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Errors occurring during blood pressure monitoring

Errors occurring during blood pressure monitoring

Blood pressure monitoring is a crucial clinical procedure in diagnosing and managing various cardiovascular conditions. Despite its significance, the accuracy of blood pressure measurements can be compromised by multiple factors, potentially leading to either falsely high or low readings. These inaccuracies are critical as they can significantly impact patient care. So, it is vital to understand these challenges deeply and adopt strategic approaches to minimize errors.
Several factors...

Measurement of Blood Pressure

Measurement of Blood Pressure

Assessing blood pressure is a standard procedure executed in virtually all medical environments. The method utilized today was established over a hundred years ago by an innovative Russian doctor, Dr. Nikolai Korotkoff. The soft ticking noise, known as Korotkoff sounds, heard while taking blood pressure readings results from turbulent blood flow within the vessels. The apparatus required for this procedure includes a sphygmomanometer, a blood pressure cuff attached to a gauge, and a stethoscope.

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Related Experiment Video

Updated: Jun 28, 2026

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea

Published on: December 6, 2016

[Falsely elevated-bispectral index].

A Odri¹, A Cavalcanti, V Billard

¹Département d'anesthésie, institut Gustave-Roussy, 39, rue Camille-Desmoulins, 94805 Villejuif cedex, France. blanieodri@wanadoo.fr

Annales Francaises D'Anesthesie Et De Reanimation

|October 29, 2008

Summary

This summary is machine-generated.

A falsely elevated Bispectral Index (BIS) during anesthesia was caused by high electromyographic activity and electrical artifacts. This highlights BIS monitoring limitations and the need for artifact elimination before deepening anesthesia.

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Area of Science:

Anesthesiology
Neurophysiology
Medical Device Technology

Background:

The Bispectral Index (BIS) is commonly used to monitor anesthetic depth.
Accurate BIS monitoring is crucial for patient safety during general anesthesia.
Factors such as electromyographic (EMG) activity and electrical artifacts can interfere with BIS readings.

Observation:

A case of falsely elevated BIS values (around 70) was observed during isolated-limb chemotherapy under general anesthesia.
The anesthesia regimen included remifentanil Target Controlled Infusion (TCI), desflurane, and nitrous oxide.
No residual neuromuscular blockade or clinical signs of awareness were present despite the high BIS.

Findings:

High BIS values were attributed to significant electromyographic activity and electrical artifacts from extracorporeal circulation machines and tourniquets.
BIS values returned to expected levels (around 50) post-operatively.
The patient reported no intraoperative recall, indicating no actual awareness.

Implications:

This case underscores the limitations of BIS monitoring, particularly its sensitivity to EMG activity and environmental electrical artifacts.
It emphasizes the importance of identifying and eliminating artifacts before adjusting anesthetic depth.
A proposed decision algorithm can aid clinicians in managing surprising high BIS readings by considering neuromuscular blockade, clinical response, and potential artifact sources.