Effects of graded vasoconstriction upon the measurement of finger arterial pressure

Ben P M I M Hoiz, Gianfranco Parati, Giuseppe Mancia, Karel H. Wesseling

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To assess the effects of incremental phenylephrine infusion rates and subsequent graded vasoconstriction upon the performance of the Ohmeda Finapres. Design: Blood pressure in eight hypertensive patients in the finger and the brachial artery was recorded simultaneously. Systolic blood pressure (SBP), diastolic blood pressure (DPB) and mean arterial pressure (MAP) were compared as well as additional waveform characteristics like the pressure at moment of the dicrotic notch and calculation of the pulsatile-systolic areas. Results: Before phenylephrine infusion SBP and DBP were higher in the finger. At maximal infusion (1.6μg/kg/min) the increase in brachial SBP was significantly underestimated by Finapres. Thus, the computed sensitivities of baroreflex control for SBP differed significantly between the two measurements. Under control conditions, the shape of the finger waveform differed from the brachial-artery waveform in terms of: (1) a more peaked appearance; (2) a dicrotic notch (Pnotch) which is located at a lower percentage of pulse pressure; and (3) a larger pulsatile-systolic area. At maximal infusion rates finger Pnotch increased whilst intrabrachial Pnotch did not. In contrast, the brachial and finger pulsatile-systolic areas changed fully in parallel. Conclusions: Phenylephrine infusion caused a significant, and clinically important, underestimation of the increase in brachial SBP when assessed by Finapres, whereas MAP and DBP and pulsatile-systolic area track intra-arterial pressure reliably.

Original languageEnglish
Pages (from-to)979-984
Number of pages6
JournalJournal of Hypertension
Volume10
Issue number9
Publication statusPublished - 1992

Keywords

  • Baroreflex sensitivity
  • Comparison
  • Direct brachial artery pressure
  • Finger arterial pressure determination
  • Phenylephrine infusion
  • Pulsatile-systolic-area

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine
  • Internal Medicine
  • Endocrinology

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