Efficacy Of A Continuous Non-invasive Arterial Pressure Monitor System During The General Anesthesia Of Patients With Heart Disease

Objective:Blood pressure(BP)is one of the basic vital signs monitoring.It also can reflect the function of cardiovascular system and the depth of anesthesia with patients during the surgery,especially for the critical cardiovascular disease patients.Continuous real-time BP monitoring measurement divides into invasive and noninvasive two kinds.TL-300(Tensys Medical,San Diego,CA,USA)is a non-invasive BP monitoring system allowing continuous ‘‘beat-to-beat’’ BP monitoring and provides a real-time BP waveform.The aim of this study was to evaluate the accuracy,precision and safety of TL-300 against the standard invasive BP by radial artery catheter during the general anesthesia of surgical patients with critical heart disease.Method:To choose the American society of anesthesiologists(ASA)classification ofⅢ-Ⅳadult patients with heart disease undergoing elective cardiac surgeries under general anesthesia in a supine position as the research object.A catheter was placed into the left radial artery under local anesthesia before induction,with the TL-300 system connected to the right arm.Continuous invasive blood pressure(IBP)monitoring was derived from the invasive artery catheter while the non-invasive blood pressure(NIBP)was from TL-300 system.Systolic,diastolic and mean blood pressure were recorded every 5 minutes simultaneously for both IBP and NIBP to the end of surgery.Record the total operation time and the patient’s satisfaction of these two measurements.Complications associated with BP monitors including infection,hematoma,distal ischemia,thrombosis,embolism,necrosis,the formation of pseudoaneurysms,paresthesia,blood vessels and nerve damage were recorded postoperatively.The accuracy and precision of IBP and NIBP was analyzed by Bland-Altman statistical analysis.the correlation of IBP and NIBP was analyzed by Pearson correlation analysisResults:1.General situation,the average time-consuming monitoring of invasive blood pressure was 242.5 ± 26.60 s.The average time-consuming monitoring of TL-300 noninvasive blood pressure was 126 ± 18.35 s.The patient satisfaction survey showed that TL-300 was 97% and A-Line was 86 %;All patients did not have the relevant complications.2.Data showed that difference between IBP and NIBP was(2.08±9.16)mmHg,(-1.30±6.61)mmHg and(-2.60±7.03)mmHg for systolic blood pressure(SBP),mean blood pressure(MBP),diastolic blood pressure(DBP),respectively.3.The correlation coefficient between two methods was 0.852,0.806 and 0.752 for SBP,MBP and DBP,respectively.Conclusion:Our study indicates that the TL-300 system has high accuracy,safety and comfort in blood pressure measurements in patients undergoing cardiac surgery under general anesthesia for critically ill heart disease,which is comparable to A-Line,And TL-300 system also has advantages as non-invasive,short time-consuming,easy to operate,high patient satisfaction et al.It is suggested that the TL-300 system can be used for continuous real-time blood pressure monitoring in small and medium-sized non-cardiac surgery.It can ensure the accuracy of blood pressure monitoring and avoid the involvement of invasive blood pressure monitoring in patients with trauma and occurrence of complications.and we think it can be safely used in adult patients with heart disease under general anesthesia during small and medium non-cardiac surgery.