Back to Search
Start Over
Noninvasive continuous monitoring versus intermittent oscillometric measurements for the detection of hypotension during digestive endoscopy
- Source :
- PLoS ONE, Vol 15, Iss 10, p e0240241 (2020), PLoS ONE
- Publication Year :
- 2020
- Publisher :
- Public Library of Science (PLoS), 2020.
-
Abstract
- BackgroundHemodynamic monitoring during digestive endoscopy is usually minimal and involves intermittent brachial pressure measurements. New continuous noninvasive devices to acquire instantaneous arterial blood pressure may be more sensitive to detect procedural hypotension.PurposeTo compare the ability of noninvasive continuous monitoring with that of intermittent oscillometric measurements to detect hypotension during digestive endoscopy.MethodsIn this observational prospective study, patients scheduled for gastrointestinal endoscopy and colonoscopy under sedation were monitored using intermittent pressure measurements and a noninvasive continuous technique (ClearSightâ„¢, Edwards). Stroke volume was estimated from the arterial pressure waveform. Mean arterial pressure and stroke volume values were recorded at T1 (prior to anesthetic induction), T2 (after anesthetic induction), T3 (gastric insufflation), T4 (end of gastroscopy), T5 (colonic insufflation). Hypotension was defined as mean arterial pressure < 65 mmHg.ResultsTwenty patients (53±17 years) were included. Six patients (30%) had a hypotension detected using intermittent pressure measurements versus twelve patients (60%) using noninvasive continuous monitoring (p = 0.06). Mean arterial pressure decreased during the procedure with respect to T1 (p < 0.05), but the continuous method provided an earlier warning than the intermittent method (T3 vs T4). Nine patients (45%) had at least a 25% reduction in stroke volume, with respect to baseline.ConclusionNoninvasive continuous monitoring was more sensitive than intermittent measurements to detect hypotension. Estimation of stroke volume revealed profound reductions in systemic flow. Noninvasive continuous monitoring in high-risk patients undergoing digestive endoscopy under sedation could help in detecting hypoperfusion earlier than the usual intermittent blood pressure measurements.
- Subjects :
- Insufflation
Adult
Mean arterial pressure
Colon
Sedation
Science
Hemodynamics
Blood Pressure
Surgical and Invasive Medical Procedures
Vascular Medicine
Endoscopy, Gastrointestinal
Digestive System Procedures
Oscillometry
medicine
Medicine and Health Sciences
Humans
Pain Management
Prospective Studies
Aged
Anesthetics
Pharmacology
Multidisciplinary
medicine.diagnostic_test
business.industry
Continuous monitoring
Drugs
Biology and Life Sciences
Blood Pressure Determination
Endoscopy
Stroke volume
Colonoscopy
Hematology
Middle Aged
Gastrointestinal Tract
Blood pressure
Anesthesia
Medicine
medicine.symptom
Hypotension
Anatomy
business
Digestive System
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Volume :
- 15
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- PLoS ONE
- Accession number :
- edsair.doi.dedup.....7a6323799df16ca6e054996bd6c29f26