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A Comparison of Non-Invasive Blood Pressure Measurement Strategies with Intra-Arterial Measurement
Matthew R Rebesco1, M Cornelia Pinkston2, Nicholas A Smyrnios3
1Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MassachusettsUSA.
Prehospital and Disaster Medicine
|July 22, 2020
Summary
Palpated blood pressure (BP) measurements significantly underestimate intra-arterial BP, raising concerns for prehospital use. Oscillometric and auscultated BP methods showed similar, though statistically lower, readings compared to intra-arterial measurements.
Area of Science:
- Critical Care Medicine
- Emergency Medicine
- Clinical Measurement Science
Background:
- Accurate blood pressure (BP) measurement is challenging, particularly in prehospital settings.
- Existing knowledge on the comparative accuracy of different non-invasive blood pressure (NIBP) techniques is limited.
Purpose of the Study:
- To compare the accuracy of various NIBP measurement strategies against the gold standard of intra-arterial (IA) measurement.
- To determine if differences in NIBP accuracy exist across different patient demographics and clinical conditions.
Main Methods:
- Adult intensive care unit (ICU) patients with radial IA catheters were enrolled.
- Systolic blood pressure (SBP) was measured using oscillometric, auscultated, and palpated NIBP techniques.
- NIBP measurements were compared to radial intra-arterial blood pressure (RIBP) using paired t-tests.
Main Results:
- Palpated SBP was significantly lower than RIBP (9.88mmHg; P < .001).
- Oscillometric and auscultated SBP were statistically, but not clinically, lower than RIBP.
- Palpated BP was significantly lower than both oscillometric and auscultated methods.
Conclusions:
- NIBP methods, particularly palpation, tend to underestimate intra-arterial blood pressure.
- The accuracy of palpated BP measurements is questionable for prehospital care.
- Oscillometric and auscultated BP measurements may offer comparable results.
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