Document Detail


Automatic postoperative monitoring of infrainguinal bypass procedures.
MedLine Citation:
PMID:  9125029     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the usefulness of a portable, computer-based, oscillometric, noninvasive blood pressure monitor for the automatic surveillance of postoperative infrainguinal bypasses. DESIGN: Prospective unblinded study. SETTING: Regional tertiary care Veterans Affairs medical center. PATIENTS: A total of 60 limbs were examined in 3 groups (n = 20 in each group): normal, asymptomatic volunteers; older patients with symptomatic peripheral vascular disease; and patients who had undergone infrainguinal bypass procedures. INTERVENTIONS: Noninvasive blood pressure monitor pressures, complete lower extremity arterial studies with Doppler ankle-brachial index (ABI), segmental pressures, and pulse volume recordings were performed in all groups. The patients who had undergone surgery also had hourly noninvasive blood pressure measurements taken. MAIN OUTCOME MEASURES: Ankle-brachial indices obtained with the noninvasive blood pressure monitor were compared with simultaneous manual Doppler ABIs and pulse volume recordings. RESULTS: There was a significant overall correlation between the Doppler-derived ABIs and automatic oscillometric values (r = 0.89, P < .001). Although there was a slight difference in absolute values (+/-SEM) (0.90 +/- 0.03 vs 0.84 +/- 0.03, respectively), an excellent correlation was found between the 2 methods in the clinically relevant range of ABI values between 0.60 and 1.10. The oscillometric method, however, overestimated the ABI when it was less than 0.60 by the Doppler method (0.61 +/- 0.02 vs 0.44 +/- 0.03, P < .001) and underestimated it when it was more than 1.10 (1.05 +/- 0.02 vs 1.16 +/- 0.01, P < .001). (All values given as +/-SEM.) Oscillometric overestimation correlated with depressed pulse volume recording waveforms (P < .001) or diminished pulse volume recording amplitudes of less than 10 mm (P < .001). CONCLUSION: The automatic oscillometric monitor provides a useful, accurate, objective, and quantitative method for postoperative bypass graft surveillance.
Authors:
J Blebea; M K Ali; M Love; R Bodenham; B Bacik
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Archives of surgery (Chicago, Ill. : 1960)     Volume:  132     ISSN:  0004-0010     ISO Abbreviation:  Arch Surg     Publication Date:  1997 Mar 
Date Detail:
Created Date:  1997-04-24     Completed Date:  1997-04-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9716528     Medline TA:  Arch Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  286-91     Citation Subset:  AIM; IM    
Affiliation:
Division of Vascular Surgery, University of Cincinnati Medical Center, Ohio, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Arteriosclerosis / physiopathology,  surgery*
Blood Pressure Monitors*
Female
Humans
Leg / blood supply*,  surgery*
Male
Middle Aged
Peripheral Vascular Diseases / physiopathology,  surgery*
Postoperative Care*
Prospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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