Critical care nurses' knowledge of arterial pressure monitoring

BACKGROUND: Direct monitoring of arterial blood pressure provides continuous, real-time information about patients' physiological status. Critical care nurses set up and maintain monitoring systems and use the obtained data to guide clinical decisions. Inaccurate measurements may lead to misdiagnosis and mismanagement. PURPOSE: To describe critical care nurses' knowledge in 3 content areas related to direct monitoring of arterial blood pressure: physiology, technical aspects, and waveform and data interpretation. METHODS: Via poster advertisements, 391 critical care nurses in 6 intensive care units at 2 hospitals were invited to complete an 18-item, criterion-referenced questionnaire on monitoring arterial blood pressure and a demographic data sheet. Summary statistics were used to analyze data from 68 subjects. Analysis of variance was used to determine if total and subset scores differed among demographic subgroups. RESULTS: Scores ranged from 11.1% to 61.1% correct answers, with a mean of 36.7% (SD, 11.8%). Item analysis indicated a knowledge deficit in all content areas at all cognitive levels. Questions with highest scores addressed waveform damping and using mean arterial pressure to guide treatment; lowest scores were related to dynamic response characteristics and reflected pressure waves. Mean scores did not differ among demographic subgroups. CONCLUSIONS: The results suggest a general knowledge deficit in arterial blood pressure monitoring. This study should be replicated on a larger scale to validate its findings and to improve the validity and reliability of the research tool. National research-based standards of practice for hemodynamic monitoring should be developed and disseminated among critical care nurses.

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Plasticity in breathing and arterial blood pressure following acute intermittent hypercapnic hypoxia in infant rat pups with a partial loss of 5-HT neurons

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.00241.2015 ◽

2015 ◽

Vol 309 (10) ◽

pp. R1273-R1284 ◽

Cited By ~ 3

Author(s):

Jennifer Magnusson ◽

Kevin J. Cummings

Keyword(s):

Blood Pressure ◽

Mean Arterial Pressure ◽

Arterial Pressure ◽

Arterial Blood Pressure ◽

Cardiovascular Responses ◽

Partial Loss ◽

Rat Pups ◽

Arterial Blood ◽

Hypercapnic Hypoxia ◽

Long Term Facilitation

The role of serotonin (5-HT) neurons in cardiovascular responses to acute intermittent hypoxia (AIH) has not been studied in the neonatal period. We hypothesized that a partial loss of 5-HT neurons would reduce arterial blood pressure (BP) at rest, increase the fall in BP during hypoxia, and reduce the long-term facilitation of breathing (vLTF) and BP following AIH. We exposed 2-wk-old, 5,7-dihydroxytryptamine-treated and controls to AIH (10% O2; n = 13 control, 14 treated), acute intermittent hypercapnia (5% CO2; n = 12 and 11), or acute intermittent hypercapnic hypoxia (AIHH; 10% O2, 5% CO2; n = 15 and 17). We gave five 5-min challenges of AIH and acute intermittent hypercapnia, and twenty ∼20-s challenges of AIHH to mimic sleep apnea. Systolic BP (sBP), diastolic BP, mean arterial pressure, heart rate (HR), ventilation (V̇e), and metabolic rate (V̇o2) were continuously monitored. 5,7-Dihydroxytryptamine induced an ∼35% loss of 5-HT neurons from the medullary raphe. Compared with controls, pups deficient in 5-HT neurons had reduced resting sBP (∼6 mmHg), mean arterial pressure (∼5 mmHg), and HR (56 beats/min), and experienced a reduced drop in BP during hypoxia. AIHH induced vLTF in both groups, reflected in increased V̇e and V̇e/V̇o2, and decreased arterial Pco2. The sBP of pups deficient in 5-HT neurons, but not controls, was increased 1 h following AIHH. Our data suggest that a relatively small loss of 5-HT neurons compromises resting BP and HR, but has no influence on ventilatory plasticity induced by AIHH. AIHH may be useful for reversing cardiorespiratory defects related to partial 5-HT system dysfunction.

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GRANGER CAUSALITY ANALYSIS BETWEEN INTRA-OSSEOUS PRESSURE AND ARTERIAL BLOOD PRESSURE IN AFRICAN GREY PARROTS (PSITTACUS ERITHACUS)

Taiwan Veterinary Journal ◽

10.1142/s1682648521500049 ◽

2021 ◽

pp. 1-8

Author(s):

Yi-Tse Hsiao ◽

Yun-Wen Peng ◽

Pin Huan Yu

Keyword(s):

Blood Pressure ◽

Arterial Pressure ◽

Granger Causality ◽

Arterial Blood Pressure ◽

Pressure Measurement ◽

Direct Method ◽

Blood Pressure Measurement ◽

Rational Approach ◽

Arterial Blood ◽

The Relationship

Monitoring blood pressure helps a clinical veterinarian assess various conditions in birds. Blood pressure is not only a bio-indicator of renal or cardiovascular disease but is also a vital indicator for anesthesia. Anesthetic- and sedation-related mortality is higher in birds than dogs or cats. The traditional method of blood pressure measurement in mammals mainly relies on indirect methods. However, indirect blood pressure measurement is not reliable in birds, making the direct method the only gold standard. Although an arterial catheter can provide continuous real-time arterial pressure in birds, the method requires technical skill and is limited by bird size, and is thus not practical in birds with circulatory collapse. Intra-osseous (IO) blood pressure is potentially related to arterial pressure and may be a much easier and safer technique that is less limited by animal size. However, the relationship between IO pressure and arterial blood pressure has not been established. This study used mathematical methods to determine the relationship between IO pressure and arterial blood pressure. The Granger causality (G.C.) theory was applied in the study and used to analyze which pressure signal was leading the other. Our findings suggest that IO pressure is G.C. by arterial blood pressure; thus, the use of IO pressure measurements as an alternative to arterial blood pressure measurement is a rational approach.

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A Simple Non-physiological Artifact Filter for Invasive Arterial Blood Pressure Monitoring: a Study of 1852 Trauma ICU Patients

2006 International Conference of the IEEE Engineering in Medicine and Biology Society ◽

10.1109/iembs.2006.4397677 ◽

2006 ◽

Author(s):

Hanqing Cao ◽

Patrick Norris ◽

Asli Ozdas ◽

Judy Jenkins ◽

John A. Morris

Keyword(s):

Blood Pressure ◽

Arterial Blood Pressure ◽

Blood Pressure Monitoring ◽

Pressure Monitoring ◽

Icu Patients ◽

Arterial Blood

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Increases in intramuscular pressure raise arterial blood pressure during dynamic exercise

Journal of Applied Physiology ◽

10.1152/jappl.2001.91.5.2351 ◽

2001 ◽

Vol 91 (5) ◽

pp. 2351-2358 ◽

Cited By ~ 33

Author(s):

K. M. Gallagher ◽

P. J. Fadel ◽

S. A. Smith ◽

K. H. Norton ◽

R. G. Querry ◽

...

Keyword(s):

Blood Pressure ◽

Mean Arterial Pressure ◽

Arterial Pressure ◽

Arterial Blood Pressure ◽

Dynamic Exercise ◽

Positive Pressure ◽

Intramuscular Pressure ◽

Arterial Blood ◽

Exercise In Humans ◽

Cuff Occlusion

This investigation was designed to determine the role of intramuscular pressure-sensitive mechanoreceptors and chemically sensitive metaboreceptors in affecting the blood pressure response to dynamic exercise in humans. Sixteen subjects performed incremental (20 W/min) cycle exercise to fatigue under four conditions: control, exercise with thigh cuff occlusion of 90 Torr (Cuff occlusion), exercise with lower body positive pressure (LBPP) of 45 Torr, and a combination of thigh cuff occlusion and LBPP (combination). Indexes of central command (heart rate, oxygen uptake, ratings of perceived exertion, and electromyographic activity), cardiac output, stroke volume, and total peripheral resistance were not significantly different between the four conditions. Mechanical stimulation during LBPP and combination conditions resulted in significant elevations in intramuscular pressure and mean arterial pressure from control at rest and throughout the incremental exercise protocol ( P < 0.05). Conversely, there existed no significant changes in mean arterial pressure when the metaboreflex was stimulated by cuff occlusion. These findings suggest that under normal conditions the mechanoreflex is tonically active and is the primary mediator of exercise pressor reflex-induced alterations in arterial blood pressure during submaximal dynamic exercise in humans.

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