Blood Pressure Measurement Methodologies

Abstract

The gold standard of arterial pressure measurement is directly through an intra-arterial catheter. [3] It is useful for beat-tobeat measurement of BP, an alternative when non-invasive methods of BP measurement are challenging (for example, in the cases of impaired skin integrity, obesity, or anatomical limitations-such as previous lymph node excision, limb amputation, and arteriovenous fistulas), superior in accuracy at extremes of BP s or in the presence of cardiac arrhythmias and allow for frequent arterial blood gas sampling. [3] There are no absolute contraindications to IABP monitoring; however, caution must be taken to avoid placement of an intra-arterial catheter in extremities with pre-existing vascular insufficiency. Complications which usually arise from misuse of the equipment include distal ischemia from resultant thrombosis, hematoma, pseudoaneurysm, damage to surrounding structures, infection, and erroneous intra-arterial drug administration. [4] As IABP monitoring is not without risk, it is usually reserved for patients on vasoactive medications and unstable patients being managed in an intensive care setting or intraoperatively where scrupulous BP monitoring is vital to the patient.