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Invasive blood pressure monitoring systems in the ICU: influence of the blood-conserving device on the dynamic response characteristics and agreement with noninvasive measurements.
MedLine Citation:
PMID:  22797516     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: Invasive blood pressure monitoring is the most reliable method in critically ill patients. Noninvasive oscillometric pressure monitoring is also widely used in the ICU, and discrepancies between the methods are common. Inclusion of a blood-conserving device may influence the fidelity of the system and reliability of the invasive pressure values. We examined the dynamic response characteristics of the monitoring systems with and without the blood-conserving device, and assessed agreement between invasive and noninvasive blood pressures. MATERIALS AND METHODS: Fifty-three invasive arterial blood pressure monitoring systems were evaluated over an 8-week period. A standard fast flush test was performed. The natural frequency (Fn) and the amplitude ratio of the invasive monitoring systems were calculated. Simultaneous invasive and noninvasive blood pressures were recorded, and the agreement between two methods was evaluated. RESULTS: The Fn was significantly higher (15.7±5.1 Hz) in the systems without the blood-conserving device than in the systems containing the device (9.1±2.6 Hz). There was no significant difference in the amplitude ratio. Significant differences were observed between invasive and noninvasive pressures, with systolic pressure showing more variability than the mean arterial pressure. CONCLUSION: Inclusion of a blood-conserving device in the existing monitoring circuit may affect its dynamic response characteristics. Discrepancies between invasive and noninvasive pressures are common, with systolic pressure showing more variability than the mean arterial pressure. The low Fn of the invasive monitoring system could be a contributing factor to the discrepancy between two methods.
Authors:
Roman Melamed; Kara Johnson; Ben Pothen; Mark D Sprenkle; Pamela Jo Johnson
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-11
Journal Detail:
Title:  Blood pressure monitoring     Volume:  -     ISSN:  1473-5725     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9606438     Medline TA:  Blood Press Monit     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
aAbbott Northwestern Hospital, Allina Hospitals and Clinics bSpecialtyCare, Abbott Northwestern Hospital cHennepin County Medical Center dCenter for Healthcare Innovation, Allina Hospitals and Clinics eDivision of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota, USA.
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