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Comparison of non-invasive blood pressure monitoring using modified arterial applanation tonometry with intra-arterial measurement

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Original languageEnglish
Pages (from-to)13–22
Number of pages10
JournalJournal of Clinical Monitoring and Computing
Issue number1
Early online date19 Jan 2017
Publication statusPublished - 2018
Publication typeA1 Journal article-refereed


Intermittent non-invasive blood pressure measurement with tourniquets is slow, can cause nerve and skin damage, and interferes with other measurements. Invasive measurement cannot be safely used in all conditions. Modified arterial tonometry may be an alternative for fast and continuous measurement. Our aim was to compare arterial tonometry sensor (BPro®) with invasive blood pressure measurement to clarify whether it could be utilized in the postoperative setting. 28 patients who underwent elective surgery requiring arterial cannulation were analyzed. Patients were monitored post-operatively for 2 h with standard invasive monitoring and with a study device comprising an arterial tonometry sensor (BPro®) added with a three-dimensional accelerometer to investigate the potential impact of movement. Recordings were collected electronically. The results revealed inaccurate readings in method comparison between the devices based on recommendations by Association for the Advancement of Medical Instrumentation (AAMI). On a Bland–Altman plot, the bias and precision between these two methods was 19.8 ± 16.7 (Limits of agreement − 20.1 to 59.6) mmHg, Spearman correlation coefficient r = 0.61. For diastolic pressure, the difference was 4.8 ± 7.7 (LoA − 14.1 to 23.6) mmHg (r = 0.72), and for mean arterial pressure it was 11.18 ± 11.1 (LoA − 12.1 to 34.2) mmHg (r = 0.642). Our study revealed inaccurate agreement (AAMI) between the two methods when measuring systolic and mean blood pressures during post-operative care. The readings for diastolic pressures were inside the limits recommended by AAMI. Movement increased the failure rate significantly (p <0.001). Thus, arterial tonometry is not an appropriate replacement for invasive blood pressure measurement in these patients.


  • Arterial pressure, Blood pressure monitors, Monitoring, intraoperative

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Field of science, Statistics Finland