A new noninvasive finger sensor (NICCI system) for continuous blood pressure and pulse pressure variation monitoring : A method comparison study in patients having neurosurgery
: A method comparison study in patients having neurosurgery
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Media type:
E-Article
Title:
A new noninvasive finger sensor (NICCI system) for continuous blood pressure and pulse pressure variation monitoring : A method comparison study in patients having neurosurgery
:
A method comparison study in patients having neurosurgery
Description:
<jats:sec>
<jats:title>BACKGROUND</jats:title>
<jats:p>The NICCI system (Getinge, Gothenburg, Sweden) is a new noninvasive haemodynamic monitoring system using a finger sensor.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>OBJECTIVE(S)</jats:title>
<jats:p>We aimed to investigate the performance of the NICCI system to measure blood pressure and pulse pressure variation compared with intra-arterial measurements.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>DESIGN</jats:title>
<jats:p>A prospective method comparison study</jats:p>
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<jats:sec>
<jats:title>SETTING</jats:title>
<jats:p>University Medical Center Hamburg-Eppendorf, Hamburg, Germany</jats:p>
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<jats:sec>
<jats:title>PATIENTS</jats:title>
<jats:p>Forty-seven neurosurgery patients</jats:p>
</jats:sec>
<jats:sec>
<jats:title>MAIN OUTCOME MEASURES</jats:title>
<jats:p>We performed a method comparison study in 47 neurosurgery patients to compare NICCI blood pressure measurements (BP<jats:sub>NICCI</jats:sub>) with intra-arterial blood pressure measurements (BP<jats:sub>ART</jats:sub>) (Bland–Altman analysis, four-quadrant plot, error grid analysis) and NICCI pulse pressure variation measurements (PPV<jats:sub>NICCI</jats:sub>) with pulse pressure variation calculated manually from the intra-arterial blood pressure waveform (PPV<jats:sub>ART</jats:sub>) (Bland–Altman analysis, predictive agreement, Cohen's kappa).</jats:p>
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<jats:sec>
<jats:title>RESULTS</jats:title>
<jats:p>The mean of the differences ± standard deviation (95% limits of agreement) between BP<jats:sub>NICCI</jats:sub> and BP<jats:sub>ART</jats:sub> was 11 ± 10 mmHg (-8 to 30 mmHg) for mean blood pressure (MBP), 3 ± 12 mmHg (-21 to 26 mmHg) for systolic blood pressure (SBP) and 12 ± 10 mmHg (-8 to 31 mmHg) for diastolic blood pressure (DBP). In error grid analysis, 54% of BP<jats:sub>NICCI</jats:sub> and BP<jats:sub>ART</jats:sub> MBP measurement pairs were classified as ‘no risk’, 43% as ‘low risk’, 3% as ‘moderate risk’ and 0% as ‘significant risk’ or ‘dangerous risk’. The mean of the differences between PPV<jats:sub>NICCI</jats:sub> and PPV<jats:sub>ART</jats:sub> was 1 ± 3% (-4 to 6%). The predictive agreement between PPV<jats:sub>NICCI</jats:sub> and PPV<jats:sub>ART</jats:sub> was 80% and Cohen's kappa was 0.55.</jats:p>
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<jats:sec>
<jats:title>CONCLUSIONS</jats:title>
<jats:p>The absolute agreement between BP<jats:sub>NICCI</jats:sub> and BP<jats:sub>ART</jats:sub> was not clinically acceptable. We recommend not using the current version of the NICCI system for blood pressure monitoring during surgery. The absolute agreement between PPV<jats:sub>NICCI</jats:sub> and PPV<jats:sub>ART</jats:sub> was clinically acceptable with moderate predictive agreement regarding pulse pressure variation categories. The NICCI system needs to be further developed and re-evaluated when an improved version is available.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>TRIAL REGISTRATION</jats:title>
<jats:p>The study was registered in the German Clinical Trials Register (DRKS00023188) on 2 October 2020.</jats:p>
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