Document Detail


Invasive arterial BP monitoring in trauma and critical care: effect of variable transducer level, catheter access, and patient position.
MedLine Citation:
PMID:  11591577     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: (1) To determine the validity of current recommendations for direct arterial BP measurement that suggest that the transducer (zeroed to atmosphere) be placed level with the catheter access regardless of subject positioning: and (2) to investigate the effect of transducer level, catheter access site, and subject positioning on direct arterial BP measurement.
DESIGN: Prospective, controlled laboratory study.
SETTING: Large animal laboratory.
SUBJECTS: Five Yorkshire pigs.
INTERVENTIONS: Anesthetized animals had 16F catheters placed at three access sites: aortic root, femoral artery, and distal hind limb. Animals were placed in supine, reverse Trendelenburg 35 degrees, and Trendelenburg 25 degrees positions with a transducer placed level to each access site while in every position.
MEASUREMENTS AND MAIN RESULTS: For each transducer level, five systolic and diastolic pressures were measured and used to calculate five corresponding mean arterial pressures (MAPs) at each access site. When transducers were at the aortic root, MAP corresponding to aortic root pressure was obtained in all positions regardless of catheter access site. When transducers were moved to the level of catheter access, as current recommendations suggest, significant errors in aortic MAP occurred in the reverse Trendelenburg position. The same trend for error was noted in the Trendelenburg position but did not reach statistical significance.
CONCLUSIONS: (1) Current recommendations that suggest placing the transducer at the level of catheter access regardless of patient position are invalid. Significant errors occur when subjects are in nonsupine positions. (2) Valid determination of direct arterial BP is dependent only on transducer placement at the level of the aortic root, and independent of catheter access site and patient position.
Authors:
U G McCann; H J Schiller; D E Carney; J Kilpatrick; L A Gatto; A M Paskanik; G F Nieman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chest     Volume:  120     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2001 Oct 
Date Detail:
Created Date:  2001-10-09     Completed Date:  2001-12-04     Revised Date:  2014-07-28    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1322-6     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Animals
Arteries
Blood Pressure Monitors*
Catheters, Indwelling*
Critical Care*
Diastole / physiology
Head-Down Tilt / physiology
Humans
Prospective Studies
Supine Position / physiology
Swine
Systole / physiology
Transducers, Pressure*
Wounds and Injuries / physiopathology*

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


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