Results of a survey of blood pressure monitoring by intensivists in critically ill patients: A preliminary study

被引:40
作者
Chatterjee, Arjun [1 ]
DePriest, Kirk
Blair, Russell
Bowton, David [2 ]
Chin, Robert [1 ]
机构
[1] Wake Forest Univ, Bowman Gray Sch Med, Dept Internal Med, Sect Pulm Crit Care Allergy & Immunol Dis, Winston Salem, NC 27103 USA
[2] Wake Forest Univ, Bowman Gray Sch Med, Dept Anaesthesia, Sect Crit Care Med, Winston Salem, NC USA
关键词
arterial blood pressure monitoring; hemodynamic monitoring; blood pressure; monitoring; medical devices; SEPTIC SHOCK; CARE-UNIT; CIRCUMFERENCE; VALIDATION;
D O I
10.1097/CCM.0b013e3181fa057f
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objectives: Maintenance of mean arterial pressure >65 mm Hg has been associated with improved clinical outcomes in many studies of critically ill patients. Current guidelines for the management of septic shock and guidelines for managing other critical illnesses suggest intra-arterial blood pressure measurement is preferred over automated oscillometric noninvasive blood pressure measurement. Despite these recommendations, anecdotal experience suggested that the use of noninvasive blood pressure measurement in our institution and others in preference to intra-arterial blood pressure measurement remained prevalent. Design: We designed an online survey and sent it by e-mail. Setting: Intensive care units. Patients and Subjects: A randomly selected group from the membership of the Society for Critical Care Medicine. Interventions: None. Measurements and Main Results: Use of non-invasive and invasive blood pressure devices. Eight hundred eighty individuals received an invitation to complete the survey and 149 responded. We found that 71% (105 of 149) of intensivists estimated the correct cuff size rather than measuring arm circumference directly. In hypotensive patients, 73% of respondents (108 of 149) reported using noninvasive blood pressure measurement measurements for patient management. In patients on a vasopressor medication, 47% (70 of 149) of respondents reported using noninvasive blood pressure measurement for management. Conclusions: The use of noninvasive blood pressure measurement measurements in critically ill patients is common despite the paucity of evidence validating its accuracy in critically ill patients. Given this widespread use, accuracy and precision validation studies comparing noninvasive blood pressure measurement with intra-arterial blood pressure measurement in critically ill patients should be performed. (Crit Care Med 2010; 38:2335-2338)
引用
收藏
页码:2335 / 2338
页数:4
相关论文
共 17 条
[1]  
Ahuja Kartikya, 2010, J Hosp Med, V5, pE11, DOI 10.1002/jhm.629
[2]   Arterial blood pressure monitoring in overweight critically ill patients: invasive or noninvasive? [J].
Araghi, Ali ;
Bander, Joseph J. ;
Guzman, Jorge A. .
CRITICAL CARE, 2006, 10 (02)
[3]  
[Blood Institute and GINA Executive Committee National Heart Lung], 2004, NIH PUBL, V02-3659
[4]   Accuracy of oscillometric blood pressure measurement according to the relation between cuff size and upper-arm circumference in critically ill patients [J].
Bur, A ;
Hirschl, MM ;
Herkner, H ;
Oschatz, E ;
Kofler, J ;
Woisetschläger, C ;
Laggner, AN .
CRITICAL CARE MEDICINE, 2000, 28 (02) :371-376
[5]   Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: 2008 [J].
Dellinger, R. Phillip ;
Levy, Mitchell M. ;
Carlet, Jean M. ;
Bion, Julian ;
Parker, Margaret M. ;
Jaeschke, Roman ;
Reinhart, Konrad ;
Angus, Derek C. ;
Brun-Buisson, Christian ;
Beale, Richard ;
Calandra, Thierty ;
Dhainaut, Jean-Francois ;
Gerlach, Herwig ;
Harvey, Maurene ;
Marini, John J. ;
Marshall, John ;
Ranieri, Marco ;
Ramsay, Graham ;
Sevransky, Jonathan ;
Thompson, B. Taylor ;
Townsend, Sean ;
Vender, Jeffrey S. ;
Zimmerman, Janice L. ;
Vincent, Jean-Louis .
CRITICAL CARE MEDICINE, 2008, 36 (01) :296-327
[6]   Survey of sedation practices during noninvasive positive-pressure ventilation to treat acute respiratory failure [J].
Devlin, John W. ;
Nava, Stefano ;
Fong, Jeffrey J. ;
Bahhady, Imad ;
Hill, Nicholas S. .
CRITICAL CARE MEDICINE, 2007, 35 (10) :2298-2302
[7]   Assessment of the validation of blood pressure monitors: a statistical reappraisal [J].
Friedman, Bruce A. ;
Alpert, Bruce S. ;
Osborn, David ;
Prisant, L. Michael ;
Quinn, David E. ;
Seller, John .
BLOOD PRESSURE MONITORING, 2008, 13 (04) :187-191
[8]   Indwelling Arterial Catheters in the Intensive Care Unit Necessary and Beneficial, or a Harmful Crutch? [J].
Garland, Allan ;
Connors, Alfred F., Jr. .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2010, 182 (02) :133-134
[9]   Tracking Hypotension and Dynamic Changes in Arterial Blood Pressure with Brachial Cuff Measurements [J].
Lakhal, Karim ;
Ehrmann, Stephan ;
Runge, Isabelle ;
Legras, Annick ;
Dequin, Pierre-Francois ;
Mercier, Emmanuelle ;
Wolff, Michel ;
Regnier, Bernard ;
Boulain, Thierry .
ANESTHESIA AND ANALGESIA, 2009, 109 (02) :494-501
[10]   Comparison of noninvasive oscillometric and intra-arterial blood pressure measurements in hyperacute stroke [J].
Manios, Efstathios ;
Vemmosa, Konstantinos ;
Tsivgoulis, Georgios ;
Barlas, Gerasimos ;
Eleni, Koroboki ;
Spengos, Konstantinos .
BLOOD PRESSURE MONITORING, 2007, 12 (03) :149-156