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(詳細はcontinuous noninvasive arterial pressure measurement (CNAP). The historical gap between ease of use, but intermittent upper arm instruments and bulky, but continuous “pulse writers” (sphygmographs) is discussed starting with the first efforts to measure pulse, published by Jules Harrison in 1835. Such sphygmographs led a shadowy existence in the past, while Riva Rocci’s upper arm blood pressure measurement started its triumphant success over 100 years ago. In recent times, CNAP measurement introduced by Jan Penáz in 1973 enabled the first recording of noninvasive beat-to-beat blood pressure resulting in marketed products such as the Finapres™ device and its successors. Recently, a novel method for CNAP monitoring has been designed for patient monitoring in perioperative, critical and emergency care, where blood pressure needs to be measured repeatedly or even continuously to facilitate the best care for patients. ==Early sphygmographs== Prior to quantitative measurement, which was applied in medicine in the 19th century, diagnostic possibilities of hemodynamic activities had been limited to qualitative sensing of pulse through palpation. In some cultures, sensitive palpation is still a main part of medicine like pulse diagnosis in Traditional Chinese medicine (TCM) or the identification of the ayurvedic doshas. The introduction of the stethoscope and the methods of auscultation by René-Théophile-Hyacinthe Laennec in 1816 changed the medical behavior consistently and forced the need of quantitative hemodynamic measurements.〔Eckert S. 100 Jahre Blutdruckmessung nach Riva-Rocci und Korotkoff: Rückblick und Ausblick. Journal für Hypertonie 2006; 10 (3), 7-13.〕 The first instrument which could measure the force of pulse with a mercury filled glass tube was developed by Jules Harrison in 1835.〔Harrison J. The Sphygmomanometer, an instrument which renders the action of arteries apparent to the eye with improvement of the instrument and prefatory remarks by the translator. Longman, London, 1835.〕 Jean Léonard Marie Poiseuille invented the first mercury “Hemodynameter”, a forerunner of the sphygmomanometer in 1821.〔(【引用サイトリンク】title=Vascular Hemodynamics )〕 The first sphygmograph (pulse writer) for the continuous graphical registration of pulse dates back to Karl von Vierordt in 1854.〔Vierordt K. Die Lehre vom Arterienpuls in gesunden und kranken Zuständen gegründet auf eine neue Methode der bildlichen Darstellung des menschlichen Pulses. Vieweg und Sohn, Braunschweig, 1855.〕 More popular, however, was the improved sphygmograph from the French physiologist and pioneer in cinematography Étienne-Jules Marey (1863).〔Marey EJ: Recherches sur l’état de la circulation d’après les caractères du pouls fourmis par le nouveau sphygmopraphe. J Physiol homme anim 1869; 3: 241–74.〕 In his famous book “La méthode graphique“ (1878) and his studies with the photographic gun, Marey’s work was related to cardiovascular movements of heart and vessels.〔Marey EJ: La méthode graphique dans les sciences expérimentales et principalement en physiologie et en médecine, Paris (1878). p. 281〕 Besides Marey's sphygmograph, a device developed by the Austrian Samuel von Basch attracted attention and was introduced in Europe in 1880 . A fluid filled bladder placed on the wrist was able to detect pulse; the pressure, which was necessary for the disappearance of the pulses, was measured with a mercury manometer. This allowed the first measurement of systolic blood pressure.〔Basch von S. Über die Messung des Blutdrucks am Menschen. Zeitschrift für klinische Medizin 1880; 2: 79–96.〕 Several other sphygmographs were developed in the late 19th century, especially in Great Britain, France and Germany.〔Dudgeon RE: The Sphygmograph. London: Bailliere Tindall and Cox 1882〕〔Richardson BW: Standard pulse readings. Asclepiad 1885 ii 194〕〔Potain PCE. Du sphygmomanometre et de measure de la pression arterielle de la homme a Iiètat normal et pathologique. Arch de Physiol 1889 i 556〕 These instruments were portable, reasonably accurate and widely available, so physicians even used them at the bedside. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「History of continuous noninvasive arterial pressure」の詳細全文を読む スポンサード リンク
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