Automated blood pressure self-measurement station compared to office blood pressure measurement for first trimester screening of pre-eclampsia

Background: Preeclampsia is a serious medical disorder affecting pregnancy. Screening in early pregnancy can identify women at risk and enable effective prophylactic treatment. Accurate blood pressure (BP) measurement is an important element of the screening algorithm. Automated self-screening, while attending the first trimester ultra sound scan, using a BP self-measurement (BPSM) station, could be a low-cost alternative to office BP measurements (OBPM) on both arms performed by clinical staff, if the measurement quality can be ensured. Objectives: The aim of this study was to compare automated BPSM using a self-measurement station on one arm, with OBPM performed by clinical staff on both arms. Primary outcome was the difference in mean arterial pressure (MAP) between the two methods and secondary outcomes were safety and practicality issues. Methods: Pregnant women attending ultrasound-examination at 12 weeks gestational age were recruited and randomized to start with having two OBPMs taken on both arms by staff, using two standard validated automatic upper arm BP devices, or self-measuring using an automated BPSM station following a crossover study design. The BPSM station consists of a validated blood pressure device, and an add-on sensor system capable of registering blood pressure values, rest-time, back-supported, legs-crossed, and ambient noise-levels respectively, and providing interactive guidance during the measurement process, for supporting the self-measurement process. Results: A total of 80 complete BP measurement sets were obtained, for a total of 240 BPSM measurements and 320 OBPM measurements. We found no significant difference between the OBPM and BPSM methods (p=0.86) for mean arterial pressure (MAP). However, erroneous measurements were observed frequently during the experiment, mainly during the first of the 3 BPSM measurements (6%), secondary during the second BPSM measurement (3%). Only one data set (1%) was excluded due to OBPM errors. Conclusion: No significant difference in MAP between the two methods was found. Means for detecting and repeating erroneous BP measurements should be implemented. Measurement errors was found in 9 % of the measurement sets which is not acceptable for clinical use. Thus, several measures have been identified in order to properly identify and recover from such measurement errors in the future.

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Perbedaan Respon Hemodinamik dengan Penambahan Blok Scalp Levobupivakain pada Operasi Kraniotomi

Jurnal Neuroanestesi Indonesia ◽

10.24244/jni.v9i1.214 ◽

2020 ◽

Vol 9 (1) ◽

pp. 8-15

Author(s):

Arya Justisia Sani ◽

Ardhana Tri Arianto ◽

Muhammad Husni Thamrin

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Mean Arterial Pressure ◽

Arterial Pressure ◽

Hemodynamic Response ◽

Anesthesia Induction ◽

Group I ◽

Significant Difference ◽

Scalp Block ◽

One Way Anova

Latar Belakang dan Tujuan: Peningkatan respon hemodinamik yang disebabkan oleh nyeri dapat menyebabkan peningkatan aliran darah otak dan tekanan intrakranial. Blok scalp pada kraniotomi menumpulkan respon hemodinamik karena rangsangan nyeri serta mengurangi penambahan analgesi lain. Penelitian ini bertujuan untuk mengetahui efektifitas blok scalp sebagai analgetik pada kraniotomi.Subjek dan Metode: Penelitian ini menggunakan uji klinik acak tersamar ganda pada 36 pasien dengan status fisik ASA 1–3 dilakukan operasi kraniotomi eksisi dan memenuhi kriteria inklusi. Sampel dibagi menjadi kelompok I (dengan blok scalp) dan kelompok II (tanpa blok scalp). Blok dilakukan sesaat setelah induksi anestesi. Digunakan levobupivakain 0,375% sebanyak 3 ml tiap insersi, pada masing-masing saraf. Tekanan darah, tekanan arteri rata-rata, detak jantung sebelum intubasi dan setelah intubasi, pemasangan pin, insisi kulit dan insisi duramater serta total kebutuhan fentanyl tambahan dicatat. Data yang diperoleh dianalisis dengan program komputer SPSS versi 17 lalu diuji menggunakan uji Kruskal-Wallis atau One-way ANOVA. Batas kemaknaan yang diambil adalah p < 0,05.Hasil: Selama kraniotomi, detak jantung, tekanan darah, tekanan arteri rata-rata secara signifikan lebih tinggi pada pasien tanpa blok scalp terutama pada saat pemasangan pin. Hasil uji statistik menunjukkan perbedaan signifikan, penambahan fentanyl pada pasien dengan blok scalp lebih sedikit dibandingkan tanpa blok scalp, p=0,000 (p<0,05).Simpulan: Blok scalp levobupivakain efektif dalam menurunkan respon hemodinamik terutama pada saat pemasangan pin. Pasien kraniotomi dengan blok scalp membutuhkan penambahan fentanyl lebih sedikit. Differences on Hemodynamic Response with Levobupivacaine Scalp Block in Craniotomy SurgeryAbstractBackground and Objective: Increased hemodynamic response caused by pain can lead to increased cerebral blood flow and intracranial pressure. Scalp block in craniotomy blunts hemodynamic response due to pain and reduce other analgesics addition. This study aims to determine effectiveness of scalp blocks as analgesic in craniotomy.Subject and Method: This study used a double-blind randomized clinical trial in 36 patients with physical status ASA 1-3 who underwent craniotomy and met inclusion criteria. Samples were divided into group I (with scalp block) and group II (without scalp block). Scalp Block was performed right after anesthesia induction. Using levobupivacaine 0.375% 3 ml for each insertion. Blood pressure, mean arterial pressure, heart rate before and after intubation, during pin placement, skin incision and duramater incision and total need for additional fentanyl were recorded. SPSS version 17 was used and data were analysed using Kruskal-Wallis or One-way ANOVA. Statistical significance was accepted at p < 0.05.Result: During craniotomy, heart rate, blood pressure, mean arterial pressure were significantly higher in patients without scalp block especially during pin placement. Statistical test showed significant difference, additional fentanyl in patients with scalp blocks was lesser, p = 0.000 (p <0.05). Conclusion: Levobupivacaine scalp block was effective to blunt hemodynamic response especially during pin placement. Scalp block also decreased additional fentanyl in craniotomy.

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Evaluation of the causal effects between dopamine infusion changeover and fluctuations in mean arterial pressure in neonates

Archives of Disease in Childhood ◽

10.1136/archdischild-2019-317123 ◽

2019 ◽

Vol 105 (4) ◽

pp. 390-394

Author(s):

Katherine Kirupakaran ◽

Paula de Sousa ◽

Celine Le Roux ◽

Lauren Redwood ◽

Heike Rabe ◽

...

Keyword(s):

Blood Pressure ◽

Mean Arterial Pressure ◽

Arterial Pressure ◽

Neonatal Unit ◽

Improvement Project ◽

Dopamine Infusion ◽

Dopamine Concentration ◽

Arterial Blood ◽

Significant Difference ◽

Change In Mean

ObjectiveTo evaluate whether changing dopamine infusions every 12 hours and preparing these infusions 30 min before administration reduces blood pressure fluctuations in preterm and term neonates.DesignThis was a retrospective study using data from live patients on the neonatal unit and prospective study exploring stability of infusions in a laboratory-based neonatal ward simulation.SettingSingle-centre study in a tertiary neonatal surgical unit in a university teaching hospital.PatientsNeonates who received more than one subsequent dopamine infusion and had invasive arterial blood pressure monitoring, during their admission in the neonatal unit, were included.InterventionsAs part of the Quality Improvement project, the standard operating procedure (SOP) was changed, and dopamine infusions were prepared by nursing staff and left to rest for 30 min before administering to the neonate. Additionally, infusions were replaced every 12 hours.Main outcome measuresThe percentage change in mean arterial pressure (MAP) and the percentage loss in the drug concentration during infusion during changeover.ResultsOur findings indicate that up to 15% of the initial dopamine concentration is lost after 24 hours. This results in a sharp variation in the dopamine concentration during infusion changeover that correlates with observed rapid fluctuations in MAP. In changing the SOP, no significant difference in the concentration of dopamine and MAP were observed over 12 hours.ConclusionsDelaying administration of dopamine infusions by 30 min after preparation combined with changing infusions 12 hourly has reduced MAP fluctuations. Therefore, the risks associated with MAP fluctuations, including intraventricular haemorrhages, are reduced.

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Differences in brand versus generic esmolol in the treatment of perioperative supraventricular tachycardia and hypertension: A pilot study

SAGE Open Medicine ◽

10.1177/2050312120962338 ◽

2020 ◽

Vol 8 ◽

pp. 205031212096233

Author(s):

Diamanto Aretha ◽

Panagiotis Kiekkas ◽

Nektarios Sioulas ◽

Fotini Fligou

Keyword(s):

Blood Pressure ◽

Mean Arterial Pressure ◽

Pilot Study ◽

Adverse Events ◽

Arterial Pressure ◽

Systolic Blood Pressure ◽

Diastolic Blood Pressure ◽

Supraventricular Tachycardia ◽

Brand Name ◽

Significant Difference

Background: Once a patent expires, generic analogue drugs are alternatives to brand name drugs. Because bioequivalence/biodistribution problems have been reported for many generic analogue drugs, we prospectively evaluated 31 patients to reveal the differences in the doses used and the efficacy and adverse events of two different intravenous esmolol formulations. Methods: This was a prospective observational pilot study. Our aim was to reveal the possible differences in the required doses between two different formulations (brand name drug vs generic analogue drug) of intravenous esmolol in beats per minute, systolic blood pressure, diastolic blood pressure and mean arterial pressure in intra- and postoperative patients with supraventricular tachycardia and hypertension. The patients were categorised into two groups according to the medication they received (brand name drug or generic analogue drug). Results: Esmolol was given to 31 patients (16 generic analogue drug and 15 brand name drug). Although there was a statistically significant difference in bolus (mg/kg) and continued (mg/kg/h) drug dose used (brand name drug/generic analogue drug, mean (standard deviation), 0.3 (0.1) vs 0.38 (0.1), p = 0.03 for bolus dose, and 0.22 (0.09) vs 0.29 (0.08) for continued dose at 10 min (p = 0.03), 0.19 (0.06) vs 0.24 (0.05) at 20 min (p = 0.01) and 0.14 (0.05) vs 0.18 (0.05) at 30 min (p = 0.02)), there were no time-related statistical significant differences in the reduction rates of the two drugs (p = 0.47). There were no time-related statistically significant differences between the two groups in systolic blood pressure, diastolic blood pressure, mean arterial pressure and beats per minute, nor in their adverse events. Conclusion: In this pilot study, smaller doses were given for controlling the patient’s haemodynamics when a brand name drug was used. Because there were no significant time-related differences in the reduction rates of the two drugs nor in any haemodynamic differences between the two groups, optimal titration of the drug used could effectively control the patient’s haemodynamics. The adverse events were also similar in both groups.

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Relationship of anthropometric indices with rate pressure product, pulse pressure and mean arterial pressure among secondary adolescents of 12–17 years

BMC Research Notes ◽

10.1186/s13104-021-05515-w ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Godfrey Katamba ◽

Abdul Musasizi ◽

Mivule Abdul Kinene ◽

Agnes Namaganda ◽

Francis Muzaale

Keyword(s):

Blood Pressure ◽

Mean Arterial Pressure ◽

Arterial Pressure ◽

Pulse Pressure ◽

Neck Circumference ◽

Rate Pressure Product ◽

Hemodynamic Parameters ◽

Anthropometric Indices ◽

Waist Hip Ratio ◽

Significant Difference

Abstract Objectives To determine the correlation between anthropometric indices and the selected hemodynamic parameters among secondary adolescents aged 12–17 years. Results Our findings showed weak positive correlation between generally body surface area, neck circumference and conicity index with the hemodynamic parameters (systolic blood pressure, diastolic blood pressure, resting pulse rate, mean arterial pressure, rate pressure product and pulse pressure). However, the ponderosity index, body mass index and waist hip ratio showed negative weak correlations with the hemodynamic parameters. There was a significant difference in pulse pressure among the BMI categories. All parameters showed significant (p < 0.05) differences across the categories of neck circumference and waist hip ratio. Generally, in multivariate regression analysis, anthropometric indices showed significant prediction of the hemodynamic parameters.

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Comparison of hemodynamic responses along with perfusion index to tracheal intubation with Macintosh and McCoy laryngoscopes

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20181757 ◽

2018 ◽

Vol 6 (5) ◽

pp. 1673 ◽

Cited By ~ 1

Author(s):

Vineet K. Choudhary ◽

Bhawana Rastogi ◽

V. P. Singh ◽

Savita Ghalot ◽

Vijay Dabass ◽

...

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Mean Arterial Pressure ◽

Tracheal Intubation ◽

Arterial Pressure ◽

Macintosh Laryngoscope ◽

Hemodynamic Response ◽

Perfusion Index ◽

Additional Parameter ◽

Significant Difference

Background: The McCoy Laryngoscope in comparison to macintosh laryngoscope requires less force for performing laryngoscopy and as a result may alter the associated hemodynamic response. Perfusion index (PI) is a noninvasive numerical value of peripheral perfusion obtained from a pulse oximeter.Methods: A randomized prospective single blind comparative clinical study was conducted on 80 patients of ASA physical status I-II aged between 18 years to 58 years of either sex with body mass index (B.M.I) between 20 and 25 undergoing elective surgeries under general anesthesia. 80 patients were divided into 2 groups: Group A (n=40)- Tracheal Intubation with Macintosh Laryngoscope, Group B (n=40)-Tracheal Intubation with McCoy Laryngoscope. Blood Pressure (systolic blood pressure, diastolic blood pressure, and mean arterial pressure) and heart rate (HR), oxygen saturation (SpO2) via pulse oximeter were monitored.Results: The demographic profile showed no significant difference between the groups. Heart rate, systolic, diastolic and mean arterial pressure had highly significant difference in both groups. Perfusion index was statistically significant immediately post laryngoscopy and intubation till 4 mins. Immediately after laryngoscopy and intubation, the correlation between PI and MAP was statistically significant and it was a negative average to good correlation.Conclusions: The McCoy laryngoscope elicits lesser haemodynamic response to laryngoscopy and tracheal intubation as compared to Macintosh laryngoscope in normotensive patients. Perfusion index can also serve as an additional parameter to assess hemodynamic response since it has good negative correlation with the mean arterial pressure.

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Differences in mean arterial pressure of young and elderly people measured by oscilometry during inflation and deflation of the arm cuff

Biomedical Engineering / Biomedizinische Technik ◽

10.1515/bmt-2015-0098 ◽

2016 ◽

Vol 61 (6) ◽

Cited By ~ 5

Author(s):

Vratislav Fabian ◽

Jan Havlik ◽

Jan Dvorak ◽

Vaclav Kremen ◽

Pavol Sajgalik ◽

...

Keyword(s):

Blood Pressure ◽

Mean Arterial Pressure ◽

Arterial Pressure ◽

Clinical Relevance ◽

Young Group ◽

Elderly Subjects ◽

Cuff Inflation ◽

Differential Analysis ◽

Arterial Blood ◽

Significant Difference

AbstractSystemic arterial blood pressure (BP) is one of the most important parameters of the cardiovascular system. An oscillometric NIBP monitor was specifically designed to measure oscillometric pulsations and mean arterial pressure (MAP) during inflation and deflation of the cuff. Nineteen healthy young (age 23.1±1.7 years; mean±SD) and 35 elderly (83.9±7.9 years; mean±SD) subjects were studied. Differential analysis of MAP during inflation and deflation show mean |ΔMAP|=2.9±2.6 mm Hg in the young group (mean±SD) and |ΔMAP|=6.3±5.2 mm Hg for seniors (mean±SD). There was a significant difference (p<0.05) in means of |ΔMAP| measured during cuff inflation and cuff deflation between both groups. In about 50% of elderly subjects |ΔMAP| was higher than 5 mm Hg. Potential clinical relevance of the method needs to be further evaluated.

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Effect of Averrhoa bilimbi Fruit Extract on Blood Pressure and Mean Arterial Pressure of NaCl Induced Hypertensive Rats

Bangladesh Journal of Medical Science ◽

10.3329/bjms.v20i3.52806 ◽

2021 ◽

Vol 20 (3) ◽

pp. 631-636

Author(s):

Rafida M ◽

AH Safitri ◽

Nurina Tyagita

Keyword(s):

Blood Pressure ◽

Mean Arterial Pressure ◽

Arterial Pressure ◽

Diastolic Blood Pressure ◽

Medical Science ◽

Control Group ◽

Hypertensive Rats ◽

Fruit Extract ◽

Significant Difference ◽

The Mean

Objective:Averrhoa bilimbi fruit contains potassium and flavonoid expected to play a role in lowering blood pressure. This study aim to examine the effect of Averrhoa bilimbi fruit extract on blood pressure and mean arterial pressure in NaCl-induced hypertensive rats. Materials and methods: This research employs pre- and post-test randomized control group design and uses 15 rats which are divided into 3 groups. On day 6, all groups are pretreated with NaCl 8% solution to induce hypertension for 14 days. On day 20, the control, furosemide and bilimbi groups are respectively treated with distilled water, 0.72mg/200gBW furosemide, and 150mg/200gBW Averrhoa bilimbi fruit extract for 7 days. The (systolic and diastolic) blood pressure and mean arterial pressure of each group are evaluated on day 20 and 27. The results are analyzed with Repeated Anova. Results: The mean systolic and diastolic blood pressure of the control, furosemide and bilimbi group before treatment are (128.4±11.8/88.0±7.8mmHg); (142.8±13.6/85.4±16.7mmHg); and (144.8±15.1/98.0±14.9mmHg) respectively. The mean systolic and diastolic blood pressure of the control, furosemide and bilimbi group after being treated are (88.0±11.8/60.8±7.8mmHg); (98.0±13.6/71.0±16.7mmHg); and (85.4±15.1/65.0±14.9mmHg) respectively. The mean arterial pressure of the control, furosemide and bilimbi groups are (69.4±8.2mmHg); (79.6±14.8mmHg); (71.4±15.0mmHg) respectively. There is a statistically significant difference in the blood pressure and the mean arterial pressure among the groups (p=0.000). Averrhoa bilimbi fruit extract has an effect on the blood pressure and the mean arterial pressure of NaCl-induced hypertensive rats. Bangladesh Journal of Medical Science Vol.20(3) 2021 p.631-636

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A STUDY ON ANALGESIA PROVIDED BY ULTRASOUND GUIDED FASCIA ILIACA COMPARTMENT BLOCK WITH AND WITHOUT PARACETAMOL: EFFECT ON HEMODYNAMICS DURING INTUBATION

10.36106/ijar/7001247 ◽

2020 ◽

pp. 31-32

Author(s):

Preethi HN ◽

Pawan Kumar C ◽

Ravishankar BM

Keyword(s):

Blood Pressure ◽

Mean Arterial Pressure ◽

Arterial Pressure ◽

Spinal Anaesthesia ◽

Ultrasound Guided ◽

Ringer Lactate ◽

Fracture Femur ◽

Significant Difference ◽

Lactate Infusion ◽

Fascia Iliaca Compartment Block

Introduction: Paracetamol acts by the inhibition of Cyclooxygenase (COX) mediated production of Prostaglandin unlike the non steroidal anti inflammatory agents, so it was found that tissue inflammation was not reduced. Methodology: A detailed pre-anaesthetic checkup carried out in each patient. Patient is kept nil per orally 6 hours prior to surgery, i.v line secured, pre medicated with Inj Ranitidine 50mg iv, Inj Ondansetron 4mg iv and IVF Ringer Lactate infusion at 100ml/hr 3 hours prior to surgery. Results: Among the patients undergoing spinal anaesthesia in fracture femur surgery, there was no statistically significant difference in Blood pressure, Mean arterial pressure (MAP) between the groups. Conclusion: Among the patients undergoing spinal anaesthesia in fracture femur surgery, there was no statistically significant difference in Oxygen saturation (SpO2) between the groups

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Use of Gabapentin, Esmolol or Their Combination to Attenuate Haemodynamic Response to Laryngoscopy and Intubation

Kathmandu University Medical Journal ◽

10.3126/kumj.v9i4.6336 ◽

2012 ◽

Vol 9 (4) ◽

pp. 238-243 ◽

Cited By ~ 1

Author(s):

G S Shrestha ◽

M N Marhatta ◽

R Amatya

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Mean Arterial Pressure ◽

Arterial Pressure ◽

Systolic Blood Pressure ◽

Normal Saline ◽

Study Drug ◽

Haemodynamic Response ◽

Rate Pressure Product ◽

Significant Difference

Background Laryngoscopy and intubation increases blood pressure and heart rate. Objective The study aims to investigate the effect and safety of gabapentin, esmolol or their combination on the haemodynamic response to laryngoscopy and intubation. Methods A total of 72 patients undergoing elective surgery were randomly allocated to one of the four groups. First study drug was administered orally as gabapentin 1200mg or placebo. Second study drug was administered intravenously as esmolol 1.5mg/kg or normal saline. Heart rate, rate pressure product, systolic blood pressure and mean arterial pressure were recorded at baseline and at zero, one, three and five minutes after tracheal intubation. Results Baseline values were compared with the values at various time intervals within the same group. In group PE (placebo, esmolol), there was significant decrease in heart rate and rate pressure product at five minutes. In group GN (gabapentin, normal saline), there was significant decrease in systolic blood pressure and mean arterial pressure at five minutes. In group GE (gabapentin, esmolol), there was significant decrease in heart rate at zero, three and five minutes. Systolic blood pressure, mean arterial pressure and rate pressure product was significantly lower at three and five minutes. In group PN (placebo, normal saline), there was significant increase in heart rate at zero, one, three and five minutes; systolic blood pressure at zero and one minutes; mean arterial pressure at zero and one minutes & rate pressure product at zero, one and three minutes. In group GN (gabapentin, normal saline), there was significant increase in heart rate at zero, one and three minutes & rate pressure product at zero, one and three minutes. In group PE (placebo, esmolol), there was significant increase in systolic blood pressure at zero and one minutes & mean arterial pressure at zero and one minutes. However, in group GE (gabapentin, esmolol) none of the variables showed statistically significant increase at any time. Inter-group comparison was made for each time point. At zero minute, there was significant difference in heart rate between groups PN and GE, GN and PE & GN and GE Significant difference was also noted in rate pressure product between PN and GE at zero minute. At one minute there was difference in heart rate between PN and PE, PN and GE, GN and PE & between GN and GE. Significant difference was observed in rate pressure product between PN and PE & between PN and GE at one minute. No significant side effects of the study drugs were observed. ConclusionsCombination of gabapentin and esmolol in this study design is safe and better attenuates both the pressor and tachycardic response to laryngoscopy and intubation, than either agent alone.DOI: http://dx.doi.org/10.3126/kumj.v9i4.6336 Kathmandu Univ Med J 2011;9(4):238-43

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Relationship of Anthropometric Indices with Rate Pressure Product, Pulse Pressure and Mean Arterial Pressure Among Secondary Adolescents of 12-17 Years

10.21203/rs.3.rs-117233/v1 ◽

2020 ◽

Author(s):

Godfrey Katamba ◽

Abdul Musasizi ◽

Mivule Abdul Kinene ◽

Agnes Namaganda ◽

Francis Muzaale

Keyword(s):

Blood Pressure ◽

Mean Arterial Pressure ◽

Arterial Pressure ◽

Pulse Pressure ◽

Neck Circumference ◽

Rate Pressure Product ◽

Hemodynamic Parameters ◽

Anthropometric Indices ◽

Waist Hip Ratio ◽

Significant Difference

Abstract Objectives: To determine the correlation between anthropometric indices and the selected hemodynamic parameters among secondary adolescents aged 12-17 years.Results: Our findings showed weak positive correlation between generally body surface area, neck circumference and conicity index with the hemodynamic parameters (systolic blood pressure, diastolic blood pressure, resting pulse rate, mean arterial pressure, rate pressure product and pulse pressure). However, the ponderosity index, body mass index and waist hip ratio showed negative weak correlations with the hemodynamic parameters. There was a significant difference in pulse pressure among the BMI categories. All parameters showed significant (p<0.05) differences across the categories of neck circumference and waist hip ratio. Generally, in multivariate regression analysis, anthropometric indices showed significant prediction of the hemodynamic parameters.

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