Comparison of Oscillometric and Intraarterial Systolic and Diastolic Blood Pressures in Lean, Overweight, and Obese Patients

Abstract

To assess the effect of obesity on blood pressure measurement the authors obtained simultaneous oscillometric and intraarterial systolic and diastolic blood pressures on 188 lean, overweight, class I/II obese, and class III obese subjects. Oscillometric arm cuff/bladder size was selected in accordance with standard guidelines. Oscillometry significantly underestimated systolic and significantly overestimated diastolic blood pressures in each of the 4 weight groups studied. The differences between oscillometric and intraarterial systolic and diastolic pressures were not significantly different among lean, overweight, class I/II obese, and class III obese subjects. Thus, obesity per se does not influence the accuracy of blood pressure measurement. However, oscillometric blood pressure measurement is associated with significant error when compared to intraarterial blood pressure.

The impact of blood pressure cuff location on the accuracy of noninvasive blood pressure measurements in obese patients: an observational study

“…Accordingly, NIBP measured with an upper arm BP cuff may be difficult to accomplish due to the size and shape of the arm, 6 resulting in uncertainty in the accuracy of the measurements obtained. 7 An alternative method is invasive blood pressure monitoring using a direct arterial cannula, but this can be a challenge to place in the obese patient and does have some, albeit very low, risk. 8 In obese individuals, the conical shape of the upper arm is exaggerated compared with that of the forearm.…”

Arm Circumference, Shape, and Length: How Interplaying Variables Affect Blood Pressure Measurement in Obese Persons

“…In 2 studies, 11,13 cuff types were compared (standard vs large, rigid cylindrical vs conical); in 3 studies, 4,17,21 blood pressure measurements obtained via direct intra-arterial vs ausculatory/oscillometric techniques were compared; and in 6 studies, [14][15][16][18][19][20] blood pressure measurements obtained from the upper arm versus the forearm were compared.…”

“…Not surprisingly, current evidence suggests that when vital decisions are required in the treatment of critically ill obese patients, direct intra-arterial measurement of blood pressure should be used instead of ausculatory/oscillometric techniques, which are associated with significant error. 4,17 A second recommendation relates to matching cuffs with the size and shape of the upper arm. Preferably on admission, clinicians should measure the arm circumference midway between the shoulder and elbow and evaluate the shape of the upper arm.…”

Intensive Care Management of Patients in the First 24 Hours After Cardiac Surgery

“…During the first 15 minutes should be evaluated central venous saturation (SvO 2), arterial blood gases, acid-base status, serum electrolytes (ABG) and serum examinations required, such as hemoglobin, platelets, hematocrit, serum www.intechopen.com electrolytes, coagulation, time Ivy, myocardial enzymes, prealbumin, liver function tests (LFT), nitrogenous, Cystatin C, urine sediment and start of urine collection for urinary urea nitrogen (NUU), subsequent tests are given in the next 6 hours or before be necesario. 31,32,33,34,35 …”