Evidence map›Paper›PMID 33099306›Full record

ArticleBMC anesthesiology2020

Non-invasive continuous blood pressure monitoring (ClearSight™ system) during shoulder surgery in the beach chair position: a prospective self-controlled study.

Konrad Chachula, Florian Lieb, Florian Hess, Joellen Welter, Nicole Graf, Alexander Dullenkopf

Open access · goldAbstract read
In one paragraph

Article in BMC anesthesiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.2field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 9 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Konrad ChachulaInstitute for Anesthesia and Intensive Care Medicine, Spital Thurgau Frauenfeld, Frauenfeld, Switzerland.
Florian LiebInstitute for Anesthesia and Intensive Care Medicine, Spital Thurgau Frauenfeld, Frauenfeld, Switzerland.
Florian HessClinic for Orthopedic Surgery and Traumatology, Spital Thurgau Frauenfeld, Frauenfeld, Switzerland.
Joellen WelterInstitute for Anesthesia and Intensive Care Medicine, Spital Thurgau Frauenfeld, Frauenfeld, Switzerland.
Nicole GrafGraf biostatistics, Winterthur, Switzerland.
Alexander DullenkopfInstitute for Anesthesia and Intensive Care Medicine, Spital Thurgau Frauenfeld, Frauenfeld, Switzerland. alexander.dullenkopf@stgag.ch.ORCID 0000-0002-1456-6457
Spital Thurgau (Switzerland) · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe beach chair position that is commonly used in shoulder surgery is associated with relative hypovolemia, which leads to a reduction in arterial blood pressure. The effects of patient positioning on the accuracy of non-invasive continuous blood pressure monitoring with the ClearSight™ system (CS-BP; Edwards Lifesciences, Irvine CA, USA) have not been studied extensively. Our research aim was to assess agreement levels between CS-BP measurements with traditional blood pressure monitoring techniques.

methodsFor this prospective self-controlled study, we included 20 consecutively treated adult patients undergoing elective shoulder surgery in the beach chair position. We performed Bland-Altman analyses to determine agreement levels between blood pressure values from CS-BP and standard non-invasive (NIBP) methods. Perioperative measurements were done in both the supine (as reference) and beach chair surgical positions. Additionally, we compared invasive blood pressure (IBP) measurements with both the non-invasive methods (CS-BP and NIBP) in a sub-group of patients (n = 10) who required arterial blood pressure monitoring.

resultsWe analyzed 229 data points (116 supine, 113 beach chair) from the entire cohort; per patient measurements were based on surgical length (range 3-9 supine, 2-10 beach chair). The mean difference (±SD; 95% limits of agreement) in the mean arterial pressure (MAP) between CS-BP and NIBP was - 0.9 (±11.0; - 24.0-22.2) in the beach chair position and - 4.9 mmHg (±11.8; - 28.0-18.2) when supine. In the sub-group, the difference between CS-BP and IBP in the beach chair position was - 1.6 mmHg (±16.0; - 32.9-29.7) and - 2.8 mmHg (±15.3; - 32.8-27.1) in the supine position. Between NIBP and IBP, we detected a difference of 3.0 mmHg (±9.1; - 20.8-14.7) in the beach chair position, and 4.6 mmHg (±13.3; - 21.4-30.6) in the supine position.

conclusionsWe found clinically acceptable mean differences in MAP measurements between the ClearSight™ and non-invasive oscillometric blood pressure systems when patients were in either the supine or beach chair position. For all comparisons of the monitoring systems and surgical positions, the standard deviations and limits of agreement were wide.

trial registrationThis study was prospectively registered at the German Clinical Trial Register (www.DRKS.de; DRKS00013773 ). Registered 26/01/2018.

Indexed as

AgedAged, 80 and overBlood PressureBlood Pressure DeterminationFemaleHumansMaleMiddle AgedMonitoring, PhysiologicPatient PositioningProspective StudiesShoulderBeach chair positionGeneral anesthesiaMonitoring, blood pressurePatient monitoring

Identifiers

PMID33099306
PMCPMC7585229
OpenAlexW3093624496

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.