Noninvasive Techniques for Blood Pressure Measurement Are Not a Reliable Alternative to Direct Measurement: A Randomized Crossover Trial in ICU

Introduction. Noninvasive blood pressure (NIBP) monitoring methods are widely used in critically ill patients despite poor evidence of their accuracy. The erroneous interpretations of blood pressure (BP) may lead to clinical errors. Objectives. To test the accuracy and reliability of aneroid (ABP) a...

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Main Authors: Sara Ribezzo, Eleonora Spina, Stefano Di Bartolomeo, Gianfranco Sanson
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:The Scientific World Journal
Online Access:http://dx.doi.org/10.1155/2014/353628
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author Sara Ribezzo
Eleonora Spina
Stefano Di Bartolomeo
Gianfranco Sanson
author_facet Sara Ribezzo
Eleonora Spina
Stefano Di Bartolomeo
Gianfranco Sanson
author_sort Sara Ribezzo
collection DOAJ
description Introduction. Noninvasive blood pressure (NIBP) monitoring methods are widely used in critically ill patients despite poor evidence of their accuracy. The erroneous interpretations of blood pressure (BP) may lead to clinical errors. Objectives. To test the accuracy and reliability of aneroid (ABP) and oscillometric (OBP) devices compared to the invasive BP (IBP) monitoring in an ICU population. Materials and Methods. Fifty adult patients (200 comparisons) were included in a randomized crossover trial. BP was recorded simultaneously by IBP and either by ABP or by OBP, taking IBP as gold standard. Results. Compared with ABP, IBP systolic values were significantly higher (mean difference ± standard deviation 9.74±13.8; P<0.0001). Both diastolic (-5.13±7.1; P<0.0001) and mean (-2.14±7.1; P=0.0033) IBP were instead lower. Compared with OBP, systolic (10.80±14.9; P<0.0001) and mean (5.36±7.1; P<0.0001) IBP were higher, while diastolic IBP (-3.62±6.0; P<0.0001) was lower. Bland-Altman plots showed wide limits of agreement in both NIBP-IBP comparisons. Conclusions. BP measurements with different devices produced significantly different results. Since in critically ill patients the importance of BP readings is often crucial, noninvasive techniques cannot be regarded as reliable alternatives to direct measurements.
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spelling doaj-art-aea65997e43647a4b483c63f4e058e532025-08-20T03:38:59ZengWileyThe Scientific World Journal2356-61401537-744X2014-01-01201410.1155/2014/353628353628Noninvasive Techniques for Blood Pressure Measurement Are Not a Reliable Alternative to Direct Measurement: A Randomized Crossover Trial in ICUSara Ribezzo0Eleonora Spina1Stefano Di Bartolomeo2Gianfranco Sanson3School of Nursing, University of Trieste, 34100 Trieste, ItalyIntensive Care Unit, University Hospital of Trieste, 34100 Trieste, ItalyDepartment of Anesthesia 1, University Hospital of Udine, 33100 Udine, ItalySchool of Nursing, University of Trieste, 34100 Trieste, ItalyIntroduction. Noninvasive blood pressure (NIBP) monitoring methods are widely used in critically ill patients despite poor evidence of their accuracy. The erroneous interpretations of blood pressure (BP) may lead to clinical errors. Objectives. To test the accuracy and reliability of aneroid (ABP) and oscillometric (OBP) devices compared to the invasive BP (IBP) monitoring in an ICU population. Materials and Methods. Fifty adult patients (200 comparisons) were included in a randomized crossover trial. BP was recorded simultaneously by IBP and either by ABP or by OBP, taking IBP as gold standard. Results. Compared with ABP, IBP systolic values were significantly higher (mean difference ± standard deviation 9.74±13.8; P<0.0001). Both diastolic (-5.13±7.1; P<0.0001) and mean (-2.14±7.1; P=0.0033) IBP were instead lower. Compared with OBP, systolic (10.80±14.9; P<0.0001) and mean (5.36±7.1; P<0.0001) IBP were higher, while diastolic IBP (-3.62±6.0; P<0.0001) was lower. Bland-Altman plots showed wide limits of agreement in both NIBP-IBP comparisons. Conclusions. BP measurements with different devices produced significantly different results. Since in critically ill patients the importance of BP readings is often crucial, noninvasive techniques cannot be regarded as reliable alternatives to direct measurements.http://dx.doi.org/10.1155/2014/353628
spellingShingle Sara Ribezzo
Eleonora Spina
Stefano Di Bartolomeo
Gianfranco Sanson
Noninvasive Techniques for Blood Pressure Measurement Are Not a Reliable Alternative to Direct Measurement: A Randomized Crossover Trial in ICU
The Scientific World Journal
title Noninvasive Techniques for Blood Pressure Measurement Are Not a Reliable Alternative to Direct Measurement: A Randomized Crossover Trial in ICU
title_full Noninvasive Techniques for Blood Pressure Measurement Are Not a Reliable Alternative to Direct Measurement: A Randomized Crossover Trial in ICU
title_fullStr Noninvasive Techniques for Blood Pressure Measurement Are Not a Reliable Alternative to Direct Measurement: A Randomized Crossover Trial in ICU
title_full_unstemmed Noninvasive Techniques for Blood Pressure Measurement Are Not a Reliable Alternative to Direct Measurement: A Randomized Crossover Trial in ICU
title_short Noninvasive Techniques for Blood Pressure Measurement Are Not a Reliable Alternative to Direct Measurement: A Randomized Crossover Trial in ICU
title_sort noninvasive techniques for blood pressure measurement are not a reliable alternative to direct measurement a randomized crossover trial in icu
url http://dx.doi.org/10.1155/2014/353628
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