Continuous non-invasive monitoring improves blood pressure stability in upright position: randomized controlled trial

Verfasser / Beitragende:
[Jan Benes, Alena Simanova, Tereza Tovarnicka, Silvie Sevcikova, Jakub Kletecka, Jan Zatloukal, Richard Pradl, Ivan Chytra, Eduard Kasal]
Ort, Verlag, Jahr:
2015
Enthalten in:
Journal of Clinical Monitoring and Computing, 29/1(2015-02-01), 11-17
Format:
Artikel (online)
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024 7 0 |a 10.1007/s10877-014-9586-2  |2 doi 
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245 0 0 |a Continuous non-invasive monitoring improves blood pressure stability in upright position: randomized controlled trial  |h [Elektronische Daten]  |c [Jan Benes, Alena Simanova, Tereza Tovarnicka, Silvie Sevcikova, Jakub Kletecka, Jan Zatloukal, Richard Pradl, Ivan Chytra, Eduard Kasal] 
520 3 |a 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: 12min (4-20) vs. 27min (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. 
540 |a Springer Science+Business Media New York, 2014 
690 7 |a Arterial pressure  |2 nationallicence 
690 7 |a General anaesthesia  |2 nationallicence 
690 7 |a Hypotension  |2 nationallicence 
690 7 |a Measurement techniques  |2 nationallicence 
700 1 |a Benes  |D Jan  |u Department of Anaesthesia and Intensive Care Medicine, Teaching Hospital and Faculty of Medicine in Plzen, Charles University Prague, Alej Svobody 80, 306 40, Plzeň, Czech Republic  |4 aut 
700 1 |a Simanova  |D Alena  |u Department of Anaesthesia and Intensive Care Medicine, Teaching Hospital and Faculty of Medicine in Plzen, Charles University Prague, Alej Svobody 80, 306 40, Plzeň, Czech Republic  |4 aut 
700 1 |a Tovarnicka  |D Tereza  |u Department of Anaesthesia and Intensive Care Medicine, Teaching Hospital and Faculty of Medicine in Plzen, Charles University Prague, Alej Svobody 80, 306 40, Plzeň, Czech Republic  |4 aut 
700 1 |a Sevcikova  |D Silvie  |u Department of Anaesthesia and Intensive Care Medicine, Teaching Hospital and Faculty of Medicine in Plzen, Charles University Prague, Alej Svobody 80, 306 40, Plzeň, Czech Republic  |4 aut 
700 1 |a Kletecka  |D Jakub  |u Department of Anaesthesia and Intensive Care Medicine, Teaching Hospital and Faculty of Medicine in Plzen, Charles University Prague, Alej Svobody 80, 306 40, Plzeň, Czech Republic  |4 aut 
700 1 |a Zatloukal  |D Jan  |u Department of Anaesthesia and Intensive Care Medicine, Teaching Hospital and Faculty of Medicine in Plzen, Charles University Prague, Alej Svobody 80, 306 40, Plzeň, Czech Republic  |4 aut 
700 1 |a Pradl  |D Richard  |u Department of Anaesthesia and Intensive Care Medicine, Teaching Hospital and Faculty of Medicine in Plzen, Charles University Prague, Alej Svobody 80, 306 40, Plzeň, Czech Republic  |4 aut 
700 1 |a Chytra  |D Ivan  |u Department of Anaesthesia and Intensive Care Medicine, Teaching Hospital and Faculty of Medicine in Plzen, Charles University Prague, Alej Svobody 80, 306 40, Plzeň, Czech Republic  |4 aut 
700 1 |a Kasal  |D Eduard  |u Department of Anaesthesia and Intensive Care Medicine, Teaching Hospital and Faculty of Medicine in Plzen, Charles University Prague, Alej Svobody 80, 306 40, Plzeň, Czech Republic  |4 aut 
773 0 |t Journal of Clinical Monitoring and Computing  |d Springer Netherlands  |g 29/1(2015-02-01), 11-17  |x 1387-1307  |q 29:1<11  |1 2015  |2 29  |o 10877 
856 4 0 |u https://doi.org/10.1007/s10877-014-9586-2  |q text/html  |z Onlinezugriff via DOI 
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900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a research-article  |2 jats 
949 |B NATIONALLICENCE  |F NATIONALLICENCE  |b NL-springer 
950 |B NATIONALLICENCE  |P 856  |E 40  |u https://doi.org/10.1007/s10877-014-9586-2  |q text/html  |z Onlinezugriff via DOI 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Benes  |D Jan  |u Department of Anaesthesia and Intensive Care Medicine, Teaching Hospital and Faculty of Medicine in Plzen, Charles University Prague, Alej Svobody 80, 306 40, Plzeň, Czech Republic  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Simanova  |D Alena  |u Department of Anaesthesia and Intensive Care Medicine, Teaching Hospital and Faculty of Medicine in Plzen, Charles University Prague, Alej Svobody 80, 306 40, Plzeň, Czech Republic  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Tovarnicka  |D Tereza  |u Department of Anaesthesia and Intensive Care Medicine, Teaching Hospital and Faculty of Medicine in Plzen, Charles University Prague, Alej Svobody 80, 306 40, Plzeň, Czech Republic  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Sevcikova  |D Silvie  |u Department of Anaesthesia and Intensive Care Medicine, Teaching Hospital and Faculty of Medicine in Plzen, Charles University Prague, Alej Svobody 80, 306 40, Plzeň, Czech Republic  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Kletecka  |D Jakub  |u Department of Anaesthesia and Intensive Care Medicine, Teaching Hospital and Faculty of Medicine in Plzen, Charles University Prague, Alej Svobody 80, 306 40, Plzeň, Czech Republic  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Zatloukal  |D Jan  |u Department of Anaesthesia and Intensive Care Medicine, Teaching Hospital and Faculty of Medicine in Plzen, Charles University Prague, Alej Svobody 80, 306 40, Plzeň, Czech Republic  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Pradl  |D Richard  |u Department of Anaesthesia and Intensive Care Medicine, Teaching Hospital and Faculty of Medicine in Plzen, Charles University Prague, Alej Svobody 80, 306 40, Plzeň, Czech Republic  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Chytra  |D Ivan  |u Department of Anaesthesia and Intensive Care Medicine, Teaching Hospital and Faculty of Medicine in Plzen, Charles University Prague, Alej Svobody 80, 306 40, Plzeň, Czech Republic  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Kasal  |D Eduard  |u Department of Anaesthesia and Intensive Care Medicine, Teaching Hospital and Faculty of Medicine in Plzen, Charles University Prague, Alej Svobody 80, 306 40, Plzeň, Czech Republic  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Journal of Clinical Monitoring and Computing  |d Springer Netherlands  |g 29/1(2015-02-01), 11-17  |x 1387-1307  |q 29:1<11  |1 2015  |2 29  |o 10877