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Optimal Calculation of Mean Pressure From Pulse Pressure.
Liam Y H Tien1,2, William H Morgan1,2, Stephen J Cringle1,2
1Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia.
American Journal of Hypertension
|March 22, 2023
Summary
Six formulas estimate mean arterial pressure (MAP), but this study compared them to a gold standard. All tested formulas adequately estimate MAP, though some are less suitable for intraocular pressure (IOP) and jugular vein pressure (JVP).
Area of Science:
- Physiology
- Medical Devices
- Biomedical Engineering
Background:
- Multiple formulas exist for calculating mean arterial pressure (MAP) from systolic and diastolic pressures.
- The gold standard for MAP calculation involves invasive measurement of pulse waveform area under the curve.
- Variability in MAP estimation necessitates evaluating formula accuracy.
Purpose of the Study:
- To determine the optimal formula for estimating mean arterial pressure (MAP).
- To compare six common MAP estimation formulas against a gold standard invasive method.
- To assess formula suitability for mean intraocular pressure (IOP) and jugular vein pressure (JVP).
Main Methods:
- Invasive femoral artery pressure (AP) was measured in eight pigs using a fluid-filled catheter and transducer.
- Intraocular pressure (IOP) and jugular vein pressure (JVP) were simultaneously recorded.
- Mean pressure (MP) was calculated using six distinct formulas and the area-under-the-curve method from digitized waveforms.
Main Results:
- The mean difference between formula-derived MAP and area-derived MAP ranged from 0.98 to 3.23 mm Hg.
- Area MAP demonstrated physiological variability, changing up to 5 mm Hg between successive pulses.
- Most formulas showed excellent agreement (ICC 0.97-0.99) for MAP, with near-perfect agreement (ICC 1.0) for IOP and JVP.
Conclusions:
- All tested formulas are generally adequate for estimating mean arterial pressure (MAP).
- Certain formulas demonstrated limitations when applied to mean intraocular pressure (IOP) and jugular vein pressure (JVP) calculations.
- The study validates the use of these formulas for MAP estimation in clinical settings.
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