Continuous non-invasive finger blood pressure monitoring - replacement of invasive pressure?

Continuous non-invasive measurement of finger arterial pressure (FAP) in humans
was introduced both for research purposes and for clinical medicine. The
Finapres device has been shown to provide a useful alternative for continuous
intra-arterial measurement in a variety of situations specifically for research
purposes. Thus far technical problems related to improper finger cuff wrapping
and low plethysmogram with cold fingers have limited application of
non-invasive pressure monitoring in clinical medicine. To fill this gap a new
monitor ABM100 with better easy-to-use finger cuffs has been developed.

To determine the clinical feasibility and performance of continuous,
non-invasive FAP recording by ABM100 as a replacement of intra-arterial
pressure in adult patients. Specifically, a) magnitude of pressure gradient
distortion of the FAP pulse waveform, b) effects of vasoconstriction on pulse
wave disparity, c) effects of reduction of left ventricular ejection period on
IAP vs. FAP amplification; d) absolute level offset of systolic, diastolic and
mean finger arterial pressures, e) loss of measurement time and f) easiness of
finger cuff application and device control are determined.

Open prospective study in 30 patients admitted to the AMC for elective surgery
who are provided for with an arterial line for monitoring purposes during
general anesthesia.

1) Informed consent
2) A finger cuff is applied to the mid-phalanx of the middle finger of the
dominant arm; the pressure transducer and the finger cuff are positioned at
heart level.
3) Continuous finger arterial and intrabrachial pressures are measured
simultaneously. In the first minute of measurement the positions of the finger
cuff and pressure transducer are checked for possible hydrostatic level errors
and, if necessary, readjusted.

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