A Comparison of Non-Invasive Blood Pressure Measurement Strategies with Intra-Arterial Measurement

2020 ◽  
Vol 35 (5) ◽  
pp. 516-523
Author(s):  
Matthew R. Rebesco ◽  
M. Cornelia Pinkston ◽  
Nicholas A. Smyrnios ◽  
Stacy N. Weisberg
Keyword(s):  
Blood Pressure ◽  
Study Objective ◽  
Invasive Blood Pressure ◽  
Non Invasive ◽  
Arterial Blood ◽  
Vasoactive Medication ◽  
Significant Difference ◽  
Clinically Significant ◽  
Measurement Strategies ◽  
Dependent Samples

AbstractIntroduction:It is difficult to obtain an accurate blood pressure (BP) measurement, especially in the prehospital environment. It is not known fully how various BP measurement techniques differ from one another.Study Objective:The study hypothesized that there are differences in the accuracy of various non-invasive blood pressure (NIBP) measurement strategies as compared to the gold standard of intra-arterial (IA) measurement.Methods:The study enrolled adult intensive care unit (ICU) patients with radial IA catheters placed to measure radial intra-arterial blood pressure (RIBP) as a part of their standard care at a large, urban, tertiary-care Level I trauma center. Systolic blood pressure (SBP) was taken by three different NIBP techniques (oscillometric, auscultated, and palpated) and compared to RIBP measurements. Data were analyzed using the paired t-test with dependent samples to detect differences between RIBP measurements and each NIBP method. The primary outcome was the difference in RIBP and NIBP measurement. There was also a predetermined subgroup analysis based on gender, body mass index (BMI), primary diagnosis requiring IA line placement, and current vasoactive medication use.Results:Forty-four patients were enrolled to detect a predetermined clinically significant difference of 5mmHg in SBP. The patient population was 63.6% male and 36.4% female with an average age of 58.4 years old. The most common primary diagnoses were septic shock (47.7%), stroke (13.6%), and increased intracranial pressure (ICP; 13.6%). Most patients were receiving some form of sedation (63.4%), while 50.0% were receiving vasopressor medication and 31.8% were receiving anti-hypertensive medication. When compared to RIBP values, only the palpated SBP values had a clinically significant difference (9.88mmHg less than RIBP; P < .001). When compared to RIBP, the oscillometric and auscultated SBP readings showed statistically but not clinically significant lower values. The palpated method also showed a clinically significant lower SBP reading than the oscillometric method (5.48mmHg; P < .001) and the auscultated method (5.06mmHg; P < .001). There was no significant difference between the oscillometric and auscultated methods (0.42mmHg; P = .73).Conclusion:Overall, NIBPs significantly under-estimated RIBP measurements. Palpated BP measurements were consistently lower than RIBP, which was statistically and clinically significant. These results raise concern about the accuracy of palpated BP and its pervasive use in prehospital care. The data also suggested that auscultated and oscillometric BP may provide similar measurements.

scholarly journals Comparison of Doppler ultrasonic and oscillometric devices (with or without proprietary optimisations) for non-invasive blood pressure measurement in conscious cats

2020 ◽  
pp. 1098612X2093240
Author(s):  
Petra Cerna ◽  
Panos E Archontakis ◽  
Hester OK Cheuk ◽  
Danièlle A Gunn-Moore
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Measurement ◽  
Reference Intervals ◽  
Invasive Blood Pressure ◽  
Non Invasive ◽  
Arterial Blood ◽  
Oscillometric Device ◽  
Significant Difference ◽  
Systolic Arterial Blood Pressure ◽  
The Mean

Objectives This study compared Doppler and oscillometric (PetMAP+) devices (with or without proprietary optimisations) for the non-invasive measurement of blood pressure in conscious cats. Methods Twenty-three cats were enrolled; however, five were excluded as fewer than five measurements were obtained for each assessment. All measurements were obtained according to American College of Veterinary Internal Medicine consensus guidelines. Oscillometric device modes A and B were operated according to the manufacturer’s guidelines. Doppler and oscillometric devices were used alternately as the first device. Results Systolic arterial blood pressure (SAP) measurements were obtained by Doppler (SAPd) and oscillometry; the mean of each set of five values was used for statistical analysis. There was a significant difference between SAPd and SAP measurements in oscillometric modes A ( P <0.001) and B ( P <0.001). While both modes measured SAP higher than SAPd, B had a smaller bias (+15.72 mmHg) and narrower limits of agreement (LOA). There was also a significant difference between SAPd and mean arterial pressure (MAP) on oscillometric modes A ( P = 0.002) and B ( P <0.001). Both modes’ MAP readings were lower than SAPd and oscillometric A MAP was closer to SAPd (–14.94 mmHg), with a smaller bias and narrower LOA. Conclusions and relevance The findings support that Doppler and oscillometric devices cannot be used interchangeably, with or without proprietary optimisations. Methodology should always be taken into account and reference intervals (RIs) need to be defined for the different methodologies. Until methodology-specific RIs are published, definitive diagnosis of hypertension and sub-staging of patients with kidney disease according to the International Renal Interest Society guidelines remains challenging.

Abstract 237: Using the Thoracic Impedance to Predict Measures From Invasive Arterial Blood Pressure in Out-Of-Hospital Cardiac Arrest

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Andoni Elola ◽  
Elisabete Aramendi ◽  
Unai Irusta ◽  
Per-Olav Berve ◽  
Fredrik K Arnwald ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiac Arrest ◽  
Pearson Correlation ◽  
Correlation Coefficients ◽  
Invasive Blood Pressure ◽  
Pulse Detection ◽  
Non Invasive ◽  
Arterial Blood ◽  
Test Sets ◽  
Hospital Cardiac Arrest

Background: During cardiopulmonary resuscitation (CPR), pulse detection can be challenging. Invasive blood pressure measurements (IBP) can help monitoring patient hemodynamics, but arterial catheter placement is difficult. Transthoracic impedance (TI) measured between the defibrillator pads can detect circulation activity. We hypothesized that TI changes can predict the corresponding IBP, and potentially be used to non-invasively detect pulse during CPR. Materials and methods: We included 28 out of hospital cardiac arrest patients receiving CPR by the Oslo Emergency Service who had concurrent recordings of IBP (radial artery, BD, 20G, US) and TI (via defibrillator pads, LP15, Stryker, US). 5-second segments with stable and CPR artefact free signals were extracted (Figure). The circulation component of the TI signal (Figure, red line) was extracted using a Kalman smoother. Ten waveform features were computed per segment and fed into a random forest regressor to predict systolic and diastolic arterial pressures (SAP, DAP), their difference (DifAP) and area of the IBP signal (ArAP). Pearson correlation coefficients between the regression model and the IBP metrics were computed. Data were divided by patient into training/test sets to fit and evaluate the model, respectively, and the process was repeated 500 times. Results: 235 minutes (2261 segments) were extracted with median (Q1-Q3) values of 71.3(39.2-88.1) mmHg for SAP, 44.2(30.0-50.0) mmHg for DAP, 25.6(7.1-38.8) mmHg for DifAP and 63.4(17.0-85.9) mmHg*sec for ArAP. The correlation coefficients between TI-predicted and IBP-measured SAP, DAP, DifAP and ArAP were 0.62 (0.49-0.72), 0.36 (0.22-0.49), 0.69 (0.57-0.76) and 0.64 (0.50-0.73), respectively. Conclusions: Different hemodynamic phases can be observed in both TI and IBP (Figure). TI-based predictions showed good correlation with IBP measures. This could lead to new non-invasive methods to monitor different phases of circulation based on the TI.

Comparison between Invasive and Non-Invasive Blood Pressure Monitoring in High-Risk Prolonged Surgeries in a Medical College of Assam

2021 ◽  
Vol 8 (30) ◽  
pp. 2790-2796
Author(s):  
Utpal Dutta ◽  
Mahin Aboobacker B ◽  
Rituparna Bora
Keyword(s):  
Blood Pressure ◽  
High Risk ◽  
Blood Pressure Monitoring ◽  
Blood Pressure Measurement ◽  
Arterial Line ◽  
Pressure Monitoring ◽  
Invasive Blood Pressure ◽  
Non Invasive ◽  
Significant Difference ◽  
Invasive Blood Pressure Monitoring

BACKGROUND Blood pressure monitoring in intraoperative period is one of the basic parameters in haemodynamic monitoring. This guides an anaesthesiologist to maintain an optimal condition between the patient’s stress condition and the depth of anaesthesia. Blood pressure can be measured either invasively or non-invasively in patients undergoing surgery. Invasive measurement from an arterial line is the preferred method even though there may be calibration errors, movement artefacts and over or under damping. The gold standard in cases of high-risk prolonged surgery is continuous monitoring of blood pressure by means of invasive blood pressure (IBP) measurement. The purpose of this study was to compare the non-invasive and invasive blood pressure monitoring in patients undergoing high risk surgeries METHODS After getting institutional ethical committee (H) clearance, study was conducted on 40 patients undergoing high-risk prolonged surgeries. Non-invasive blood pressures (NIBP) were recorded by oscillometric method before intubation, after intubation, half an hour after intubation and one hour after intubation. Simultaneously invasive blood pressure monitoring was done by establishing radial artery line. Bland-Altman plot was used to compare the blood pressure measurement by the non-invasive and invasive method. RESULTS Systolic blood pressure readings using non-invasive blood pressure monitoring was overestimated, diastolic and mean arterial pressure (MAP) readings using noninvasive blood pressure monitoring was underestimated in all instances. In all time points non-invasive blood pressure showed a good correlation with invasive blood pressure. CONCLUSIONS The study revealed that there is statistically significant difference between noninvasive and invasive blood pressure readings. We recommend invasive blood pressure monitoring in high-risk surgeries and critically ill patients, although a large-scale study is required to arrive at a conclusion. KEYWORDS Non-invasive Blood Pressure, Invasive Blood Pressure, Bland-Altman Analysis, High Risk Surgery

STUDY THE CHANGE OF ARTERIAL BLOOD PRESSURE MEASURED BY NON-INVASIVE AND INVASIVE METHODS IN CHILDREN WITH DENGUE HEMORRHAGIC FEVER SHOCK

2011 ◽  
pp. 101-107
Author(s):  
Anh Tuan Ha ◽  
Hung Viet Phan ◽  
Huu Hoa Pham
Keyword(s):  
Blood Pressure ◽  
Intensive Care Unit ◽  
Systolic Blood Pressure ◽  
Arterial Blood Pressure ◽  
Dengue Hemorrhagic Fever ◽  
Hemorrhagic Fever ◽  
Non Invasive ◽  
Arterial Blood ◽  
Significant Difference ◽  
Level 3

Objective: To study the change of arterial blood pressure measured by non-invasive (NIBP) and invasive (PA) methods in children with Dengue Hemorrhagic fever shock. Patients and methods: included 60 patients ≤ 15 years old and hospitalized with diagnosis of Dengue Hemorrhagic fever with shock (level 3, level 4) at intensive care unit of Can tho Children's Hospital. Each patient’s arterial blood pressure will be simultaneously measured by both NIBP and PA methods. Results: At the time of shock, value of systolic blood pressure measured by the NIBP was 100.7 ± 10.8 mmHg, which was higher than the values measured by the PA was 91.7 ± 8.9 mmHg (p<0.05). Differentiating between the two methods was 9.1 ± 9.4 mmHg. At the time of shock exit, value of systolic blood pressure measured by the NIBP was 104.4 ± 10.6 mm Hg and measured by the PA was 105.5 ± 12.3 mmHg. Differentiating between the two measurements was 12.3 ± 10.3 mmHg. Conclusion: There was a statistically significant difference of blood pressure values measured by two non-invasive and invasive methods at the time of shock.

scholarly journals An Estimation Method of Continuous Non-Invasive Arterial Blood Pressure Waveform Using Photoplethysmography: A U-Net Architecture-Based Approach

Sensors ◽  
2021 ◽  
Vol 21 (5) ◽  
pp. 1867
Author(s):  
Tasbiraha Athaya ◽  
Sunwoong Choi
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Health ◽  
Estimation Method ◽  
Absolute Error ◽  
British Hypertension Society ◽  
Non Invasive ◽  
Arterial Blood ◽  
Blood Pressure Waveform ◽  
The Mean ◽  
Mimic Iii

Blood pressure (BP) monitoring has significant importance in the treatment of hypertension and different cardiovascular health diseases. As photoplethysmogram (PPG) signals can be recorded non-invasively, research has been highly conducted to measure BP using PPG recently. In this paper, we propose a U-net deep learning architecture that uses fingertip PPG signal as input to estimate arterial BP (ABP) waveform non-invasively. From this waveform, we have also measured systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP). The proposed method was evaluated on a subset of 100 subjects from two publicly available databases: MIMIC and MIMIC-III. The predicted ABP waveforms correlated highly with the reference waveforms and we have obtained an average Pearson’s correlation coefficient of 0.993. The mean absolute error is 3.68 ± 4.42 mmHg for SBP, 1.97 ± 2.92 mmHg for DBP, and 2.17 ± 3.06 mmHg for MAP which satisfy the requirements of the Association for the Advancement of Medical Instrumentation (AAMI) standard and obtain grade A according to the British Hypertension Society (BHS) standard. The results show that the proposed method is an efficient process to estimate ABP waveform directly using fingertip PPG.

scholarly journals Continuous non-invasive blood pressure during continuous repositioning by pulse transit time

2016 ◽  
Vol 3 (1) ◽  
Author(s):  
Hieyong Jeong ◽  
Kayo Yoshimoto ◽  
Tianyi Wang ◽  
Takafumi Ohno ◽  
Kenji Yamada ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Transit Time ◽  
Pulse Transit Time ◽  
Invasive Blood Pressure ◽  
Non Invasive
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