Document Detail


Results of a survey of blood pressure monitoring by intensivists in critically ill patients: a preliminary study.
MedLine Citation:
PMID:  20890190     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Maintenance of mean arterial pressure>65 mm Hg has been associated with improved clinical outcomes in many studies of critically ill patients. Current guidelines for the management of septic shock and guidelines for managing other critical illnesses suggest intra-arterial blood pressure measurement is preferred over automated oscillometric noninvasive blood pressure measurement. Despite these recommendations, anecdotal experience suggested that the use of noninvasive blood pressure measurement in our institution and others in preference to intra-arterial blood pressure measurement remained prevalent.
DESIGN: We designed an online survey and sent it by e-mail.
SETTING: Intensive care units.
PATIENTS AND SUBJECTS: A randomly selected group from the membership of the Society for Critical Care Medicine.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: Use of non-invasive and invasive blood pressure devices. Eight hundred eighty individuals received an invitation to complete the survey and 149 responded. We found that 71% (105 of 149) of intensivists estimated the correct cuff size rather than measuring arm circumference directly. In hypotensive patients, 73% of respondents (108 of 149) reported using noninvasive blood pressure measurement measurements for patient management. In patients on a vasopressor medication, 47% (70 of 149) of respondents reported using noninvasive blood pressure measurement for management.
CONCLUSIONS: The use of noninvasive blood pressure measurement measurements in critically ill patients is common despite the paucity of evidence validating its accuracy in critically ill patients. Given this widespread use, accuracy and precision validation studies comparing noninvasive blood pressure measurement with intra-arterial blood pressure measurement in critically ill patients should be performed.
Authors:
Arjun Chatterjee; Kirk DePriest; Russell Blair; David Bowton; Robert Chin
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Critical care medicine     Volume:  38     ISSN:  1530-0293     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-22     Completed Date:  2010-12-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2335-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, Section on Pulmonary, Critical Care, Allergy, and Immunologic Disease, Wake Forest University School of Medicine, Winston-Salem, NC, USA. achatter@wfubmc.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Pressure Determination / instrumentation*,  methods
Blood Pressure Monitors
Critical Care / methods
Critical Illness
Data Collection
Electronic Mail
Female
Focus Groups
Humans
Intensive Care Units*
Male
Middle Aged
Monitoring, Physiologic / methods*
Physician's Practice Patterns
Physician's Role
Questionnaires
Sensitivity and Specificity

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


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