Document Detail


Fifteen years experience with finger arterial pressure monitoring: assessment of the technology.
MedLine Citation:
PMID:  9747429     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We review the Finapres technology, embodied in several TNO-prototypes and in the Ohmeda 2300 and 2300e Finapres NIBP. Finapres is an acronym for FINger Arterial PRESsure, the device delivers a continuous finger arterial pressure waveform. Many papers report on the accuracy of the device in comparison with intra-arterial or with noninvasive but intermittent blood pressure measurements. We compiled the results of 43 such papers and found systolic, diastolic and mean accuracies, in this order, ranging from -48 to 30 mmHg, from -20 to 18 mmHg, and from -13 to 25 mmHg. Weighted for the number of subjects included pooled accuracies were -0.8 (SD 11.9), -1.6 (8.3) and -1.6 (7.6) mmHg respectively. Subdividing the pooled group according to criteria such as reference blood pressure, place of application, and prototype or commercial device we found no significant differences in mean differences or SD. Measurement at the finger allows uninterrupted recordings of long duration. The transmission of the pressure pulse along the arm arteries, however, causes distortion of the pulse waveform and depression of the mean blood pressure level. These effects can be reduced by appropriate filtering, and upper arm 'return-to-flow' calibration to bring accuracy and precision within AAMI limits. For the assessment of beat-to-beat changes in blood pressure and assessment of blood pressure variability Finapres proved a reliable alternative for invasive measurements when mean and diastolic pressures are concerned. Differences in systolic pressure are larger and reach statistical significance but are not of clinical relevance. Finger arteries are affected by contraction and dilatation in relation to psychological and physical (heat, cold, blood loss, orthostasis) stress. Effects of these phenomena are reduced by the built-in Physiocal algorithm. However, full smooth muscle contraction should be avoided in the awake patient by comforting the patient, and covering the hand. Arterial state can be monitored by observing the behaviour of the Physiocal algorithm. We conclude that Finapres accuracy and precision usually suffice for reliable tracking of changes in blood pressure. Diagnostic accuracy may be achieved with future application of corrective measures.
Authors:
B P Imholz; W Wieling; G A van Montfrans; K H Wesseling
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Cardiovascular research     Volume:  38     ISSN:  0008-6363     ISO Abbreviation:  Cardiovasc. Res.     Publication Date:  1998 Jun 
Date Detail:
Created Date:  1998-10-15     Completed Date:  1998-10-15     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0077427     Medline TA:  Cardiovasc Res     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  605-16     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Academic Medical Center, Amsterdam, Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Blood Pressure Monitoring, Ambulatory / instrumentation*,  methods,  trends
Evaluation Studies as Topic
Fingers / physiopathology*
Humans
Reproducibility of Results
Sensitivity and Specificity

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