Universität zu Köln

Greiwe, G., Tariparast, P. A., Behem, C., Petzoldt, M., Herich, L., Trepte, C. J., Reuter, D. A. and Haas, S. A. (2016). Is applanation tonometry a reliable method for monitoring blood pressure in morbidly obese patients undergoing bariatric surgery? Br. J. Anaesth., 116 (6). S. 790 - 797. OXFORD: ELSEVIER SCI LTD. ISSN 1471-6771

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Abstract

Background: The aim of this study was to evaluate the validity of non-invasive continuous BP measurement by applanation tonometry in morbidly obese patients undergoing bariatric surgery. Methods: Arterial blood pressure (AP) was recorded intraoperatively both by applanation tonometry (AT) (T-Line 200pro, Tensys Medical(R), USA) and an arterial line (AL) after radial cannulation in obese patients undergoing bariatric surgery. Discrepancies between the two methods were assessed as bias, limits of agreement and percentage error. Mean, systolic, and diastolic arterial pressures were assessed (MAP, SAP, DAP respectively). Trending ability was assessed by concordance based on four-quadrant plotting. Results: Mean (SD) BMI of the 28 patients was 49.4 (9.7 kg m(-2)). A total of 201 907 time points were available for analysis. Bias for MAP(AT) compared with MAP(AL) was +3.97 mm Hg (SAP(AT) + 3.45 mm Hg; DAP(AT) +3.66 mm Hg) with limits of agreement for MAP(AT) of -14.47 and +22.41 mm Hg (SAP(AT) -22.0 and +28.9 mm Hg; DAP(AT) -15.7 and +23.1 mm Hg). Percentage error for MAP(AT) was 23.5% (23.4% for SAP(AT); 30.5% for DAP(AT)). Trending ability for MAP, SAP, and DAP revealed a concordance of 0.74, 0.72, and 0.71, respectively. Conclusions: Continuous BP assessment by applanation tonometry is feasible in morbidly obese patients undergoing bariatric surgery. However, despite a low mean difference, 95% limits of agreement and trending ability indicate that the technology needs to be improved further, before being recommended for routine use in this group of patients.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Greiwe, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Tariparast, P. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Behem, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Petzoldt, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Herich, L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Trepte, C. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Reuter, D. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Haas, S. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-274159
DOI:	10.1093/bja/aew100
Journal or Publication Title:	Br. J. Anaesth.
Volume:	116
Number:	6
Page Range:	S. 790 - 797
Date:	2016
Publisher:	ELSEVIER SCI LTD
Place of Publication:	OXFORD
ISSN:	1471-6771
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ACCURACY; PROPOFOL; DEVICE Multiple languages Anesthesiology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/27415