An evaluation of a new continuous blood pressure monitoring system in critically ill patients

Heard, Stephen O.; Lisbon, Alan; Tóth, Ildikó; Ramasubramanian, R.

doi:10.1016/s0952-8180(00)00201-4

Cited by 26 publications

(20 citation statements)

References 20 publications

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“…Although our study focused on overweight critically ill patients, these findings are in agreement with those of previously reported trials conducted in different patient populations [6,14,15]. Because the oscillometric method is not standardized, measuring algorithms differ from manufacturer to manufacturer and even from device to device [10,16].…”

Section: Overall Biassupporting

confidence: 91%

Arterial blood pressure monitoring in overweight critically ill patients: invasive or non-invasive?

Bander

Guzmán

Araghi

2004

Chest

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Introduction Blood pressure measurements frequently guide management in critical care. Direct readings, commonly from a major artery, are considered to be the gold standard. Because arterial cannulation is associated with risks, alternative noninvasive blood pressure (NIBP) measurements are routinely used. However, the accuracy of NIBP determinations in overweight patients in the outpatient setting is variable, and little is known about critically ill patients. This prospective, observational study was performed to compare direct intraarterial blood pressure (IABP) with NIBP measurements obtained using auscultatory and oscillometric methods in overweight patients admitted to our medical intensive care unit.

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Section: Overall Biassupporting

confidence: 91%

Arterial blood pressure monitoring in overweight critically ill patients: invasive or non-invasive?

Bander

Guzmán

Araghi

2004

Chest

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“…A common solution to the calibration of PTT-based is to use readings of conventional cuff-based BP devices [3]- [5], [1]. Nevertheless, this results of this study found that this approach may not be suitable for estimating beat-to-beat BP.…”

Section: Discussionmentioning

confidence: 74%

The beat-to-beat relationship between pulse transit time and systolic blood pressure

Poon

Zhang²,

Wong

et al. 2008

2008 International Conference on Technology and Applications in Biomedicine

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Non-invasive measurement of beat-to-beat arterial blood pressure (BP) is an interesting but currently unsolved topic in long-term physiological monitoring by wearable devices and body sensor networks. Although it is suggested that pulse transit time (PTT) is related to and can be used to estimate BP, few studies showed how their relationship changes over time. This study reported the beat-to-beat correlation between PTT and invasive BP of short segments for 4 subjects during an 8-hour period. The results of the study found that the median correlation of beat-to-beat PTT and invasive BP decreased from -0.73 to -0.63 when the number of consecutive beats used to calculate the correlation increased from 15 to 360, suggesting that PTT-based techniques may need frequent calibration in order to estimate beat-to-beat BP.

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“…The use of rPTT in this way was originally described in the 1950s (34), and considerable research was subsequently performed on its application in the study of cardiovascular feedback, mainly in the field of psychophysiology (9,19,33,37). There have been several studies that revisited the technique in recent years, probably due to the increasing ease with which signal analysis can be carried out using modern technology (1,7,14,26). However, little work has been published on the effects of vasoactive drugs on this measurement in humans.…”

mentioning

confidence: 99%

Pulse transit time measured from the ECG: an unreliable marker of beat-to-beat blood pressure

Payne¹,

Symeonides²,

Webb³

et al. 2006

Journal of Applied Physiology

372

280

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The arterial pulse-wave transit time can be measured between the ECG R-wave and the finger pulse (rPTT), and has been shown previously to have a linear correlation with blood pressure (BP). We hypothesized that the relationship between rPTT, preejection period (PEP; the R-wave/mechanical cardiac delay), and BP would vary with different vasoactive drugs. Twelve healthy men (mean age 22 yr) were studied. Beat-to-beat measurements were made of rPTT (using ECG and photoplethysmograph finger probe), intra-arterial radial pressure, PEP (using cardiac bioimpedance), and transit time minus PEP (pPTT). Four drugs (glyceryl trinitrate, angiotensin II, norepinephrine, salbutamol) were administered intravenously over 15 min, with stepped dosage increase every 5 min and a 25-min saline washout between agents. All subjects in all conditions had a negative linear correlation (R2 = 0.39) between rPTT and systolic BP (SBP), generally constant between different drugs, apart from four subjects who had a positive rPTT/SBP correlation with salbutamol. The 95% limits of agreement between measured and rPTT-predicted SBP were +/-17.0 mmHg. Beat-to-beat variability of rPTT showed better coherence with SBP variability than it did with heart rate variability (P < 0.001). PEP accounted for a substantial and variable proportion of rPTT (12-35%). Diastolic (DBP) and mean arterial BP (MAP) correlated poorly with rPTT (R2 = 0.02 and 0.08, respectively) but better with pPTT (rPTT corrected for PEP, R2 = 0.41 and 0.45, respectively). The 95% limits of agreement between measured and pPTT-predicted DBP were +/- 17.3 mmHg. In conclusion, the negative correlation between rPTT and SBP is generally constant, even with marked hemodynamic perturbations. However, the relationship is not reliable enough for rPTT to be used as a surrogate marker of SBP, although it may be useful in assessing BP variability. DBP and MAP cannot be predicted from rPTT without correction for PEP. The significant contribution of PEP to rPTT means that rPTT should not be used as a marker of purely vascular function.

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An evaluation of a new continuous blood pressure monitoring system in critically ill patients

Cited by 26 publications

References 20 publications

Arterial blood pressure monitoring in overweight critically ill patients: invasive or non-invasive?

Arterial blood pressure monitoring in overweight critically ill patients: invasive or non-invasive?

The beat-to-beat relationship between pulse transit time and systolic blood pressure

Pulse transit time measured from the ECG: an unreliable marker of beat-to-beat blood pressure

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