Blood pressure monitoring: Automated oscillometric devices

Abstract

An understanding of the principles of blood pressure measurement with automated oscillometric devices (e.g., Dinamap) allows a user to realize the purpose and level of accuracy for which the equipment is designed. Good technique cells for various actions: (1) using a cuff of proper size (too large a cuff will generally work acceptably, but too small a cuff will yield erroneously high readings); (2) squeezing all of the residual air out of the cuff before applying it to the arm or leg; (3) wrapping the cuff snugly around the arm or leg; (4) instructing the patient to refrain from talking or moving and letting nothing press against the cuff during measurement; (5) keeping the cuff and heart at the same horizontal level. (6) When instrument malfunction is suspected, first checking the status of the patient (not the status of the instrument) to be sure that a clinical emergency is not causing the suspected "malfunction"; (7) repeating a reading several times when it is suspicious and, if necessary, modifying the measurement conditions by using, for example, different limbs or different cuffs until the question is resolved; and (8) remembering that a leak in the cuff, hoses, or connection can cause an unexpected malfunction.

Blood pressure estimation using oscillometric pulse morphology

“…Breathing in normal depth may cause SBP fluctuation up to 3-6 mmHg and deep breathing has been found to influence SBP up to 15-20 mmHg [71].…”

Clinical exercise testing with reference to lung diseases: indications, standardization and interpretation strategies. ERS Task Force on Standardization of Clinical Exercise Testing. European Respiratory Society

“…Automated blood pressure measurement systems have been developed specifically for use during exercise. Many operate with the oscillometric method, in which, as the cuff is automatically deflated in stages, pressure oscillations induced within the cuff by pulsations in the arm are detected [170]. Despite algorithms designed to decrease the effects of artefacts, blood pressure mea surements may be inaccurate when, for example, the arm moves during the measurement cycle.…”

Mean arterial pressure (MAP): An alternative and preferable measurement to systolic blood pressure (SBP) in patients for hypotension detection during hemapheresis

“…According to Ramsey [7], MAP is preferable to SBP because it is a single, numerical value that combines the values of SBP and DBP with pressure waves of SBP and DBP; this makes a change in MAP easier to interpret than SBP and DBP, which can often move in the opposite direction. Furthermore, MAP re¯ects arterial blood volume and arterial compliance and is thus indicative of organ and tissue perfusion.…”