Results of a survey of blood pressure monitoring by intensivists in critically ill patients: A preliminary study

Chatterjee, Arjun B.; DePriest, Kirk L.; Blair, Russell; Bowton, David L.; Chin, Robert

doi:10.1097/ccm.0b013e3181fa057f

Cited by 46 publications

(33 citation statements)

References 14 publications

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“…There is, however, ample evidence suggesting that non-invasively measured MAP is a better indicator of invasive blood pressure than non-invasive systolic blood pressure alone (45–47). While to solve this partial discrepancy is beyond the scope of this study, it has been shown recently that the difference of NIBP and invasive arterial blood pressure is clinically negligible in both adults and children with few exceptions (48,49); NIBP continues to be widely used by ICU physicians (50), and NIBP is proportional to intravascular volume during hemorrhage (12). It is furthermore readily and feasibly available to professionals of all levels of experience and causes few complications (51).…”

Section: Discussionmentioning

confidence: 99%

Closed-Loop– and Decision-Assist–Guided Fluid Therapy of Human Hemorrhage*

Hundeshagen

Kramer

Marques

et al. 2017

Critical Care Medicine

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Objectives We sought to evaluate the efficacy, efficiency and physiological consequences of automated, end-point directed resuscitation systems and compare them to formula-based bolus resuscitation. Design Experimental human hemorrhage and resuscitation Setting Clinical Research Laboratory Subjects Healthy volunteers Interventions Subjects (n=7) were subjected to hemorrhage and underwent a randomized fluid resuscitation scheme on separate visits 1) formula-based bolus resuscitation (BR) 2) semi-autonomous (decision-assist, DA) fluid administration and 3) fully autonomous (closed-loop, CL) resuscitation. Hemodynamic parameters, volume shifts, fluid balance, and cardiac function were monitored during hemorrhage and resuscitation. Treatment modalities were compared based on resuscitation efficacy and efficiency. Measurements and Main Results All approaches achieved target BP by 60 min. Following hemorrhage, the total amount of infused fluid (BR: 30ml/kg, DA: 5.6±3 ml/kg, CL: 4.2±2ml/kg, p<0.001), plasma volume, extravascular volume (BR: 17±4ml/kg, DA: 3±1ml/kg, CL: -0.3±0.3ml/kg, p<0.001), body weight and urinary output remained stable under DA and CL and were significantly increased under bolus resuscitation. Mean arterial pressure initially decreased further under bolus resuscitation (-10mmHg, p<0.001) and was lower under BR than CL at 20min (BR: 57±2mmHg CL: 69±4mmHg, p=0.036). Colloid-osmotic pressure (BR: 19.3±2mmHg DA, CL: 24±0.4mmHg, p<0.05) and hemoglobin concentration were significantly decreased after bolus fluid administration. Conclusions We define efficacy of decision-assist and closed-loop resuscitation in human hemorrhage. In comparison to formula-based bolus resuscitation, both semiautonomous and autonomous approaches were more efficient in goal-directed resuscitation of hemorrhage. They provide favorable conditions for the avoidance of over-resuscitation and its adverse clinical sequelae. Decision-assist and closed-loop resuscitation algorithms are promising technological solutions for constrained environments and areas of limited resources.

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Section: Discussionmentioning

confidence: 99%

Closed-Loop– and Decision-Assist–Guided Fluid Therapy of Human Hemorrhage*

Hundeshagen

Kramer

Marques

et al. 2017

Critical Care Medicine

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“…14 Today, intra-arterial blood pressure is often considered to be the gold standard of blood pressure monitoring. 15 Invasive blood pressure monitoring involves direct measurement of arterial pressure by placing a cannula needle in an artery. It provides a more accurate reading of the patient's current blood pressure, but it is generally reserved for critically ill patients where rapid variations in blood pressure are anticipated.…”

Section: Discussionmentioning

confidence: 99%

Determination of trigeminocardiac reflex during rhinoplasty

Yorgancılar

Gün

Yıldırım

et al. 2012

International Journal of Oral and Maxillofacial Surgery

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“…17 In a survey of 800 members of the Society of Critical Care Medicine, 73% of respondents reported using NIBP measurement for hypotensive patients and 47% reported using NIBP measurements for patients being treated with a vasopressor. 16 What was unclear in this study was whether clinicians consistently validate the oscillometric method of NIBP measurement by comparing its measurements with auscultatory measurements and whether providers ensured that the size of the blood pressure cuff was accurate for the child's age with the upper extremity positioned level with the right atrium. NIBP measurement is commonly used in the assessment of critically ill children; consistent use of a measurement technique that is based on best evidence is needed in practice to ensure that blood pressure assessment data are accurate.…”

Section: Related Beliefs and Evidencementioning

confidence: 99%

“…However, study results are inconsistent because the research questions vary, the blood pressure measurement techniques are inconsistent, different limbs or body positions are used, the blood pressure parameters assessed (systolic, diastolic, mean) vary, and the statistical procedures used vary, making it difficult to provide a definitive clinical recommendation for acute care practice. 16,[18][19][20] Two studies 14,20 have explored the accuracy of NIBP measurement in critically ill children (Table 1). NIBP Methods.…”

Section: Related Beliefs and Evidencementioning

confidence: 99%

“…10,15 NIBP measurement is more common in the management of critically ill children than is direct measurement of blood pressure via an arterial catheter. 14,16,17 Arterial catheters are often not used because of technical challenges with device insertion and complications such as bleeding, impairment of distal perfusion (thrombosis and arteriospasm), and infection. 17 In a survey of 800 members of the Society of Critical Care Medicine, 73% of respondents reported using NIBP measurement for hypotensive patients and 47% reported using NIBP measurements for patients being treated with a vasopressor.…”

Section: Related Beliefs and Evidencementioning

confidence: 99%

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Putting Evidence Into Nursing Practice: Four Traditional Practices Not Supported by the Evidence

Makic

Martin

Burns

et al. 2013

Critical Care Nurse

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E vidence-based nursing practice involves integration of a problem-solving approach within the context of caring, considering best evidence from studies, patient care data, clinical experience and expertise, and patients' preferences and values.1 Health care agencies, government agencies, and national professional organizations such as the American Association of Critical-Care Nurses have all been supporters of evidence-based practice (EBP) as studies continue to show improved outcomes when best evidence is used in the delivery of patient care. Feature Evidence-based nursing practice is essential to the delivery of high-quality care that optimizes patients' outcomes. Studies continue to show improved outcomes when best evidence is used in the delivery of patient care. Despite awareness of the importance of practicing by using best evidence, achieving and sustaining evidencebased practice within practice environments can be challenging, and research suggests that integration of evidence-based practice into daily clinical practice remains inconsistent. This article addresses 4 practice issues that, first, are within the realm of nursing and if changed might improve care of patients and, second, are areas in which the tradition and the evidence do not agree and practice continues to follow tradition. The topics addressed are (1) noninvasive measurement of blood pressure in children, (2) oxygen administration for patients with chronic obstructive pulmonary disease, (3) intravenous catheter size and blood administration, and (4) infection control practices to prevent infections. The related beliefs, current evidence, and recommendations for practice related to each topic are described. (Critical Care Nurse. 2013;33[2]:28-44) This article has been designated for CNE credit. A closed-book, multiple-choice examination follows this article, which tests your knowledge of the following objectives:1. Identify key evidence-based components that demonstrate how research can be translated into bedside nursing practice 2. Analyze 4 nursing practice issues to understand how to incorporate evidence-based guidelines into nursing interventions 3. Validate evidence-based guidelines and nursing research to incorporate practice changes in your own work environment

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Results of a survey of blood pressure monitoring by intensivists in critically ill patients: A preliminary study

Cited by 46 publications

References 14 publications

Closed-Loop– and Decision-Assist–Guided Fluid Therapy of Human Hemorrhage*

Closed-Loop– and Decision-Assist–Guided Fluid Therapy of Human Hemorrhage*

Determination of trigeminocardiac reflex during rhinoplasty

Putting Evidence Into Nursing Practice: Four Traditional Practices Not Supported by the Evidence

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