HYPOTENSION during surgery with general anesthesia is associated with postoperative organ injury and death,1,2  although evidence of a causal relationship remains sparse. But there is little question that excessively low or high blood pressures can cause organ injury. Blood pressure is therefore monitored frequently during anesthesia to guide hemodynamic management.

Effective intraoperative blood pressure management requires sufficiently accurate monitoring methods. In this issue of the Journal, Briegel et al. propose an intriguing new method for noninvasive intermittent blood pressure monitoring, “hydraulic coupling,” which uses a silicone oil-filled sensor pad inside a semirigid conical upper-arm shell wrapped by an inflatable air-filled cuff.

Blood pressure changes through the cardiac cycle are transmitted from arteries into surrounding tissue. The new hydraulic coupling method uses a silicone oil-filled sensor pad to detect and transmit changes in...

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