scholarly journals Non-invasive continuous arterial pressure measurement based on radial artery tonometry in the intensive care unit: a method comparison study using the T-Line TL-200pro device

2013 ◽  
Vol 111 (2) ◽  
pp. 185-190 ◽  
Author(s):  
B Saugel ◽  
A.S. Meidert ◽  
A Hapfelmeier ◽  
F Eyer ◽  
R.M. Schmid ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Arterial Pressure ◽  
Radial Artery ◽  
Pressure Measurement ◽  
Method Comparison ◽  
Comparison Study ◽  
Non Invasive ◽  
Arterial Pressure Measurement ◽  
Method Comparison Study

Blood Pressure Measurement

2011 ◽  
Author(s):  
Patrick Magee ◽  
Mark Tooley
Keyword(s):  
Blood Pressure ◽  
Arterial Pressure ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
Measurement Techniques ◽  
Non Invasive ◽  
Mercury Column ◽  
Arterial Pressure Measurement ◽  
Mercury Manometer

Blood pressure measurement occurs either non-invasively or invasively, and usually refers to systemic arterial pressure measurement, but can also refer to systemic venous or pulmonary arterial pressure measurement. In 1733 the Reverend Stephen Hales was the first person to measure the blood pressure in vivo in unanaesthetised horses by direct cannulation of the carotid and femoral arteries. In doing so he observed the pulsatile nature of flow in the circulation. In 1828 Poiseuille developed the mercury manometer, and used it to measure blood pressure in a dog. The mercury manometer has, of course, become the standard technique against which other techniques are compared. The earliest numerical information on blood pressure measurement came from direct rather than indirect measurement in 1856 by Faivre, using Poiseuille’s device. However, in the last part of the nineteenth century, non-invasive measurement techniques were developed. In 1903, Codman and Cushing introduced the concept of routine intraoperative blood pressure measurement, which at the time was a revolutionary concept. Nowadays it is a fundamental part of minimal monitoring criteria. There are several techniques of non-invasive BP (NIBP) measurement, all of which function by occluding the pulse in a limb with a proximal cuff, then detecting its onset again distally, on lowering the cuff pressure. Detection methods include palpation, auscultation, plethysmography, oscillotonometry and oscillometry. Accuracy of all non-invasive techniques depends on cuff size in relation to the limb concerned, and over which artery the cuff is placed. Such techniques of NIBP measurement are necessarily intermittent. Much discussion has taken place on the accuracy of these devices, and the accuracy of diastolic pressure measurements needs improving, and there are ideas proposed for new non-invasive devices [Tooley and Magee 2009]. In the absence of a stethoscope, this technique is simple and reliable. After inflating the cuff on the upper arm to a pressure of above that of systolic, the cuff is then deflated while palpating the brachial artery and the systolic pressure is measured with a mercury column at first detection of the pulse. A study by van Bergen [1954] showed that BP can be underestimated by this method by up to 25% at 120 mmHg.

scholarly journals From palpation of the pulse to cuff-free methods: evolution of arterial pressure measurement methods

2021 ◽  
Vol 93 (4) ◽  
pp. 526-531
Author(s):  
Tatiana D. Solnceva ◽  
Olga A. Sivakova ◽  
Irina E. Chazova
Keyword(s):  
Arterial Pressure ◽  
Pressure Measurement ◽  
Measurement Methods ◽  
Main Stage ◽  
Daily Monitoring ◽  
Non Invasive ◽  
Arterial Pressure Measurement ◽  
Invasive Arterial Pressure ◽  
Physiological Indicator

The arterial pressure is an important physiological indicator. The review describes the different techniques of measurement of arterial pressure, their advantages and limitations. Moreover, it also represents a historical reference about the main stage of the development of clinical sphygmomanometrya that nowadays is a relevant method for measuring arterial pressure. The emergence and the development of devices for daily monitoring of arterial pressure and modern techniques for non-invasive arterial pressure measurement are described too.

scholarly journals Non-invasive detection of a femoral-to-radial arterial pressure gradient in intensive care patients with vasoactive agents

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Matthias Jacquet-Lagrèze ◽  
David Claveau ◽  
Julie Cousineau ◽  
Kun Peng Liu ◽  
Jean-Gilles Guimond ◽  
...  
Keyword(s):  
Intensive Care ◽  
Arterial Pressure ◽  
Pressure Gradient ◽  
Critically Ill ◽  
Radial Artery ◽  
Brachial Artery ◽  
Critically Ill Patients ◽  
Vasoactive Agents ◽  
Non Invasive ◽  
Radial Artery Pressure

Abstract Background In patient requiring vasopressors, the radial artery pressure may underestimate the true central aortic pressure leading to unnecessary interventions. When using a femoral and a radial arterial line, this femoral-to-radial arterial pressure gradient (FR-APG) can be detected. Our main objective was to assess the accuracy of non-invasive blood pressure (NIBP) measures; specifically, measuring the gradient between the NIBP obtained at the brachial artery and the radial artery pressure and calculating the non-invasive brachial-to-radial arterial pressure gradient (NIBR-APG) to detect an FR-APG. The secondary objective was to assess the prevalence of the FR-APG in a targeted sample of critically ill patients. Methods Adult patients in an intensive care unit requiring vasopressors and instrumented with a femoral and a radial artery line were selected. We recorded invasive radial and femoral arterial pressure, and brachial NIBP. Measurements were repeated each hour for 2 h. A significant FR-APG (our reference standard) was defined by either a mean arterial pressure (MAP) difference of more than 10 mmHg or a systolic arterial pressure (SAP) difference of more than 25 mmHg. The diagnostic accuracy of the NIBR-APG (our index test) to detect a significant FR-APG was estimated and the prevalence of an FR-APG was measured and correlated with the NIBR-APG. Results Eighty-one patients aged 68 [IQR 58–75] years and an SAPS2 score of 35 (SD 7) were included from which 228 measurements were obtained. A significant FR-APG occurred in 15 patients with a prevalence of 18.5% [95%CI 10.8–28.7%]. Diabetes was significantly associated with a significant FR-APG. The use of a 11 mmHg difference in MAP between the NIBP at the brachial artery and the MAP of the radial artery led to a specificity of 92% [67; 100], a sensitivity of 100% [95%CI 83; 100] and an AUC ROC of 0.93 [95%CI 0.81–0.99] to detect a significant FR-APG. SAP and MAP FR-APG correlated with SAP (r2 = 0.36; p < 0.001) and MAP (r2 = 0.34; p < 0.001) NIBR-APG. Conclusion NIBR-APG assessment can be used to detect a significant FR-APG which occur in one in every five critically ill patients requiring vasoactive agents.

Sign in / Sign up

Export Citation Format

Share Document