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Non-invasive oscillometric versus invasive arterial blood pressure measurements in critically ill patients: A post hoc analysis of a prospective observational study

Title: Non-invasive oscillometric versus invasive arterial blood pressure measurements in critically ill patients: A post hoc analysis of a prospective observational study
Authors: Kaufmann, T.; Cox, E.G.M.; Wiersema, R.; Hiemstra, B.; Eck, R.J.; Koster, G.; Scheeren, T.W.L.; Keus, F.; Saugel, B.; van der Horst, I.C.C.
Source: Kaufmann, T, Cox, E G M, Wiersema, R, Hiemstra, B, Eck, R J, Koster, G, Scheeren, T W L, Keus, F, Saugel, B, van der Horst, I C C & SICS Study Group 2020, 'Non-invasive oscillometric versus invasive arterial blood pressure measurements in critically ill patients: A post hoc analysis of a prospective observational study', Journal of Critical Care, vol. 57, pp. 118-123. https://doi.org/10.1016/j.jcrc.2020.02.013
Publication Year: 2020
Collection: Maastricht University Research Publications
Subject Terms: agreement; arterial pressure; cuff; intensive care; norepinephrine; oscillometry; shock; vascular access devices; vasoactive medication
Description: Purpose: The aimwas to compare non-invasive blood pressuremeasurementswith invasive blood pressure measurements in critically ill patients. Methods: Non-invasive blood pressure was measured via automated brachial cuff oscillometry, and simultaneously the radial arterial catheter-derived measurement was recorded as part of a prospective observational study. Measurements of systolic arterial pressure (SAP), diastolic arterial pressure (DAP), and mean arterial pressure (MAP) were compared using Bland-Altman and error grid analyses. Results: Paired measurements of blood pressurewere available for 736 patients. Observedmean difference (+/- SD, 95% limits of agreement) between oscillometrically and invasively measured blood pressure was 0.8 mmHg (+/- 15.7 mmHg, -30.2 to 31.7 mmHg) for SAP, -2.9 mmHg (+/- 11.0 mmHg, -24.5 to 18.6 mmHg) for DAP, and -1.0 mmHg (+/- 10.2 mmHg, -21.0 to 18.9 mmHg) for MAP. Error grid analysis showed that the proportions of measurements in risk zones A to E were 78.3%, 20.7%, 1.0%, 0%, and 0.1% for MAP. Conclusion: Non-invasive blood pressure measurements using brachial cuff oscillometry showed large limits of agreement compared to invasivemeasurements in critically ill patients. Error grid analysis showed that measurement differences between oscillometry and the arterial catheter would potentially have triggered at least lowrisk treatment decisions in one in five patients. (c) 2020 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).
Document Type: article in journal/newspaper
Language: English
ISSN: 0883-9441; 1557-8615
Relation: info:eu-repo/semantics/altIdentifier/pmid/32109843; info:eu-repo/semantics/altIdentifier/wos/000536499000017; info:eu-repo/semantics/altIdentifier/pissn/0883-9441; info:eu-repo/semantics/altIdentifier/eissn/1557-8615
DOI: 10.1016/j.jcrc.2020.02.013
Availability: https://cris.maastrichtuniversity.nl/en/publications/412b285b-9ab1-4e2c-b422-f94de29f2cc7; https://doi.org/10.1016/j.jcrc.2020.02.013
Rights: info:eu-repo/semantics/openAccess ; http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.1E02A5E6
Database: BASE