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Performance of a tonometer for arterial pressure measurement during anesthesia in the elderly
Katsumi Harasawa1, Masahiro Yamane, Yuji Morimoto
1Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, N-15, W-7, Kita-ku, Sapporo 060-8638, Japan.
Abstract:
We investigated performance of an arterial tonometer during anesthesia in the elderly. Thirty patients (17 men and 13 women), ranging from 70 to 86 years old, were included, and agreement between tonometric arterial pressure (TAP) and intraarterial pressure (IAP) was calculated. A total of 6487 paired points was sampled, and values for precision (mean absolute difference +/- SD) were 6.8 +/- 5.2 for systolic, 6.9 +/- 4.6 for mean, and 9.2 +/- 5.4 mmHg for diastolic blood pressures. Values for bias and limits of agreement [mean difference (TAP - IAP) +/- SD, mean difference (TAP - IAP) +/- 2 SD, respectively] for systolic, mean, and diastolic pressure were 1.2 +/- 8.4 and 1.2 +/- 16.8, 5.7 +/- 5.9 and 5.7 +/- 11.8, and 8.6 +/- 6.2 and 8.6 +/- 12.4 mmHg, respectively. Compared with previous data, aging is likely to affect the performance of an arterial tonometer.
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Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Assessment of blood pressure in brachial artery(two-step method)
Assessment of blood pressure in brachial artery(one-step method)
Prepare for the Procedure:
Pre-Procedural Guidelines for Assessing Blood Pressure
Sites for measuring blood pressure
The Brachial Artery: Primary Site for Blood Pressure Measurement
Equipments Used To Measure Blood Pressure
This invasive approach involves cannulating a peripheral artery. During each cardiac contraction, pressure generates mechanical motion within the catheter, transmitted through rigid, fluid-filled tubing to a transducer. This transducer converts mechanical motion into electrical signals displayed as waveforms on a monitor. An automatic flushing system prevents blood backflow. Due to the potential risk of unexpected arterial blood loss, this method is primarily used in intensive...

