Comparison between invasive and noninvasive blood pressure measurements in critically ill patients receiving inotropes
Abstract
OBJECTIVE: The aim of this study was to compare invasive and noninvasive monitoring of blood pressure (BP) in patients on inotropes. SETTINGS AND DESIGN: This study was carried out in the ICU of a tertiary care centre. The design was comparative analytical. PATIENTS AND METHODS: Thirty-six adult patients receiving inotropes with invasive arterial BP monitoring were studied. Systolic and diastolic BPs were recorded simultaneously using invasive (radial arterial cannula) and noninvasive (Philips Intellivue MP-60 oscillometric monitor attached to the opposite arm) methods every 30 min. STATISTICAL ANALYSIS: Agreement (precision) between both the methods was assessed using Bland-Altman analysis. A difference of more than 10 mmHg was considered clinically unacceptable. Linear regression of difference with invasive BP and analysis of variance with Tukey's correction of difference with the number of inotropes were carried out. RESULTS: Overall, 1400 pairs of systolic and diastolic BP measurements were obtained. Systolic and diastolic pressures showed a difference of 2.3±16.9 and 0.7±10.6 mmHg, respectively. In all, 93.4% of systolic and 98.6% of diastolic pressure measurements were within the limits of agreement. The difference was clinically acceptable in 54.2% of measurements of systolic and 74.1% of diastolic measurements. Both systolic and diastolic BP differences were correlated with the number of inotropes that the patient was receiving. CONCLUSION: Noninvasive BP measurement using an oscilllometric monitor (Philips Intellivue MP-60) is not a reliable alternative to invasive intra-arterial measurement in patients receiving inotropes. The observed difference increased with the number of inotropes that the patient was receiving.
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Shorter durations of antimicrobial therapy are in general recommended, but critically ill patients often receive antimicrobials for more days than necessary.
“Shorter durations of antimicrobial therapy are in general recommended; however, critically ill patients often receive antimicrobials for more days than necessary (288,301,306).”
From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [301]
Non-invasive cuff blood pressure estimation tends to be inaccurate, with discrepancy more pronounced in shock states.
“Estimation of blood pressure using a non-invasive cuff tends to be inaccurate and the discrepancy more pronounced in shock states [375–379].”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [377]
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Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021.
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Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021
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- Authors
- Kaur, B., Kaur, S., Yaddanapudi, L. N., & Singh, N. V.
- Affiliations
- Post Graduate Institute of Medical Education and Research (IN)
- Corresponding author
- Kaur, Babandeep
- Kaur, Sukhpal
- Venue
- Blood Pressure Monitoring
- Published
- 2019-02
- Volume
- 24
- Issue
- 1
- Pages
- 24-29
- ISSN
- 1359-5237 (ISSN-L)
- OpenAlex
- W2905077461
- Cited by
- 22
- References
- 20
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 2 · 2023: 4 · 2022: 3 · 2021: 3
- FWCI
- 0.78
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Blood Pressure Monitoring (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
- Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Keywords
- invasive blood pressure monitoring, non-invasive blood pressure measurement, oscillometric blood pressure monitor, inotropic agents, critically ill patients, arterial cannula, measurement agreement, systolic and diastolic blood pressure, hemodynamic monitoring
- MeSH terms
- Adult, Blood Pressure, Blood Pressure Determination, Female, Humans, Male, Middle Aged, Blood Pressure Monitors, Critical Illness
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