arterial pressure during induction of anesthesia. ClearSight System™ enables noninvasive continuous measurement of beat-to-beat arterial pressure via a single finger cuff without pain using photoplethysmographic technology. If ClearSight System™ can replace intra-arterial pressure measurement, blood pressure could be easily and noninvasively assessed. However, the validity of ClearSight System™ during induction of anesthesia in patients undergoing cardiovascular surgery has not been evaluated. The aim of this study was to compare blood pressure measured by ClearSight System™ with intra-arterial pressure during induction of anesthesia for cardiovascular surgery. Methods: This study was registered retrospectively. Data during induction of anesthesia for elective cardiovascular surgery were obtained for patients in whom noninvasive arterial pressure was measured by ClearSight System™ (APcs) and invasive radial arterial pressure (APrad) was measured simultaneously. According to the widely used criteria formulated by international standards from the Association for the Advancement of Medical Instrumentation, the acceptable bias and precision for arterial pressure measurements were fixed at < 5 mmHg and 8 mmHg, respectively. Results: Data for 18 patients were analyzed. For 3068 analyzed paired measurements, values of APcs vs APrad bias (precision) were 13.2 (17.5), - 9.1 (7.3) and - 3.9 (7.8) mmHg for systolic, diastolic, and mean arterial pressures, respectively. Conclusions: Mean arterial pressure measured by ClearSight System™ could be considered as an alternative for mean radial arterial pressure during induction of anesthesia for elective cardiovascular surgery.