Blood pressure measurements in the ankle are not equivalent to blood pressure measurements in the arm

Goldstein, Lara Nicole; Wells, Mike; Sliwa, Karen

doi:10.7196/samj.8102

Cited by 7 publications

(10 citation statements)

References 19 publications

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“…In patients undergoing such surgery, BP monitoring using a pneumatic cuff on the surgical-side arm is avoided to prevent lymphedema [4]. Many studies have evaluated the feasibility of obtaining BP measurements at other sites as a substitute for standard arm BP [3,15,[25][26][27].…”

Section: Discussionmentioning

confidence: 99%

“…BP measurements obtained at the lower extremities, including ankle BP, have been well studied [3,5,6,25,26,28,29]. Wilkes et al [6] reported that the ankle is a suitable alternative site for BP measurement only when the arm is not available, because ankle BP measurements tend to be higher than brachial ones [3,6,25,26]. Proposed reasons for the higher leg BP readings include greater resistance of distal vessels, ineffective compression by the cuff on the posterior tibial artery and poor detection of the oscillations [26].…”

Section: Discussionmentioning

confidence: 99%

“…Wilkes et al [6] reported that the ankle is a suitable alternative site for BP measurement only when the arm is not available, because ankle BP measurements tend to be higher than brachial ones [3,6,25,26]. Proposed reasons for the higher leg BP readings include greater resistance of distal vessels, ineffective compression by the cuff on the posterior tibial artery and poor detection of the oscillations [26]. In addition, ankle BP measurements may be affected by positions, such as the lithotomy and reverse Trendelenburg positions [28,29].…”

Section: Discussionmentioning

confidence: 99%

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Continuous Non-Invasive Arterial Pressure Monitoring (ClearSight System) and Ankle Blood Pressure Measurements as Alternatives to Conventional Arm Blood Pressure

Lee

Chung

Bae

et al. 2020

JCM

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Measuring blood pressure (BP) via a pneumatic cuff placed around the arm has long been the standard method. However, in clinical situations where BP monitoring at the arm is difficult, the ankle is frequently used instead. We compared continuous non-invasive blood pressure (CNBP) measurements obtained at the finger, ankle BP and arm BP in patients undergoing breast cancer surgery. Arm BP, ankle BP (both obtained with a conventional pneumatic cuff) and CNBP measurements were obtained every 2.5 min during surgery. Correlation and Bland–Altman analyses were performed and differences among measurements were analyzed using a linear mixed model. A total of 245 sets of BP measurements were obtained from 10 patients. All systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean blood pressure (MBP) measurements of ankle BP and CNBP were positively correlated with the arm BP measurements (Spearman rho 0.688–0.836, p < 0.001 for each correlation). The difference between CNBP and arm SBP was significantly smaller (least squares mean (95% confidence interval): −6.03 (−11.40, −0.67)) compared to that between ankle and arm SBP (least squares mean (95% CI): −15.32 (−20.69, −9.96), p = 0.019). However, this significant difference was not observed in DBP and MBP (−1.23 vs. 1.75, p = 0.190 and −3.85 vs. −2.63, p = 0.604, respectively). Ankle SBP measurements showed larger differences from arm SBP measurements than did CNBP SBP measurements in patients undergoing breast cancer surgery. CNBP could serve as a useful alternative to ankle BP when standard arm BP measurements cannot be obtained.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Continuous Non-Invasive Arterial Pressure Monitoring (ClearSight System) and Ankle Blood Pressure Measurements as Alternatives to Conventional Arm Blood Pressure

Lee

Chung

Bae

et al. 2020

JCM

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show abstract

“…The basis of NIBP measurement by oscillometry is the determination of MAP from the maximum pulse oscillation during cuff deflation [ 7 ]. Systolic and diastolic pressure can only be estimated indirectly according to some empirically derived algorithm [ 8 ]. Variation in propagation of pressure waves as they pass down the descending aorta results in narrowing and increase in the systolic portions of the pressure wave in the ankle compared with the aortic arch, when measured directly in the anaesthetized dog [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Can we use the ankle non-invasive blood pressure during otolaryngologic surgery: an observational study

Jaouhari¹,

Meziane²,

Kessouati³

et al. 2020

Pan Afr Med J

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Introduction In otolaryngologic surgery, ankle is frequently used for monitoring anesthesia in place of brachial when the patient doesn´t need invasive arterial cannulation. If there is a clinically useful and Predictable link between the two readings in hemodynamic normal patient, this difference during otolaryngologic surgery, was not evaluated. We aimed to investigate the reliability and the acceptability of non invasive blood pressure measurements at the ankle compared to those obtained concurrently at the arm during otolaryngologic surgery. Methods Eighty ASA grade I and II patients who had to be operated under general anesthesia were taken as subjects for our study. Blood pressures were measured simultaneously in the 2 limbs before induction and then every 10 minutes until the end of the surgical procedure. Readings were initiated concurrently. Statistical analysis was performed with PASW Statistics 13. Results There were 41 males (51.2 %) and 39 females (48.8 %). Bland-Altman analysis of mean difference between the ankle and arm (95 % limits of agreement) was -11.47 (- 23.77 to 0.82) mmHg for systolic blood pressure (SBP), -7.89 (-19.16 to 3.36) mmHg for diastolic blood pressure (DBP) and - 9.09 (18.19 to 0.00) mmHg for mean arterial pressure (MAP). Non-parametric analysis showed that 67.5 % of SBP, 46.2 % of DBP and 56.2 % of MAP measurements differed by > 10mmHg. Conclusion Ankle BP cannot be used routinely in otolaryngological surgery. Although, the ankle can be used as an alternative where the arm cannot be used taking into account a difference.

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“…To control cryptococcal infections, three drugs, namely, fluconazole, amphotericin b and flucytosine, have been recommended for management purposes [ 13 , 14 ]. However, in South Africa, only fluconazole and amphotericin b are routinely used in public health institutions [ 7 , 15 , 16 , 17 ]. To compound this, the clinical application of these two drugs is often limited.…”

Section: Introductionmentioning

confidence: 99%

The Repurposing of Acetylsalicylic Acid as a Photosensitiser to Inactivate the Growth of Cryptococcal Cells

et al. 2021

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Photodynamic treatment (PDT) is often successful when used against aerobic microbes, given their natural susceptibility to oxidative damage. To this end, the current study aimed to explore the photodynamic action of acetylsalicylic acid (ASA; aspirin, which is commonly used to treat non-infectious ailments), when administered to respiring cryptococcal cells. The treatment of cryptococcal cells, i.e., exposure to 0.5 or 1 mM of ASA in the presence of ultraviolet light (UVL) for 10 min, resulted in a significant (p < 0.05) reduction in the growth of tested cells when compared to non-treated (non-Rx) cells, i.e., no ASA and no UVL. The treated cells were also characterised by diseased mitochondria, which is crucial for the survival of respiring cells, as observed by a significant (p < 0.05) loss of mitochondrial membrane potential (ΔΨM) and significant (p < 0.05) accumulation of reactive oxygen species (ROS) when compared to non-Rx cells. Moreover, the photolytic products of acetylsalicylic acid altered the ultrastructural appearance of treated cells as well as limited the expression levels of the capsular-associated gene, CAP64, when compared to non-Rx cells. The results of the study highlight the potential use of ASA as a photosensitiser that is effective for controlling the growth of cryptococcal cells. Potentially, this treatment can also be used as an adjuvant, to complement and support the usage of current anti-microbial agents.

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Blood pressure measurements in the ankle are not equivalent to blood pressure measurements in the arm

Cited by 7 publications

References 19 publications

Continuous Non-Invasive Arterial Pressure Monitoring (ClearSight System) and Ankle Blood Pressure Measurements as Alternatives to Conventional Arm Blood Pressure

Continuous Non-Invasive Arterial Pressure Monitoring (ClearSight System) and Ankle Blood Pressure Measurements as Alternatives to Conventional Arm Blood Pressure

Can we use the ankle non-invasive blood pressure during otolaryngologic surgery: an observational study

The Repurposing of Acetylsalicylic Acid as a Photosensitiser to Inactivate the Growth of Cryptococcal Cells

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