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The accuracy of noninvasive cardiac output and pressure measurements with finger cuff: a concise review

Ameloot, Koena,b; Palmers, Pieter-Jana,b; Malbrain, Manu L.N.G.c,d

Current Opinion in Critical Care: June 2015 - Volume 21 - Issue 3 - p 232–239
doi: 10.1097/MCC.0000000000000198

Purpose of review The present review aims to summarize literature on the accuracy of the finger cuff method to measure cardiac output (CO) and blood pressure, its ability to track hemodynamic changes, and to predict fluid responsiveness.

Recent findings Finger cuff is an easy-to-use hemodynamic monitoring technique. Different devices are currently available, which provide continuous arterial blood pressure (Finapress), whereas only ClearSight (previously known as Nexfin; BMEYE) provides an estimate of CO. In most studies, the criteria for clinical interchangeability (for CO) were not met, when compared with the currently used invasive monitoring systems such as uncalibrated CO via a radial artery line, and calibrated CO either via a pulmonary artery catheter or a femoral artery catheter connected to the PiCCO (Pulsion Medical Systems) or VolumeView (Edwards Lifesciences) devices. In particular, ClearSight obtained CO seems to be less accurate in patients with a low CO. However, in most patients, ClearSight is able to track hemodynamic changes induced by a fluid challenge or passive leg raising test. We will discuss in this review the relevant literature with regard to validation of the finger cuff technique for both arterial blood pressure and CO.

Summary The finger cuff method provides a reasonable estimate of CO and blood pressure, which does not meet the criteria for clinical interchangeability with the currently used invasive devices.

aDepartment of Cardiology

bDepartment of Intensive Care, University Hospitals Leuven, Leuven

cDepartment of Intensive Care

dDepartment of High Care Burn Unit, Ziekenhuis Netwerk Antwerpen, ZNA Stuivenberg, Antwerp, Belgium

Correspondence to Dr Manu L.N.G. Malbrain, MD, PhD, ICU and High Care Burn Unit Director, Ziekenhuis Netwerk Antwerpen, ZNA Stuivenberg, Lange Beeldekensstraat 267, B-2060 Antwerp 6 Belgium. Tel: +32 3 217 7399; fax: + 32 3 217 7574; e-mail:

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