Continuous Noninvasive Blood Pressure Measurement With "ClearSight" Compared to Standard Intermittent Blood Pressure Measurement in Patients With Peripheral Arterial Disease. Are Potential Differences Influenced by Phenylephrine or Dobutamine?

Objectives: To investigate the agreement between continuous noninvasive blood pressure measurement with the ClearSight system (cNIBP-CS) and standard intermittent noninvasive blood pressure measurement (iNIBP) in patients with peripheral arterial disease (PAD). Additionally, the influence of vasoactive medication on potential measurement differences was assessed.Design: A secondary analysis of a randomized controlled trial.Setting: At a university hospital.Participants: Thirty-four patients with PAD undergoing percutaneous transluminal angioplasty of the lower limbs.Measurements and Main Results: Continuous noninvasive blood pressures were measured with the "ClearSight" system and compared to standard iNIBPs. Bland-Altman analysis revealed a mean bias of 13 mmHg (+/- 15) between cNIBP-CS and iNIBP, with 95% limits of agreement (LOA) ranging from -17 to 42 mmHg. When comparing both medication groups, a similar mean bias was found for phenylephrine and dobutamine (12 mmHg [+/- 13] and 13 mmHg [+/- 13], respectively).Conclusion: In this study, in patients with PAD, cNIBP-CS showed an underestimation of blood pressure compared to iNIBP in phenylephrineand dobutamine-treated patients. Compared to previous studies, a larger bias and wider 95% LOA were found.(c) 2023 Elsevier Inc. All rights reserved.