scholarly journals Noninvasive Techniques for Blood Pressure Measurement Are Not a Reliable Alternative to Direct Measurement: A Randomized Crossover Trial in ICU

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Sara Ribezzo ◽  
Eleonora Spina ◽  
Stefano Di Bartolomeo ◽  
Gianfranco Sanson
Keyword(s):  
Blood Pressure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Crossover Trial ◽  
Blood Pressure Measurement ◽  
Monitoring Methods ◽  
Noninvasive Blood Pressure ◽  
Noninvasive Techniques ◽  
Randomized Crossover Trial ◽  
Direct Measurements

Introduction.Noninvasive blood pressure (NIBP) monitoring methods are widely used in critically ill patients despite poor evidence of their accuracy. The erroneous interpretations of blood pressure (BP) may lead to clinical errors.Objectives.To test the accuracy and reliability of aneroid (ABP) and oscillometric (OBP) devices compared to the invasive BP (IBP) monitoring in an ICU population.Materials and Methods.Fifty adult patients (200 comparisons) were included in a randomized crossover trial. BP was recorded simultaneously by IBP and either by ABP or by OBP, taking IBP as gold standard.Results.Compared with ABP, IBP systolic values were significantly higher (mean difference ± standard deviation9.74±13.8;P<0.0001). Both diastolic (-5.13±7.1;P<0.0001) and mean (-2.14±7.1;P=0.0033) IBP were instead lower. Compared with OBP, systolic (10.80±14.9;P<0.0001) and mean (5.36±7.1;P<0.0001) IBP were higher, while diastolic IBP (-3.62±6.0;P<0.0001) was lower. Bland-Altman plots showed wide limits of agreement in both NIBP-IBP comparisons.Conclusions.BP measurements with different devices produced significantly different results. Since in critically ill patients the importance of BP readings is often crucial, noninvasive techniques cannot be regarded as reliable alternatives to direct measurements.

Factors influencing the accuracy of oscillometric blood pressure measurement in critically ill patients

2003 ◽  
Vol 31 (3) ◽  
pp. 793-799 ◽  
Author(s):  
Andreas Bur ◽  
Harald Herkner ◽  
Marianne Vlcek ◽  
Christian Woisetschläger ◽  
Ulla Derhaschnig ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
Factors Influencing ◽  
Oscillometric Blood Pressure Measurement

Accuracy and reliability of noninvasive continuous finger blood pressure measurement in critically ill patients

1996 ◽  
Vol 24 (10) ◽  
pp. 1684-1689 ◽  
Author(s):  
Michael M. Hirschl ◽  
Michael Binder ◽  
Harald Herkner ◽  
Andreas Bur ◽  
Michael Brunner ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
Finger Blood Pressure

scholarly journals Automated versus manual blood pressure measurement: A randomized crossover trial

2008 ◽  
Vol 14 (4) ◽  
pp. 296-302 ◽  
Author(s):  
Megan Heinemann ◽  
Ken Sellick ◽  
Claire Rickard ◽  
Pam Reynolds ◽  
Matthew McGrail
Keyword(s):  
Blood Pressure ◽  
Pressure Measurement ◽  
Crossover Trial ◽  
Blood Pressure Measurement ◽  
Randomized Crossover Trial ◽  
Manual Blood Pressure

scholarly journals Report of the first AKI Round Table meeting: an initiative of the ESICM AKI Section

2019 ◽  
Vol 7 (1) ◽  
Author(s):  
M. Ostermann ◽  
A. Schneider ◽  
T. Rimmele ◽  
I. Bobek ◽  
M. van Dam ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Critical Care ◽  
Intensive Care ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Future Research ◽  
Knowledge Gaps ◽  
Blood Pressure Targets

Abstract Purpose Critical Care Nephrology is an emerging sub-specialty of Critical Care. Despite increasing awareness about the serious impact of acute kidney injury (AKI) and renal replacement therapy (RRT), important knowledge gaps persist. This report represents a summary of a 1-day meeting of the AKI section of the European Society of Intensive Care Medicine (ESICM) identifying priorities for future AKI research. Methods International Members of the AKI section of the ESICM were selected and allocated to one of three subgroups: “AKI diagnosis and evaluation”, “Medical management of AKI” and “Renal Replacement Therapy for AKI.” Using a modified Delphi methodology, each group identified knowledge gaps and developed potential proposals for future collaborative research. Results The following key research projects were developed: Systematic reviews: (a) epidemiology of AKI with stratification by patient cohorts and diagnostic criteria; (b) role of higher blood pressure targets in patients with hypertension admitted to the Intensive Care Unit, and (c) specific clearance characteristics of different modalities of continuous renal replacement therapy (CRRT). Observational studies: (a) epidemiology of critically ill patients according to AKI duration, and (b) current clinical practice of CRRT. Intervention studies:( a) Comparison of different blood pressure targets in critically ill patients with hypertension, and (b) comparison of clearance of solutes with various molecular weights between different CRRT modalities. Conclusion Consensus was reached on a future research agenda for the AKI section of the ESICM.

scholarly journals Risk factors for death among critically ill patients with acute renal failure

2006 ◽  
Vol 124 (5) ◽  
pp. 257-263 ◽  
Author(s):  
Geraldo Bezerra da Silva Júnior ◽  
Elizabeth De Francesco Daher ◽  
Rosa Maria Salani Mota ◽  
Francisco Albano Menezes
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Mechanical Ventilation ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Intensive Care ◽  
Liver Failure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Urine Volume

CONTEXT AND OBJECTIVE: Acute renal failure is a common medical problem, with a high mortality rate. The aim of this work was to investigate the risk factors for death among critically ill patients with acute renal failure. DESIGN AND SETTING: Retrospective cohort at the intensive care unit of Hospital Universitário Walter Cantídio, Fortaleza. METHODS: Survivors and non-survivors were compared. Univariate and multivariate analyses were performed to establish risk factors for death. RESULTS: Acute renal failure occurred in 128 patients (33.5%), with mean age of 49 ± 20 years (79 males; 62%). Death occurred in 80 (62.5%). The risk factors most frequently associated with death were hypotension, sepsis, nephrotoxic drug use, respiratory insufficiency, liver failure, hypovolemia, septic shock, multiple organ dysfunction, need for vasoactive drugs, need for mechanical ventilation, oliguria, hypoalbuminemia, metabolic acidosis and anemia. There were negative correlations between death and: prothrombin time, hematocrit, hemoglobin, systolic blood pressure, diastolic blood pressure, arterial pH, arterial bicarbonate and urine volume. From multivariate analysis, the independent risk factors for death were: need for mechanical ventilation (OR = 3.15; p = 0.03), hypotension (OR = 3.48; p = 0.02), liver failure (OR = 5.37; p = 0.02), low arterial bicarbonate (OR = 0.85; p = 0.005), oliguria (OR = 3.36; p = 0.009), vasopressor use (OR = 4.83; p = 0.004) and sepsis (OR = 6.14; p = 0.003). CONCLUSIONS: There are significant risk factors for death among patients with acute renal failure in intensive care units, which need to be identified at an early stage for early treatment.

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