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Background:

Intermittent non-invasive blood pressure (NIBP) cuff measurements remain the standard method of hemodynamic monitoring for many surgical patients but may fail to detect transient blood pressure abnormalities between measurement cycles. Invasive arterial catheters provide continuous monitoring but are reserved for select patients due to associated risks, including infection, thrombosis, bleeding, and vascular injury. Novel wearable technologies offer the potential for continuous, non-invasive blood pressure monitoring without these limitations. The Vena Vitals device uses a soft, conformal pressure sensor to directly measure arterial pulse waveforms. We hypothesized that continuous monitoring with this device would demonstrate close agreement with intermittent cuff measurements and improve the detection of clinically significant blood pressure changes. Earlier identification of hemodynamic instability may reduce the duration and severity of perioperative hypotension and improve patient safety.

Objective:

To evaluate agreement between a continuous non-invasive wearable blood pressure monitor and standard intermittent cuff measurements, and to assess whether continuous monitoring improves detection of clinically significant blood pressure fluctuations.

Methods:

We will conduct a prospective observational study of adult surgical patients undergoing general anesthesia without arterial catheter placement at a tertiary academic medical center. The study has received institutional review board (IRB) approval. Patients will be monitored intraoperatively using standard intermittent NIBP cuffs and the Vena Vitals continuous non-invasive blood pressure sensor placed on the lower extremity. The primary endpoint will be agreement between Vena Vitals and cuff measurements, assessed using mean bias, standard deviation, and Bland–Altman analysis, with calibration measurements excluded. Secondary endpoints include evaluation of blood pressure variability between cuff cycles and detection of clinically significant abnormalities (MAP <65 or >105 mmHg) missed by intermittent monitoring.

Results:

This study has received institutional review board approval. Enrollment is underway, with data collection pending completion of institutional contracting.

Conclusions:

This study will evaluate the accuracy and clinical utility of continuous non-invasive blood pressure monitoring compared with standard intermittent cuff measurements. If validated, wearable continuous monitoring may improve perioperative hemodynamic surveillance and support earlier recognition of blood pressure instability in patients without arterial catheters.