Continuous noninvasive arterial pressure

Continuous noninvasive arterial pressure (CNAP) is the method of measuring arterial blood pressure in real-time without any interruptions (continuously) and without cannulating the human body (noninvasive).

Continuous noninvasive arterial blood pressure measurement (CNAP) combines the advantages of the following two clinical “gold standards”: it measures blood pressure (BP) continuously in real-time like the invasive arterial catheter system (IBP) and it is non-invasive like the standard upper arm sphygmomanometer (NBP). Latest developments in this field show promising results in terms of accuracy, ease of use and clinical acceptance.

For the use in clinical environment a CNAP system must provide the following blood pressure information:

A high demand for easily applicable and accurate CNAP-systems is proven. This is why researchers, practitioners and the medical device industry focus on such devices. Like in other fields of innovation, the use of small but powerful microcomputers and digital signal processors facilitates the development of efficient blood pressure measurement instruments. These processors enable complex and computationally intensive mathematical functions in small inexpensive devices, which are necessary for this purpose.

Recent literature, a nationally representative survey among 200 German and Austrian physicians and additional expert interviews provide strong evidence that in only 15% to 18% of inpatient surgeries blood pressure is measured continuously with invasive catheters (IBP). In all other inpatient and outpatient surgeries intermittent, noninvasive blood pressure (NBP) monitoring is the standard of care. Due to the discontinuous character of NBP, dangerous hypotensive episodes might be missed: In women undergoing Caesarean section, CNAP detected hypotensive phases in 39% of the cases, whereas only 9% were detected by the standard NBP. Dangerous fetal acidosis did not occur when systolic blood pressure measured with CNAP was above 100mmHg. Another study showed more than 22% of missed hypotensive episodes leading to delayed or no treatment.

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