TY - JOUR
T1 - Non-invasive oscillometric versus invasive arterial blood pressure measurements in critically ill patients
T2 - A post hoc analysis of a prospective observational study
AU - SICS Study Group
AU - Kaufmann, Thomas
AU - Cox, Eline G M
AU - Wiersema, Renske
AU - Hiemstra, Bart
AU - Eck, Ruben J
AU - Koster, Geert
AU - Scheeren, Thomas W L
AU - Keus, Frederik
AU - Saugel, Bernd
AU - van der Horst, Iwan C C
N1 - Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.
PY - 2020/6
Y1 - 2020/6
N2 - PURPOSE: The aim was to compare non-invasive blood pressure measurements with invasive blood pressure measurements in critically ill patients.METHODS: Non-invasive blood pressure was measured via automated brachial cuff oscillometry, and simultaneously the radial arterial catheter-derived measurement was recorded as part of a prospective observational study. Measurements of systolic arterial pressure (SAP), diastolic arterial pressure (DAP), and mean arterial pressure (MAP) were compared using Bland-Altman and error grid analyses.RESULTS: Paired measurements of blood pressure were available for 736 patients. Observed mean difference (±SD, 95% limits of agreement) between oscillometrically and invasively measured blood pressure was 0.8 mmHg (±15.7 mmHg, -30.2 to 31.7 mmHg) for SAP, -2.9 mmHg (±11.0 mmHg, -24.5 to 18.6 mmHg) for DAP, and -1.0 mmHg (±10.2 mmHg, -21.0 to 18.9 mmHg) for MAP. Error grid analysis showed that the proportions of measurements in risk zones A to E were 78.3%, 20.7%, 1.0%, 0%, and 0.1% for MAP.CONCLUSION: Non-invasive blood pressure measurements using brachial cuff oscillometry showed large limits of agreement compared to invasive measurements in critically ill patients. Error grid analysis showed that measurement differences between oscillometry and the arterial catheter would potentially have triggered at least low-risk treatment decisions in one in five patients.
AB - PURPOSE: The aim was to compare non-invasive blood pressure measurements with invasive blood pressure measurements in critically ill patients.METHODS: Non-invasive blood pressure was measured via automated brachial cuff oscillometry, and simultaneously the radial arterial catheter-derived measurement was recorded as part of a prospective observational study. Measurements of systolic arterial pressure (SAP), diastolic arterial pressure (DAP), and mean arterial pressure (MAP) were compared using Bland-Altman and error grid analyses.RESULTS: Paired measurements of blood pressure were available for 736 patients. Observed mean difference (±SD, 95% limits of agreement) between oscillometrically and invasively measured blood pressure was 0.8 mmHg (±15.7 mmHg, -30.2 to 31.7 mmHg) for SAP, -2.9 mmHg (±11.0 mmHg, -24.5 to 18.6 mmHg) for DAP, and -1.0 mmHg (±10.2 mmHg, -21.0 to 18.9 mmHg) for MAP. Error grid analysis showed that the proportions of measurements in risk zones A to E were 78.3%, 20.7%, 1.0%, 0%, and 0.1% for MAP.CONCLUSION: Non-invasive blood pressure measurements using brachial cuff oscillometry showed large limits of agreement compared to invasive measurements in critically ill patients. Error grid analysis showed that measurement differences between oscillometry and the arterial catheter would potentially have triggered at least low-risk treatment decisions in one in five patients.
KW - Arterial pressure
KW - Vascular access devices
KW - Oscillometry
KW - Intensive care
KW - Norepinephrine
KW - Vasoactive medication
KW - SHOCK
KW - AGREEMENT
KW - CUFF
U2 - 10.1016/j.jcrc.2020.02.013
DO - 10.1016/j.jcrc.2020.02.013
M3 - Article
C2 - 32109843
VL - 57
SP - 118
EP - 123
JO - Journal of Critical Care
JF - Journal of Critical Care
SN - 0883-9441
ER -