Modification of Dinamap 845 Automatic Blood Pressure Cuff to Permit Continuous Display of Cuff Pressure

Objectives Iatrogenic guidewire perforation is a well-known complication of lower extremity angioplasty that is often benign or can be easily treated with endovascular techniques. However, perforations that occur in arterial side branches may be more challenging to manage. If bleeding persists, open surgery and fasciotomy may be required to evacuate the resulting hematoma and prevent compartment syndrome. These subsequent procedures increase morbidity and, if the angioplasty was performed in the outpatient setting, necessitate patient transfer to a hospital. To address these challenges, we describe a non-invasive hemostasis technique involving serial sphygmomanometer cuff inflations over the affected site in a series of five patients who experienced this complication at our office. Methods We retrospectively reviewed the medical records of consecutive patients undergoing lower extremity angioplasty that were found to have an arterial guidewire perforation on completion angiogram at our outpatient center between February 2012 and February 2017. Patients found to have iatrogenic guidewire perforations were administered intravenous protamine sulfate and were transferred to the surgical recovery room. Patients received ibuprofen or acetaminophen for pain management. A blood pressure cuff was placed around the site of perforation, and patients received serial cuff inflation cycles with repeated examinations of both limbs until patients reported cessation of pain and there were no signs of a developing hematoma. Patients were observed for two hours before they were discharged home. A follow-up duplex ultrasound examination was completed within one week of the intervention. Results Over the course of five years, 536 angioplasties were performed at our outpatient office. Five of these patients experienced iatrogenic guidewire perforation (0.93%). Perforations occurred in branches of the anterior or posterior tibial artery. All of these patients were successfully managed with the aforementioned hemostasis technique. None of these patients required transfer to a hospital for further management, and no complications were reported at follow-up. Conclusions Complications of iatrogenic guidewire perforations in lower extremity arterial side branches can be safely and effectively managed by applying external compression around the affected site with an automatic blood pressure cuff.

Download Full-text

146 Could Placement of the Blood Pressure Cuff Over the Elbow Rather than the Upper Arm Increase the Accuracy of Automatic Blood Pressure Machines in the Detection of Systolic Blood Pressure?

Heart ◽

10.1136/heartjnl-2015-308066.146 ◽

2015 ◽

Vol 101 (Suppl 4) ◽

pp. A84.1-A84

Author(s):

Charlotte Pollard ◽

Umna Naveed ◽

Philip S Lewis ◽

Maureen Holland

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Blood Pressure Cuff ◽

Upper Arm ◽

Pressure Cuff ◽

Automatic Blood Pressure

Download Full-text

POSITIONING THE BLOOD PRESSURE CUFF

Nursing ◽

10.1097/00152193-197610000-00005 ◽

1976 ◽

Vol 6 (10) ◽

pp. 18-29

Author(s):

Rebecca Sills ◽

Carolyn M. Jarvis

Keyword(s):

Blood Pressure ◽

Blood Pressure Cuff ◽

Pressure Cuff

Download Full-text

Sensor Fused Blood Pressure Measuring Device Capable of Recording Korotkoff Sounds in Inflationary Curves

2021 Design of Medical Devices Conference ◽

10.1115/dmd2021-1020 ◽

2020 ◽

Author(s):

Enrique Alvarez Vazquez ◽

Daniel Ewert ◽

Dave Jorgenson ◽

Michael Sand

Keyword(s):

Blood Pressure ◽

Cuff Pressure ◽

High Sensitivity ◽

Skin Surface ◽

Pressure System ◽

Measuring Device ◽

Arterial Blood ◽

Pressure Cuff ◽

System 2 ◽

Control Electronics

Abstract This study describes a non-invasive medical device capable of measuring arterial blood pressure (BP) with a combination of inflationary and deflationary procedures. The device uses the pressure cuff pressure signal, arterial skin-surface acoustics, and photoplethysmography (PPG) to make a sensor-fusion estimation of blood pressure readings. We developed an apparatus composed of 1) a modified off-the-shelf oscillometric blood pressure system, 2) a contact microphone with an amplifier, 3) and high-sensitivity pulse oximeter, and its control electronics.

Download Full-text

BLOOD PRESSURE CUFF

Anesthesiology ◽

10.1097/00000542-196209000-00054 ◽

1962 ◽

Vol 23 (5) ◽

pp. 728-728

Keyword(s):

Blood Pressure ◽

Blood Pressure Cuff ◽

Pressure Cuff

Download Full-text

Incidence of Fractures From Perioperative Blood Pressure Cuff Use, Tourniquet Use, and Patient Positioning in Osteogenesis Imperfecta

Journal of Pediatric Orthopaedics ◽

10.1097/bpo.0000000000001105 ◽

2019 ◽

Vol 39 (1) ◽

pp. e68-e70 ◽

Cited By ~ 3

Author(s):

Brian T. Sullivan ◽

Adam Margalit ◽

Vaibhav S. Garg ◽

Dolores B. Njoku ◽

Paul D. Sponseller

Keyword(s):

Blood Pressure ◽

Osteogenesis Imperfecta ◽

Patient Positioning ◽

Blood Pressure Cuff ◽

Pressure Cuff

Download Full-text

Abstract P129: Role of the Autonomic Nervous System in Remote Postconditioning in Humans

Circulation ◽

10.1161/circ.118.suppl_18.s_1473-a ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Rupert P Williams ◽

Michael I Okorie ◽

Harminder Gill ◽

John E Deanfield ◽

Raymond J MacAllister ◽

...

Keyword(s):

Blood Pressure ◽

Nervous System ◽

Autonomic Nervous System ◽

Whole Body ◽

Limb Ischaemia ◽

Protective Effects ◽

Blood Pressure Cuff ◽

Autonomic Nervous ◽

Pressure Cuff ◽

Remote Postconditioning

Brief periods of ischaemia activate systemic mechanisms that induce whole-body tolerance to subsequent prolonged and injurious ischaemia. This phenomenon, remote ischaemic preconditioning (RIPC), is sufficiently acute to reduce ischaemia-reperfusion (IR) injury even when applied simultaneously with injurious ischaemia. This aspect of RIPC is termed remote postconditioning (RPostC). We have previously demonstrated a role for the autonomic nervous system in RIPC. Using an in vivo model of endothelial IR injury, we determined if RPostC is dependent on adrenergic autonomic mechanisms. Vascular ultrasound was used to assess endothelial function in healthy volunteers by measuring dilatation of the brachial artery in response to increased blood flow during reactive hyperaemia (flow-mediated dilatation; FMD). Endothelial IR injury was induced by 20 min of upper limb ischaemia (inflation of a blood pressure cuff to 200 mm Hg) followed by reperfusion. RPostC was induced by applying 2 cycles of 5 minutes ischaemia and 5 minutes reperfusion on the leg during arm ischaemia (via a second blood pressure cuff). In order to determine the dependence of RPostC on autonomic activation, we administered the alpha adrenoceptor blocker phentolamine (0.2– 0.7mg/min, intravenously) during the application of the RPostC stimulus. FMD was determined before ischaemia and at 20 minutes of reperfusion. FMD (percentage change from baseline diameter) was compared statistically by ANOVA. IR alone caused a significant reduction in FMD (5.9±0.7% pre- versus 2.2±0.4% post-IR, n=9, P<0.001). This reduction was prevented by RPostC (5.8±0.4% pre- versus 5.4±0.3% post-IR, n=8, P>0.05). Systemic phentolamine blocked the protective effects of RPostC (FMD 6.1±0.5% pre- versus 2.0±0.3% post-IR, n=7, P<0.001). These data indicate, for the first time in humans, that protection from RPostC depends on preservation of adrenergic signalling. Alpha blockade neutralises one of the endogenous mechanisms of ischemic protection in humans; the clinical consequences of this remain to be determined.

Download Full-text