Clinical agreement of a novel algorithm to estimate radial artery blood pressure from the non-invasive finger blood pressure

J Clin Anesth. 2022 Dec:83:110976. doi: 10.1016/j.jclinane.2022.110976. Epub 2022 Sep 26.


Study objective: A new algorithm was developed that transforms the non-invasive finger blood pressure (BP) into a radial artery BP (B̂PRad), whereas the original algorithm estimated brachial BP (B̂PBra). In this study we determined whether this new algorithm shows better agreement with invasive radial BP than the original one and whether in the operating room this algorithm can be used safely.

Design, setting and patients: This observational study was conducted on thirty-three non-cardiac surgery patients.

Intervention and measurements: Invasive radial and non-invasive finger BP were measured, of the latter B̂PRad and B̂PBra were transformed. Agreement of systolic, mean, and diastolic arterial BP (SAP, MAP, and DAP, respectively) was assessed traditionally with Bland-Altman and trend analysis and clinically safety was quantified with error grid analyses. A bias (precision) of 5 (8) mmHg or less was considered adequate.

Main results: Thirty-three patients were included with an average of 676 (314) 20 s segments. For both comparisons, bias (precision) of MAP was within specified criteria, whereas for SAP, precision was higher than 8 mmHg. B̂PRad showed a better agreement than B̂PBra with BPRad for DAP values (bias (precision): 0.7 (6.0) and - 6.4 (4.3) mmHg, respectively). B̂PRad and B̂PBra both showed good concordance in following changes in BPRad (for all parameters overall degree was <7°). There were slightly more measurement pairs of MAP within the no-risk zone for B̂PRad than for B̂PBra (96 vs 77%, respectively).

Conclusions: In this cohort of non-cardiac surgery patients, we found good agreement between BPRad and B̂PRad. Compared to B̂PBra, B̂PRad shows better agreement although clinical implications are small. This trial was registered with (

Keywords: Blood pressure monitoring; Brachial artery; ClearSight; Non-invasive; Radial artery.

Publication types

  • Observational Study

MeSH terms

  • Algorithms
  • Arterial Pressure / physiology
  • Blood Pressure / physiology
  • Blood Pressure Determination*
  • Humans
  • Radial Artery*

Associated data