Clinical Comparison of Automatic, Noninvasive Measurements of Blood Pressure in the Forearm and Upper Arm

2005 ◽  
Vol 14 (3) ◽  
pp. 232-241 ◽  
Author(s):  
Kathleen Schell ◽  
Elisabeth Bradley ◽  
Linda Bucher ◽  
Maureen Seckel ◽  
Denise Lyons ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Pressure ◽  
Vital Signs ◽  
Stable Condition ◽  
Correlation Coefficients ◽  
Upper Arm ◽  
Mean Values ◽  
Noninvasive Measurements ◽  
Measure Blood Pressure ◽  
Pressure Cuff

• Background When the upper arm (area from shoulder to elbow) is inaccessible and/or a standard-sized blood pressure cuff does not fit, some healthcare workers use the forearm to measure blood pressure. • Objective To compare automatic noninvasive measurements of blood pressure in the upper arm and forearm. • Methods A descriptive, correlational comparison study was conducted in the emergency department of a 1071-bed teaching hospital. Subjects were 204 English-speaking patients 6 to 91 years old in medically stable condition who had entered the department on foot or by wheelchair and who had no exclusions to using their left upper extremity. A Welch Allyn Vital Signs 420 series monitor was used to measure blood pressure in the left upper arm and forearm with the subject seated and the upper arm or forearm at heart level. • Results Pearson r correlation coefficients between measurements in the upper arm and forearm were 0.88 for systolic blood pressure and 0.76 for diastolic blood pressure (P < .001 for both). Mean systolic pressures, but not mean diastolic pressures, in the upper arm and forearm differed significantly (t = 2.07, P = .04). A Bland-Altman analysis indicated that the distances between the mean values and the limits of agreement for the 2 sites ranged from 15 mm Hg (mean arterial pressure) to 18.4 mm Hg (systolic pressure). • Conclusions Despite strict attention to correct cuff size and placement of the upper arm or forearm at heart level, measurements of blood pressure obtained noninvasively in the arm and forearm of seated patients in stable condition are not interchangeable.

Clinical Comparison of Automatic, Noninvasive Measurements of Blood Pressure in the Forearm and Upper Arm With the Patient Supine or With the Head of the Bed Raised 45°: A Follow-Up Study

2006 ◽  
Vol 15 (2) ◽  
pp. 196-205 ◽  
Author(s):  
Kathleen Schell ◽  
Denise Lyons ◽  
Elisabeth Bradley ◽  
Linda Bucher ◽  
Maureen Seckel ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Vital Signs ◽  
Upper Arm ◽  
Mean Values ◽  
Noninvasive Measurements ◽  
Starting Position ◽  
Arm Circumference ◽  
Blood Pressures ◽  
Cuff Size

• Background Noninvasive measurement of blood pressure in the forearm is used when the upper arm is inaccessible and/or when available blood pressure cuffs do not fit a patient’s arm. Evidence supporting this practice is limited. • Objective To compare noninvasive measurements of blood pressure in the forearm and upper arm of medical-surgical inpatients positioned supine and with the head of the bed raised 45°. • Methods Cuff size was selected on the basis of forearm and upper arm circumference and manufacturers’ recommendations. With a Welch Allyn Vital Signs 420 Series monitor, blood pressures were measured in the forearm and then in the upper arm of 221 supine patients with their arms resting at their sides. Patients were repositioned with the head of the bed elevated 45° and after 2 minutes, blood pressures were measured in the upper arm and then the forearm. Starting position was alternated on subsequent subjects. • ResultsPaired t tests revealed significant differences between systolic and diastolic blood pressures measured in the upper arm and forearm with patients supine and with the head of the bed elevated 45°. The Bland-Altman procedure revealed that the distances between the mean values and the limits of agreement were from 15 to 33 mm Hg for individual subjects. • Conclusions Noninvasive measurements of blood pressure in the forearm and upper arm cannot be interchanged in medical-surgical patients who are supine or in patients with the head of the bed elevated 45°.

Normative Arm and Calf Blood Pressure Values in the Newborn

PEDIATRICS ◽  
1989 ◽  
Vol 83 (2) ◽  
pp. 240-243
Author(s):  
Myung K. Park ◽  
Da-Hae Lee
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mexican Americans ◽  
Newborn Infants ◽  
Coarctation Of The Aorta ◽  
Upper Arm ◽  
Mean Values ◽  
The Right ◽  
Diagnosis Of Hypertension ◽  
Mean Heart Rate

Indirect BP measurement was obtained in the right upper arm in 219 healthy newborn infants with the Dinamap monitor and was compared with values obtained from the calf to establish normative BP values and to help establish a diagnosis of hypertension and coarctation of the aorta in the newborn. There were 174 Mexican-Americans (79.5%), 33 whites (15.0%), and 12 blacks (5.5%). The width of the BP cuff was selected to be 0.4 to 0.5 times the circumference of the extremities. Three supine position readings of BPs and heart rate were obtained from each site and were averaged for statistical analyses. Mean arm BP values (±SD) of the neonate less than 36 hours of age were 62.6±6.9/38.9± 5.7 mm Hg (48.0±6.2 mm Hg). Neonates older than 36 hours had slightly but significantly (P<.05) greater values (4 to 6 mm Hg) than did infants younger than 36 hours of age. Active neonates had values 6 to 10 mm Hg greater than quiet neonates (P<.05). BP values in the calf obtained with the same-sized cuff were almost identical with those obtained from the arm. Differences in consecutively obtained arm and calf BPs (arm values minus calf values) were 1.1±7.7 mm Hg systolic, -0.01 ± 6.2 mm Hg diastolic, and 0.9 ±6.9 mm Hg mean pressures. Mean heart rate (±SD) of neonates less than 36 hours of age was 129.4± 13.2 beats per minute and that of neonates older than 36 hours of age was 139.4± 14.1 beats per minute. These results show the following: (1) arm BPs and calf BPs using the same-sized cuff are almost identical with mean values of approximately 65/ 41 mm Hg (50 mm Hg) in neonates one to three days of age, (2) arm BP of 75/49 mm Hg (59 mm Hg) or greater is in the hypertensive range, and (3) calf BPs that are less than arm BPs by mean + 1 SD (6 to 9 mm Hg) necessitate a thorough investigation for coarctation of the aorta.

scholarly journals The difference in pediatric blood pressure between middle childhood and late childhood prior to dental treatment

2018 ◽  
Vol 25 (1) ◽  
Author(s):  
Fitri Anissa Syaimima Syaiful Azim ◽  
Arlette Suzy Puspa Pertiwi ◽  
Rosiliwati Wihardja
Keyword(s):  
Blood Pressure ◽  
Middle Childhood ◽  
Dental Treatment ◽  
Systolic Pressure ◽  
The Body ◽  
Late Childhood ◽  
Test Analysis ◽  
Mean Values ◽  
Significant Difference ◽  
The Difference

Every child will go through several stages in his or her life. They are different from each other as they are in the process of development of cognition, physics, emotion, and personality. For many children, a visit to the dentist can raise their anxiety. This anxiousness will lead to stress that influences the cardiovascular function in the body. The purpose of this research was to determine the difference in pediatric blood pressure between middle childhood and late childhood prior to dental treatment. This research was a clinical trial, pure experimental study. The sample consisted of 30 children within the range of 4-12 years old where they were divided into two groups of age; middle childhood (4-7 years old) and late childhood (8-12 years old). The blood pressures were measured before any dental treatment began and the values were recorded. The data were then analyzed using the One-Sample T-Test analysis. The results of blood pressure in middle childhood and late childhood were compared to the average mean values for each age group. It showed that there was a significant difference in the systolic pressure, which was found higher in the middle childhood group compared to the late childhood. From the result can be concluded that there was a difference in the pediatric blood pressure between middle childhood and late childhood prior to dental treatment.

scholarly journals The QardioArm App in the Assessment of Blood Pressure and Heart Rate: Reliability and Validity Study (Preprint)

2017 ◽  
Author(s):  
Victoria Mazoteras Pardo ◽  
Marta E Losa Iglesias ◽  
José López Chicharro ◽  
Ricardo Becerro de Bengoa Vallejo
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
European Society ◽  
Intraclass Correlation ◽  
Reliability And Validity ◽  
Correlation Coefficients ◽  
Mobile App ◽  
Blood Pressure Monitor ◽  
Pressure Monitor ◽  
Mean Values

BACKGROUND Self-measurement of blood pressure is a priority strategy for managing blood pressure. OBJECTIVE The aim of this study was to evaluate the reliability and validity of blood pressure and heart rate following the European Society of Hypertension’s international validation protocol, as measured with the QardioArm, a fully automatic, noninvasive wireless blood pressure monitor and mobile app. METHODS A total of 100 healthy volunteers older than 25 years from the general population of Ciudad Real, Spain, participated in a test-retest validation study with two measurement sessions separated by 5 to 7 days. In each measurement session, seven systolic blood pressure, diastolic blood pressure, and heart rate assessments were taken, alternating between the two devices. The test device was the QardioArm and the previously validated criterion device was the Omron M3. Sessions took place at a single study site with an evaluation room that was maintained at an appropriate temperature and kept free from noises and distractions. RESULTS The QardioArm displayed very consistent readings both within and across sessions (intraclass correlation coefficients=0.80-0.95, standard errors of measurement=2.5-5.4). The QardioArm measurements corresponded closely to those from the criterion device (r>.96) and mean values for the two devices were nearly identical. The QardioArm easily passed all validation standards set by the European Society of Hypertension International Protocol. CONCLUSIONS The QardioArm mobile app has validity and it can be used free of major measurement error.

Blood Pressure Cuff Confusion

PEDIATRICS ◽  
1988 ◽  
Vol 81 (2) ◽  
pp. 328-329
Author(s):  
JENNIFER LOGGIE
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Control ◽  
Task Force ◽  
Pressure Control ◽  
Blood Pressure Cuff ◽  
Upper Arm ◽  
Pressure Cuff ◽  
Published Report ◽  
Transcription Error ◽  
Cuff Size

To the Editor.— Since the report of the Second Task Force on Blood Pressure Control in Children (Pediatrics 1987;79:1-25) was published, several individuals have asked me (1) why we changed the recommendation for cuff size from one that covers two thirds to one that covers three quarters of the upper arm and (2) what data formed the basis for this change in recommendations? When I reread the published report to verify cuff size recommendations, it appeared to me that somewhere along the line a transcription error had taken place.

INDIRECT ESTIMATION OF SYSTOLIC AND DIASTOLIC BLOOD PRESSURE IN THE NEWBORN

PEDIATRICS ◽  
1972 ◽  
Vol 50 (3) ◽  
pp. 387-394
Author(s):  
Colin H. M. Walker ◽  
Phillip J. West ◽  
Sanford L. Simons ◽  
Anthony R. Whytock
Keyword(s):  
Blood Pressure ◽  
Diastolic Pressure ◽  
Blood Pressure Monitoring ◽  
Systolic Pressure ◽  
Correlation Coefficients ◽  
Mean Value ◽  
Arithmetic Mean ◽  
Pressure Monitoring ◽  
Blood Pressures ◽  
The Mean

An impedance plethysmographic method for measuring systolic and diastolic blood pressures in small infants using standard electro-cardiogram recorders has been studied. The overall 95% confidence limit of the mean of five estimations was found to be ±3.74 mm Hg for the systolic and ±3.72 mm Hg for the diastolic value. Comparing this method with intra-arterial measurements gave correlation coefficients (r) of 0.95 (bias 10.09 mm Hg) for systolic pressure and 0.89 (Bias 10.09 mm Hg) for diastolic pressure. Values for the comparison with auscultation were 0.98 (bias 19.29 mm Hg) systolic and 0.86 (bias 10.17 mm Hg) diastolic, and for the comparison of the arithmetic mean value with the flush method 0.84 (bias 30.17 mm Hg). These results reveal a good correlation with the intra-arterial measurements and indicate that this technique can be used for the periodic or continuous blood pressure monitoring of infants.

Arterial audiophotoplethysmography

Phlebologie ◽  
2003 ◽  
Vol 32 (03) ◽  
pp. 68-75
Author(s):  
B. Lambotte ◽  
C. El Gammal ◽  
V. Blazek ◽  
S. El Gammal
Keyword(s):  
Blood Pressure ◽  
Systolic Pressure ◽  
Arterial Disease ◽  
Transmission Mode ◽  
Reflection Mode ◽  
Pressure Cuff ◽  
Significant Difference ◽  
Peripheral Arterial ◽  
Audio Output

SummaryBackground: Digital blood pressure is an important prognostic parameter in peripheral arterial disease. However, it is rarely determined in clinical routine because the methods available are too cumbersome. Patients and methods: Arterial audiophotoplethysmography (APPG) uses an in-built audio output. The systolic pressure corresponds to the reappearance of a pulssynchrone beep during deflation of the pressure cuff (25 mm wide on fingers and toes) after suprasystolic inflation. Measurements can be performed either in transmission or reflection mode. 50 healthy volunteers (age: 23-75 years) were examined in supine position. Blood pressure was taken at the A. brachialis, A. ulnaris, A. radialis, A. poplitea, A. tibialis anterior and posterior using ultrasound Doppler (USD), at the A. brachialis, fingers 1-5, A. poplitea and toes 1-3 using APPG. Results: Regarding the A. brachialis and poplitea, we found an excellent correlation between values obtained by USD and APPG in transmission mode (r: 0.92-0.99), the correlation with the reflection mode-values was slightly lower (r: 0.81- 0.93). The values obtained in reflection mode were significantly lower than in transmission mode (average 5.2 mmHg on the arms, 12.9 mmHg on the legs). Finger pressure was identical with A. brachialis-pressure. Toe/- brachial index was 0.81-0.86 (transmission) and 0.72- 0.78 (reflection). No significant difference was found between any of the fingers, respectively the toes. Conclusions: APPG is a reliable method for determination of digital blood pressure, which can be easily performed. Measurements in transmission mode should be preferred.

scholarly journals Assessment of patient’s anxiety and expectation associated with hemodynamic changes during surgical procedure under local anesthesia

2017 ◽  
Vol 46 (5) ◽  
pp. 299-306
Author(s):  
Marcos Vinícius Mendes DANTAS ◽  
Bianca NESSO ◽  
Daniel Sagawa MITUUTI ◽  
Marisa Aparecida Cabrini GABRIELLI
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Dental Anxiety ◽  
Third Molar ◽  
Vital Signs ◽  
Correlation Coefficients ◽  
Hemodynamic Changes ◽  
Emergency Situations ◽  
Third Molar Extraction ◽  
Molar Extraction

Abstract Introduction The dental patient’s anxiety and expectation may significantly alter their vital signs. The use of local anesthetics associated with a vasoconstrictor may also alter the vital signs of these patients, promoting hemodynamic changes that may result in emergency situations. Objective To evaluate the influence of anxiety of patients submitted to third molar extraction and the use of different anesthetic substances with adrenaline on their vital signs (oxygen saturation, heart rate, and systolic and diastolic blood pressure) in different moments. Material and method Forty patients answered the questionnaire of the Dental Anxiety Scale (Corah’s Scale) and fear (KleinKnecht’s Scale) and were submitted to third molar extraction in two surgical times for the use of articaine or mepivacaine, both associated with adrenaline. The results were analyzed by ANOVA followed by Tukey post hoc test, Student's t test, and Pearson's correlation coefficients (α=0.05). Result There was no significant differences in saturation or heart rate. The blood pressure showed significant variations during time for both anesthetics, however mepivacaine resulted in a longer postoperative time to restore blood pressure. Patients with high or moderate anxiety and high fear index were those who had positive correlations with the highest blood pressure values. Conclusion Anxiety and fear positively influence the increase in blood pressure. Mepivacaine promoted a greater resistance to the return of normal vital signs, especially blood pressure levels.

scholarly journals Blood pressure measurement on the cheek

2016 ◽  
Vol 2 (1) ◽  
pp. 237-240 ◽  
Author(s):  
Sarah Schneider ◽  
Klaus Affeld ◽  
Claudia Kopic ◽  
Ulrich Kertzscher
Keyword(s):  
Blood Pressure ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
Light Signal ◽  
Infrared Light ◽  
Upper Arm ◽  
Non Invasive ◽  
Measure Blood Pressure ◽  
Limb Deformities ◽  
Invasive Method

AbstractIn a large group of patients, it is impossible to measure blood pressure using an upper arm cuff. An alternative, non-invasive method of blood pressure measurement is required for patients with severe limb deformities or obesity, for amputees, and in the emergency medicine. The device proposed here measures blood pressure in the cheek using a small pressure pad and a pump to occlude the cheek artery – arteria facialis – and assesses blood flow with an infrared light source and a detector. The infrared light signal is analysed to assess the systolic and diastolic blood pressure of the patient. Manual evaluation of the light intensity signal showed a good agreement between cheek blood pressure measurement and a reference measurement using an upper arm cuff.

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