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Published in: BMC Anesthesiology 1/2019

Open Access 01-12-2019 | Research article

Estimation of central arterial pressure from the radial artery in patients undergoing invasive neuroradiological procedures

Authors: Sabino Scolletta, Antoine Herpain, Salvatore Mario Romano, Fabio Silvio Taccone, Katia Donadello, Boris Lubicz, Federico Franchi, Keitiane Michele Kaefer, Enrico Polati, Jean-Louis Vincent, Daniel De Backer

Published in: BMC Anesthesiology | Issue 1/2019

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Abstract

Backgrounds

Central arterial pressure can be derived from analysis of the peripheral artery waveform. The aim of this study was to compare central arterial pressures measured from an intra-aortic catheter with peripheral radial arterial pressures and with central arterial pressures estimated from the peripheral pressure wave using a pressure recording analytical method (PRAM).

Methods

We studied 21 patients undergoing digital subtraction cerebral angiography under local or general anesthesia and equipped with a radial arterial catheter. A second catheter was placed in the ascending aorta for central pressure wave acquisition. Central (AO) and peripheral (RA) arterial waveforms were recorded simultaneously by PRAM for 90–180 s. During an off-line analysis, AO pressures were reconstructed (AOrec) from the RA trace using a mathematical model obtained by multi-linear regression analysis. The AOrec values obtained by PRAM were compared with the true central pressure value obtained from the catheter placed in the ascending aorta.

Results

Systolic, diastolic and mean pressures ranged from 79 to 180 mmHg, 47 to 102 mmHg, and 58 to 128 mmHg, respectively, for AO, and 83 to 174 mmHg, 47 to 107 mmHg, and 60 to 129 mmHg, respectively, for RA. The correlation coefficients between AO and RA were 0.86 (p < 0.01), 0.83 (p < 0.01) and 0.86 (p < 0.01) for systolic, diastolic and mean pressures, respectively, and the mean differences − 0.3 mmHg, 2.4 mmHg and 1.5 mmHg. The correlation coefficients between AO and AOrec were 0.92 (p < 0.001), 0.87 (p < 0.001) and 0.92 (p < 0.001), for systolic, diastolic and mean pressures, respectively, and the mean differences 0.01 mmHg, 1.8 mmHg and 1.2 mmHg.

Conclusions

PRAM can provide reliable estimates of central arterial pressure.
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Literature
1.
go back to reference Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, et al. Surviving sepsis campaign: international guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Med. 2017;43:304–77.PubMedCrossRef Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, et al. Surviving sepsis campaign: international guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Med. 2017;43:304–77.PubMedCrossRef
2.
go back to reference Hashimoto J, Ito S. Central diastolic pressure decay mediates the relationship between aortic stiffness and myocardial viability: potential implications for aortosclerosis-induced myocardial ischemia. J Hypertens. 2017;35(10):2034–43.PubMedCrossRef Hashimoto J, Ito S. Central diastolic pressure decay mediates the relationship between aortic stiffness and myocardial viability: potential implications for aortosclerosis-induced myocardial ischemia. J Hypertens. 2017;35(10):2034–43.PubMedCrossRef
3.
go back to reference Bello H, Norton GR, Ballim I, Libhaber CD, Sareli P, Woodiwiss AJ. Contributions of aortic pulse wave velocity and backward wave pressure to variations in left ventricular mass are independent of each other. J Am Soc Hypertens. 2017;11(5):265–74.PubMedCrossRef Bello H, Norton GR, Ballim I, Libhaber CD, Sareli P, Woodiwiss AJ. Contributions of aortic pulse wave velocity and backward wave pressure to variations in left ventricular mass are independent of each other. J Am Soc Hypertens. 2017;11(5):265–74.PubMedCrossRef
4.
go back to reference Sztrymf B, Jacobs F, Chemla D, Richard C, Millasseau SC. Validation of the new Complior sensor to record pressure signals non-invasively. J Clin Monit Comput. 2013;27(6):613–9.PubMedCrossRef Sztrymf B, Jacobs F, Chemla D, Richard C, Millasseau SC. Validation of the new Complior sensor to record pressure signals non-invasively. J Clin Monit Comput. 2013;27(6):613–9.PubMedCrossRef
5.
go back to reference Vlachopoulos C, Aznaouridis K, O’Rourke MF, Safar ME, Baou K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with central haemodynamics: a systematic review and meta-analysis. Eur Heart J. 2010;31:1865–71.PubMedCrossRef Vlachopoulos C, Aznaouridis K, O’Rourke MF, Safar ME, Baou K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with central haemodynamics: a systematic review and meta-analysis. Eur Heart J. 2010;31:1865–71.PubMedCrossRef
6.
go back to reference Pini R, Cavallini MC, Palmieri V, Marchionni N, Di Bari M, Devereux RB, et al. Central but not brachial arterial pressure predicts cardiovascular events in an unselected geriatric population: the ICARe Dicomano study. J Am Coll Cardiol. 2008;51(25):2432–9.PubMedCrossRef Pini R, Cavallini MC, Palmieri V, Marchionni N, Di Bari M, Devereux RB, et al. Central but not brachial arterial pressure predicts cardiovascular events in an unselected geriatric population: the ICARe Dicomano study. J Am Coll Cardiol. 2008;51(25):2432–9.PubMedCrossRef
7.
go back to reference De Backer D, Annane D. Beta-blockers in septic shock to optimize hemodynamics? We are not sure. Intensive Care Med. 2016;42(10):1613–4.PubMedCrossRef De Backer D, Annane D. Beta-blockers in septic shock to optimize hemodynamics? We are not sure. Intensive Care Med. 2016;42(10):1613–4.PubMedCrossRef
9.
go back to reference Williams B, Lacy PS, Thom SM, Cruickshank K, Stanton A, Collier D, et al. CAFE investigators; Anglo-Scandinavian cardiac outcomes trial investigators; CAFE steering committee and writing committee. Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: principal results of the conduit artery function evaluation (CAFE) study. Circulation. 2006;113(9):1213–25.PubMedCrossRef Williams B, Lacy PS, Thom SM, Cruickshank K, Stanton A, Collier D, et al. CAFE investigators; Anglo-Scandinavian cardiac outcomes trial investigators; CAFE steering committee and writing committee. Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: principal results of the conduit artery function evaluation (CAFE) study. Circulation. 2006;113(9):1213–25.PubMedCrossRef
10.
go back to reference Roman MJ, Devereux RB, Kizer JR, Lee ET, Galloway JM, Ali T, et al. Central pressure more strongly relates to vascular disease and outcome than does brachial pressure: the strong heart study. Hypertension. 2007;50(1):197–203.PubMedCrossRef Roman MJ, Devereux RB, Kizer JR, Lee ET, Galloway JM, Ali T, et al. Central pressure more strongly relates to vascular disease and outcome than does brachial pressure: the strong heart study. Hypertension. 2007;50(1):197–203.PubMedCrossRef
11.
go back to reference Chirinos JA, Kips JG, Jacobs DR Jr, Brumback L, Duprez DA, Kronmal R, et al. Arterial wave reflections and incident cardiovascular events and heart failure: MESA (multiethnic study of atherosclerosis). J Am Coll Cardiol. 2012;60(21):2170–7.PubMedPubMedCentralCrossRef Chirinos JA, Kips JG, Jacobs DR Jr, Brumback L, Duprez DA, Kronmal R, et al. Arterial wave reflections and incident cardiovascular events and heart failure: MESA (multiethnic study of atherosclerosis). J Am Coll Cardiol. 2012;60(21):2170–7.PubMedPubMedCentralCrossRef
12.
go back to reference Chen CH, Nevo E, Fetics B, Pak PH, Yin FC, Maughan WL, et al. Estimation of central aortic pressure waveform by mathematical transformation of radial tonometry pressure. Validation of generalized transfer function. Circulation. 1997;95(7):1827–36.PubMedCrossRef Chen CH, Nevo E, Fetics B, Pak PH, Yin FC, Maughan WL, et al. Estimation of central aortic pressure waveform by mathematical transformation of radial tonometry pressure. Validation of generalized transfer function. Circulation. 1997;95(7):1827–36.PubMedCrossRef
14.
go back to reference Millasseau S, Agnoletti D. Non-invasive estimation of aortic blood pressures: a close look at current devices and methods. Curr Pharm Des. 2015;21:709–18.PubMedCrossRef Millasseau S, Agnoletti D. Non-invasive estimation of aortic blood pressures: a close look at current devices and methods. Curr Pharm Des. 2015;21:709–18.PubMedCrossRef
15.
go back to reference Sharman JE, Avolio AP, Baulmann J, et al. Validation of non-invasive central blood pressure devices: ARTERY society task force consensus statement on protocol standardization. Eur Heart J. 2017;38(37):2805–12.PubMedPubMedCentralCrossRef Sharman JE, Avolio AP, Baulmann J, et al. Validation of non-invasive central blood pressure devices: ARTERY society task force consensus statement on protocol standardization. Eur Heart J. 2017;38(37):2805–12.PubMedPubMedCentralCrossRef
16.
go back to reference Romano SM, Chiostri M, Pistolesi M, Gensini GF, Viroli L, Castellani W, et al. The reconstruction of the waveform in the ascending aorta derived from the finger measured non invasively. Med Biol Eng Comput. 1999;37:319–20 abstract book - congress presentation. Romano SM, Chiostri M, Pistolesi M, Gensini GF, Viroli L, Castellani W, et al. The reconstruction of the waveform in the ascending aorta derived from the finger measured non invasively. Med Biol Eng Comput. 1999;37:319–20 abstract book - congress presentation.
17.
go back to reference Romano SM, Pistolesi M. Assessment of cardiac output from systemic arterial pressure in humans. Crit Care Med. 2002;30(8):1834–41.PubMedCrossRef Romano SM, Pistolesi M. Assessment of cardiac output from systemic arterial pressure in humans. Crit Care Med. 2002;30(8):1834–41.PubMedCrossRef
18.
go back to reference Kleinman B, Powell S, Kumar P, Gardner RM. The fast flush test measures the dynamic response of the entire blood pressure monitoring system. Anesthesiology. 1992;77(6):1215–20.PubMedCrossRef Kleinman B, Powell S, Kumar P, Gardner RM. The fast flush test measures the dynamic response of the entire blood pressure monitoring system. Anesthesiology. 1992;77(6):1215–20.PubMedCrossRef
19.
go back to reference Romagnoli S, Franchi F, Ricci Z, Scolletta S, Payen D. The pressure recording analytical method (PRAM): technical concepts and literature review. J Cardiothorac Vasc Anesth. 2017;31(4):1460–70.PubMedCrossRef Romagnoli S, Franchi F, Ricci Z, Scolletta S, Payen D. The pressure recording analytical method (PRAM): technical concepts and literature review. J Cardiothorac Vasc Anesth. 2017;31(4):1460–70.PubMedCrossRef
20.
go back to reference Gardner RM. Direct blood pressure measurement: dynamic response requirements. Anesthesiology. 1981;54:227–36.PubMedCrossRef Gardner RM. Direct blood pressure measurement: dynamic response requirements. Anesthesiology. 1981;54:227–36.PubMedCrossRef
21.
go back to reference Romano SM. Cardiac cycle efficiency: a new parameter able to fully evaluate the dynamic interplay of the cardiovascular system. Int J Cardiol. 2012;155(2):326–7.PubMedCrossRef Romano SM. Cardiac cycle efficiency: a new parameter able to fully evaluate the dynamic interplay of the cardiovascular system. Int J Cardiol. 2012;155(2):326–7.PubMedCrossRef
22.
go back to reference Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1:307–10.PubMedCrossRef Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1:307–10.PubMedCrossRef
23.
go back to reference Karamanoglu M, O'Rourke MF, Avolio AP, Kelly RP. An analysis of the relationship between central aortic and peripheral upper limb pressure waves in man. Eur Heart J. 1993;14(2):160–7.PubMedCrossRef Karamanoglu M, O'Rourke MF, Avolio AP, Kelly RP. An analysis of the relationship between central aortic and peripheral upper limb pressure waves in man. Eur Heart J. 1993;14(2):160–7.PubMedCrossRef
24.
go back to reference Pauca AL, O'Rourke MF, Kon ND. Prospective evaluation of a method for estimating ascending aortic pressure from the radial artery pressure waveform. Hypertension. 2001;38(4):932–7.PubMedCrossRef Pauca AL, O'Rourke MF, Kon ND. Prospective evaluation of a method for estimating ascending aortic pressure from the radial artery pressure waveform. Hypertension. 2001;38(4):932–7.PubMedCrossRef
25.
go back to reference Pauca AL, Kon ND, O'Rourke MF. The second peak of the radial artery pressure wave represents aortic systolic pressure in hypertensive and elderly patients. Br J Anaesth. 2004;92(5):651–7.PubMedCrossRef Pauca AL, Kon ND, O'Rourke MF. The second peak of the radial artery pressure wave represents aortic systolic pressure in hypertensive and elderly patients. Br J Anaesth. 2004;92(5):651–7.PubMedCrossRef
26.
go back to reference Avolio AP, Van Bortel LM, Boutouyrie P, Cockcroft JR, McEniery CM, Protogerou AD, et al. Role of pulse pressure amplification in arterial hypertension: experts' opinion and review of the data. Hypertension. 2009;54(2):375–83.PubMedCrossRef Avolio AP, Van Bortel LM, Boutouyrie P, Cockcroft JR, McEniery CM, Protogerou AD, et al. Role of pulse pressure amplification in arterial hypertension: experts' opinion and review of the data. Hypertension. 2009;54(2):375–83.PubMedCrossRef
27.
go back to reference Agnoletti D, Zhang Y, Borghi C, Blacher J, Safar ME. Effects of antihypertensive drugs on central blood pressure in humans: a preliminary observation. Am J Hypertens. 2013;26(8):1045–52.PubMedCrossRef Agnoletti D, Zhang Y, Borghi C, Blacher J, Safar ME. Effects of antihypertensive drugs on central blood pressure in humans: a preliminary observation. Am J Hypertens. 2013;26(8):1045–52.PubMedCrossRef
28.
go back to reference McEniery CM, Yasmin MDB, Munnery M, Wallace SM, Rowe CV, Cockcroft JR, et al. Central pressure: variability and impact of cardiovascular risk factors: the Anglo-Cardiff collaborative trial II. Hypertension. 2008;51(6):1476–82.PubMedCrossRef McEniery CM, Yasmin MDB, Munnery M, Wallace SM, Rowe CV, Cockcroft JR, et al. Central pressure: variability and impact of cardiovascular risk factors: the Anglo-Cardiff collaborative trial II. Hypertension. 2008;51(6):1476–82.PubMedCrossRef
29.
go back to reference Kostapanos M, McEniery CM, Wilkinson IB. Clinical relevance of central blood pressure - a critical review. Vasa. 2016;45(6):451–60.PubMedCrossRef Kostapanos M, McEniery CM, Wilkinson IB. Clinical relevance of central blood pressure - a critical review. Vasa. 2016;45(6):451–60.PubMedCrossRef
30.
go back to reference Mitchell GF, Hwang SJ, Larson MG, Hamburg NM, Benjamin EJ, Vasan RS, et al. Transfer function-derived central pressure and cardiovascular disease events: the Framingham heart study. J Hypertens. 2016;34(8):1528–34.PubMedPubMedCentralCrossRef Mitchell GF, Hwang SJ, Larson MG, Hamburg NM, Benjamin EJ, Vasan RS, et al. Transfer function-derived central pressure and cardiovascular disease events: the Framingham heart study. J Hypertens. 2016;34(8):1528–34.PubMedPubMedCentralCrossRef
31.
go back to reference Cheng HM, Lang D, Tufanaru C, Pearson A. Measurement accuracy of non-invasively obtained central blood pressure by applanation tonometry: a systematic review and meta-analysis. Int J Cardiol. 2013;167(5):1867–76.PubMedCrossRef Cheng HM, Lang D, Tufanaru C, Pearson A. Measurement accuracy of non-invasively obtained central blood pressure by applanation tonometry: a systematic review and meta-analysis. Int J Cardiol. 2013;167(5):1867–76.PubMedCrossRef
32.
go back to reference Romagnoli S, Ricci Z, Quattrone D, Tofani L, Tujjar O, Villa G, et al. Accuracy of invasive arterial pressure monitoring in cardiovascular patients: an observational study. Crit Care. 2014;18(6):644.PubMedPubMedCentralCrossRef Romagnoli S, Ricci Z, Quattrone D, Tofani L, Tujjar O, Villa G, et al. Accuracy of invasive arterial pressure monitoring in cardiovascular patients: an observational study. Crit Care. 2014;18(6):644.PubMedPubMedCentralCrossRef
33.
go back to reference Greco E, Peruzzi M, Biondi-Zoccai G, Frati G, Romano SM. Heart rate reduction with esmolol is associated with improved arterial elastance in patients with septic shock: a prospective observational study. Intensive Care Med. 2016;42(10):1528–34.PubMedCrossRef Greco E, Peruzzi M, Biondi-Zoccai G, Frati G, Romano SM. Heart rate reduction with esmolol is associated with improved arterial elastance in patients with septic shock: a prospective observational study. Intensive Care Med. 2016;42(10):1528–34.PubMedCrossRef
34.
go back to reference Li Y, Gu H, Fok H, Alastruey J, Chowienczyk P. Forward and backward pressure waveform morphology in hypertension. Hypertension. 2017;69(2):375–81.PubMedCrossRef Li Y, Gu H, Fok H, Alastruey J, Chowienczyk P. Forward and backward pressure waveform morphology in hypertension. Hypertension. 2017;69(2):375–81.PubMedCrossRef
Metadata
Title
Estimation of central arterial pressure from the radial artery in patients undergoing invasive neuroradiological procedures
Authors
Sabino Scolletta
Antoine Herpain
Salvatore Mario Romano
Fabio Silvio Taccone
Katia Donadello
Boris Lubicz
Federico Franchi
Keitiane Michele Kaefer
Enrico Polati
Jean-Louis Vincent
Daniel De Backer
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Anesthesiology / Issue 1/2019
Electronic ISSN: 1471-2253
DOI
https://doi.org/10.1186/s12871-019-0844-1

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