Accuracy in Blood Pressure Monitoring: The Effect of Noninvasive Blood Pressure Cuff Inflation on Intra-arterial Blood Pressure Values
Identifieur interne : 008E54 ( Ncbi/Curation ); précédent : 008E53; suivant : 008E55Accuracy in Blood Pressure Monitoring: The Effect of Noninvasive Blood Pressure Cuff Inflation on Intra-arterial Blood Pressure Values
Auteurs : Veena Sheshadri [Canada] ; Akhilesh Kumar Tiwari [Canada] ; Mahesh Nagappa [Canada] ; Lashmi Venkatraghavan [Canada]Source :
- Anesthesia, Essays and Researches [ 0259-1162 ] ; 2017.
Abstract
Both invasive and noninvasive blood pressure (invasive arterial blood pressure [IABP] and noninvasive BP [NIBP]) monitors are used perioperatively; however, they often produce different values. The reason for this discrepancy is not clear, and it is possible that the act of cuff inflation itself might affect the IABP values, especially with the recurrent cycling of NIBP cuff.
The aim of this study was to determine the effect of ipsilateral NIBP cuff inflation on the contralateral IABP values.
Prospective, observational study.
One hundred consecutive patients were studied. The NIBP device was set to cycle every 5 min for a total of 6 times. During each cuff inflation cycle, changes in IABP values from the arterial line in the contralateral arm were recorded. A total of 582 measurements were included for data analysis.
Chi-square, paired
Mean (± standard deviation) changes in systolic BP (SBP), diastolic BP, and mean BP with cuff inflation were 6.7 ± 5.9, 2.6 ± 4.0, and 4.0 ± 3.9 mmHg, respectively. We observed an increase of 0–10 mmHg in SBP in majority (73.4%) of cuff inflations. The changes in IABP did not differ between the patients with or without hypertension or with the baseline SBP.
This study showed that there is a transient reactive rise in IABP values with NIBP cuff inflation. This is important information in the perioperative and intensive care settings, where both these measurement techniques are routinely used. The exact mechanism for this effect is not known but may be attributed to the pain and discomfort from cuff inflation.
Url:
DOI: 10.4103/0259-1162.181430
PubMed: 28298779
PubMed Central: 5341678
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<author><name sortKey="Sheshadri, Veena" sort="Sheshadri, Veena" uniqKey="Sheshadri V" first="Veena" last="Sheshadri">Veena Sheshadri</name>
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<author><name sortKey="Tiwari, Akhilesh Kumar" sort="Tiwari, Akhilesh Kumar" uniqKey="Tiwari A" first="Akhilesh Kumar" last="Tiwari">Akhilesh Kumar Tiwari</name>
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<author><name sortKey="Sheshadri, Veena" sort="Sheshadri, Veena" uniqKey="Sheshadri V" first="Veena" last="Sheshadri">Veena Sheshadri</name>
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<author><name sortKey="Tiwari, Akhilesh Kumar" sort="Tiwari, Akhilesh Kumar" uniqKey="Tiwari A" first="Akhilesh Kumar" last="Tiwari">Akhilesh Kumar Tiwari</name>
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<author><name sortKey="Nagappa, Mahesh" sort="Nagappa, Mahesh" uniqKey="Nagappa M" first="Mahesh" last="Nagappa">Mahesh Nagappa</name>
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<author><name sortKey="Venkatraghavan, Lashmi" sort="Venkatraghavan, Lashmi" uniqKey="Venkatraghavan L" first="Lashmi" last="Venkatraghavan">Lashmi Venkatraghavan</name>
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<series><title level="j">Anesthesia, Essays and Researches</title>
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<front><div type="abstract" xml:lang="en"><sec id="st1"><title>Context:</title>
<p>Both invasive and noninvasive blood pressure (invasive arterial blood pressure [IABP] and noninvasive BP [NIBP]) monitors are used perioperatively; however, they often produce different values. The reason for this discrepancy is not clear, and it is possible that the act of cuff inflation itself might affect the IABP values, especially with the recurrent cycling of NIBP cuff.</p>
</sec>
<sec id="st2"><title>Aim:</title>
<p>The aim of this study was to determine the effect of ipsilateral NIBP cuff inflation on the contralateral IABP values.</p>
</sec>
<sec id="st3"><title>Settings and Designs:</title>
<p>Prospective, observational study.</p>
</sec>
<sec id="st4"><title>Materials and Methods:</title>
<p>One hundred consecutive patients were studied. The NIBP device was set to cycle every 5 min for a total of 6 times. During each cuff inflation cycle, changes in IABP values from the arterial line in the contralateral arm were recorded. A total of 582 measurements were included for data analysis.</p>
</sec>
<sec id="st5"><title>Statistical Analysis:</title>
<p>Chi-square, paired <italic>t</italic>
-test, analysis of variance.</p>
</sec>
<sec id="st6"><title>Results:</title>
<p>Mean (± standard deviation) changes in systolic BP (SBP), diastolic BP, and mean BP with cuff inflation were 6.7 ± 5.9, 2.6 ± 4.0, and 4.0 ± 3.9 mmHg, respectively. We observed an increase of 0–10 mmHg in SBP in majority (73.4%) of cuff inflations. The changes in IABP did not differ between the patients with or without hypertension or with the baseline SBP.</p>
</sec>
<sec id="st7"><title>Conclusions:</title>
<p>This study showed that there is a transient reactive rise in IABP values with NIBP cuff inflation. This is important information in the perioperative and intensive care settings, where both these measurement techniques are routinely used. The exact mechanism for this effect is not known but may be attributed to the pain and discomfort from cuff inflation.</p>
</sec>
</div>
</front>
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