Blood pressure measurement during transport A comparison of direct and oscillotonometric readings in critically ill patients

Runcie, C. J.; Reeve, William; Reidy, J.; Dougall, J.

doi:10.1111/j.1365-2044.1990.tb14393.x

Cited by 48 publications

(11 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Most, but not all, studies assessing this relation have shown that sphygmomanometric techniques and oscillometric devices (including Dinamap) underestimate systolic pressure (range: 6-19%) and overestimate diastolic pressure (range: 5-27%). 6,[8][9][10][11][12][13] Our results confirm that oscillometric techniques underestimate systolic and overestimate diastolic blood pressures to a degree similar to that previously reported, but add to these observations by showing that the magnitude of error is comparable among lean, overweight, class I/II obese, and class III obese subjects.…”

Section: Discussionsupporting

confidence: 92%

Comparison of Oscillometric and Intraarterial Systolic and Diastolic Blood Pressures in Lean, Overweight, and Obese Patients

et al. 2006

View full text Add to dashboard Cite

To assess the effect of obesity on blood pressure measurement the authors obtained simultaneous oscillometric and intraarterial systolic and diastolic blood pressures on 188 lean, overweight, class I/II obese, and class III obese subjects. Oscillometric arm cuff/bladder size was selected in accordance with standard guidelines. Oscillometry significantly underestimated systolic and significantly overestimated diastolic blood pressures in each of the 4 weight groups studied. The differences between oscillometric and intraarterial systolic and diastolic pressures were not significantly different among lean, overweight, class I/II obese, and class III obese subjects. Thus, obesity per se does not influence the accuracy of blood pressure measurement. However, oscillometric blood pressure measurement is associated with significant error when compared to intraarterial blood pressure.

show abstract

Section: Discussionsupporting

confidence: 92%

Comparison of Oscillometric and Intraarterial Systolic and Diastolic Blood Pressures in Lean, Overweight, and Obese Patients

et al. 2006

View full text Add to dashboard Cite

show abstract

“…Mean differences for DBP ranged from 8.3 to 18, with SDs from 1.1 to 9.3 mm Hg. 13 Some comparisons of the auscultatory versus oscillometric methods have been good, 14 some poor (especially DBP [15][16][17][18][19] ), some with oscillometric pressures too high, 20 and some too low 21 in a variety of clinical populations. Only a single, early study measured oscillometric arm pressures along with directly recorded aortic pressures and found them comparable.…”

Section: Smulyan Et Al Calculated Aortic Pulses 153mentioning

confidence: 99%

Clinical Utility of Aortic Pulses and Pressures Calculated From Applanated Radial-Artery Pulses

et al. 2003

View full text Add to dashboard Cite

Abstract-Brachial artery cuff blood pressures are but approximations of central aortic pressures. The actual pressures against which the left ventricle must pump would be useful clinical information if obtained noninvasively. Our aim was to determine the clinical utility of aortic pulses and pressures calculated from noninvasively obtained radial-artery pulses. Radial-arterial pulses were recorded by applanation and calibrated with arm/cuff oscillometric pressures. Aortic pulses and pressures were calculated from the radial pulses by Fourier analysis and transfer functions. These calculated aortic pulses were compared with directly recorded aortic pulses by a transducer-tip catheter in a series of 50 patients undergoing cardiac catheterization. The correlation coefficient (r) of the measured versus the calculated aortic systolic blood pressure was ϩ0.89, but the scatter was large (standard deviation of the differencesϭϮ11.3 mm Hg). The pulse pressure correlations were less good (rϭϩ0.79) and also had a large scatter (Ϯ13.6 mm Hg). The average calculated pulse pressure was 11.5 mm Hg lower than the measured value because the cuff diastolic blood pressures, used to calibrate the radial pulses, were systematically higher than those in the aorta (8.9 mm Hg). Multivariable analysis incorporating height, age, heart rate, and ejection fraction as additional, independent variables eliminated mean differences between the new "predicted" and measured pressures, significantly improved correlation coefficients, and reduced the scatter. However, the improvements were small. The inaccuracy of the oscillometric cuff method for measuring arm blood pressure appears to be the limiting factor in the prediction of clinically useful, noninvasive aortic pressures. Key Words: aorta Ⅲ arterial pressure Ⅲ Fourier analysis Ⅲ blood pressure determination T he cuff technique for the measurement of brachial-artery (BA) pressure has been of inestimable benefit in the diagnosis and treatment of multiple diseases. It is well known, however, that BA pressure is not the same as and is often an inaccurate estimate of central aortic pressure. The difference between the 2 pressures is difficult to predict because it is influenced by many factors, such as body height, age, heart rate, stroke volume, ejection time, and the distensibility of the conduit arterial tree. An accurate, noninvasive method to measure aortic pressures would be an important clinical advance. It would permit better estimates of cardiac work, better diagnoses of hypertension, and the response to antihypertensive treatment; improve the correction of hemodynamic abnormalities in hypotensive states; and offer better assessments of the pressor responses to exercise stress, during which arm pressures are known to be falsely elevated. 1 Aortic pressures can now only be measured accurately by invasive catheterization, a method unsuitable for widespread clinical use. O'Rourke and colleagues 2-5 have proposed a solution involving transformation of the applanated and calibrated radial-art...

show abstract

“…The inaccuracy of NIBP has been shown to persist out of hospital as well. A French land-based pre-hospital medical team found 44% of systolic readings results differed by 20% or greater in one group [23], and another intensive care transport team concluded that NIBP underestimated systolic pressure by 13-21%, yet over estimated diastolic by 5-27% [13]. Feasibility studies have suggested that IABP monitoring can be established in the pre-hospital environment [22,23].…”

Section: Discussionmentioning

confidence: 99%

“…In a transport environment, it is recommended to have a lower threshold for invasive arterial monitoring [2], as the accuracy of oscillometric NIBP measurement devices is reduced by noise and vibration in the transport environment [13]. Noise and vibration are significant in aircraft [14], and it has been suggested that this may make NIBP measurement less accurate in the aeromedical environment [15].…”

mentioning

confidence: 99%

Comparison of non‐invasive and invasive blood pressure in aeromedical care

McMahon¹,

Hogg²,

Corfield³

et al. 2012

Anaesthesia

View full text Add to dashboard Cite

SummaryBlood pressure measurement is an essential physiological measurement for all critically ill patients. Previous work has shown that non-invasive blood pressure is not an accurate reflection of invasive blood pressure measurement. In a transport environment, the effects of motion and vibration may make non-invasive blood pressure less accurate. Consecutive critically ill patients transported by a dedicated aeromedical retrieval and critical care transfer service with simultaneous invasive and non-invasive blood pressure measurements were analysed. Two sets of measurements were recorded, first in a hospital environment before departure (pre-flight) and a second during aeromedical transport (inflight). A total of 56 complete sets of data were analysed. Bland-Altman plots showed limits of agreement (precision) for pre-flight systolic blood pressure were )37.3 mmHg to 30.0 mmHg, and for pre-flight mean arterial pressure )20.5 mmHg to 25.0 mmHg. The limits of agreement for in-flight systolic blood pressure were )40.6 mmHg to 33.1 mmHg, while those for in-flight mean blood pressure in-flight were )23.6 mmHg to 24.6 mmHg. The bias for the four conditions ranged from 0.5 to )3.8 mmHg. There were no significant differences in values between pre-flight and in-flight blood pressure measurements for all categories of blood pressure measurement. Thus, our data show that noninvasive blood pressure is not a precise reflection of invasive intra-arterial blood pressure. Mean blood pressure measured non-invasively may be a better marker of invasive blood pressure than systolic blood pressure. Our data show no evidence of non-invasive blood pressures being less accurate in an aeromedical transport environment.

show abstract

Blood pressure measurement during transport A comparison of direct and oscillotonometric readings in critically ill patients

Abstract: Summary

Cited by 48 publications

References 23 publications

Comparison of Oscillometric and Intraarterial Systolic and Diastolic Blood Pressures in Lean, Overweight, and Obese Patients

Comparison of Oscillometric and Intraarterial Systolic and Diastolic Blood Pressures in Lean, Overweight, and Obese Patients

Clinical Utility of Aortic Pulses and Pressures Calculated From Applanated Radial-Artery Pulses

Comparison of non‐invasive and invasive blood pressure in aeromedical care

Contact Info

Product

Resources

About