Monitores automáticos de pressão arterial: avaliação de três modelos em voluntárias
Automatic blood pressure monitors: evaluation of three models in volunteers
Luiz Eduardo Imbelloni; Lúcia Beato; Ana Paula Tolentino; Dulcimar Donizete de Souza; José Antônio Cordeiro
Resumo
Palavras-chave
Abstract
BACKGROUND AND OBJECTIVES: Since 1903, blood pressure has been noninvasively monitored (NIBP), either with manual sphygmomanometer or automated noninvasive devices. One NIBP measurement problem is the considerable variance in blood pressure data, both within and between available techniques. The oscillometric method for NIBP monitoring evaluates blood pressure during cuff deflation. Difficulties in blood pressure measurement by oscillometry may arise from: inadequate cuff size, inadequate cuff application, undetected fails in cuff, hoses, or connectors, arm movement, shock and vascular compression proximal to the cuff. This study aimed at evaluating the reliability of three noninvasive blood pressure monitoring devices during five measurements.
METHODS: Blood pressure of 60 healthy female volunteers aged 20 to 40 years was evaluated from 7 am to 11 am, in the sitting position during a normal workday. Five measures were taken with each device at 2-minute intervals. Three automatic blood pressure monitors were studied. No patient was obese, hypertensive or suffering from cardiac disease and cardiac arrhythmia. Indirect measurements were made according to manufacturers' instructions.
RESULTS: There were no differences in demographics among the three studied groups. Mean intrapersonal variation from one measurement to the other was up to 6.7 mmHg for systolic blood pressure (SBP), 4.9 mmHg for mean blood pressure (MBP) and 3.3 mmHg for diastolic blood pressure (DBP) with 95% confidence interval. The highest difference between measures in the same volunteer was 49 mmHg for SBP, 46 mmHg for MBP and 28 mmHg for DBP.
CONCLUSIONS: This study has shown significant variations in SBP, MBP and DBP and that SBP is the most reliable parameter to check blood pressure changes in volunteers.
Keywords
Referencias
Dominguez RC, Michel A. Evolucion de la esfigmomanometria. Arch Inst Cardiol Méx. 1994;34:315-323.
Riva-Rocci S. Um nuovo sfigmomanometro. Gazzetta Medica di Torino. 1896;50:981-996.
Riva-Rocci S. Um nuovo sfigmomanometro. Gazzetta Medica di Torino. 1896:51981-1001.
Lelhane A, O'Malley K, O'Brien ET. Reporting of blood pressure data in medical journals. Br Med J. 1980;281:1603-1604.
Roche V, O'Malley K, OBrien ET. How scientific is blood pressure measurement in leading medical journal?. J Hypert. 1990;8:1167-1168.
Consenso Brasileiro para tratamento da hipertensão arterial. Arq Bras Card. 1994;16(^s2):S257-S258.
Holanda HEM, Mion Jr D, Peirin AMG. Medida da pressão arterial: Critérios empregados em artigos científicos de periódicos brasileiros. Arq Bras Card. 1997;68:433-436.
Carvalho JCA, Cardoso MMSC, Capelli EL. Prophylactic ephedrine during cesarean delivery spinal anesthesia: dose-response study of bolus and continuous infusion administration. Rev Bras Anestesiol. 1999;49:309-314.
Carvalho JCA, Cardoso MMSC, Lorenz E. Prophylactic ephedrine during spinal anesthesia for cesarean section: bolus followed by continuous infusion in fixed doses or continuous infusion in decreasing doses. Rev Bras Anestesiol. 2000;50:425-430.
Oliveira Filho GR, Garcia JHS, Goldschimidit R. Predictors of early hypotension during spinal anesthesia. Rev Bras Anestesiol. 2001;51:298-304.
Korotkoff NS. On the subject of methods of determining blood pressure. Bull Imperial Medical Academy. 1905;11:365.
Ramsey III M. Non-invasive automatic determination of mean arterial pressure. Med Biol Eng Comput. 1979;17:11-18.
Yelderman M, Ream AK. Indirect measurement of mean blood pressure in the anesthetized patient. Anesthesiology. 1979;50:253-256.
Hutton P, Dye J, Prys-Roberts C. An assessment of the Dinamap 845. Anaesthesia. 1984;39:261-267.
Park MK, Menard SM. Accuracy of blood pressure measurement of the Dinamap monitor in infants and children. Pediatrics. 1987;79:907-914.
Wareham JS, Haugh LD, Yeager SB. Prediction of arterial pressure in the premature neonate using the oscillometric method. Am J Dis Child. 1987;141:1108-1110.
Johnson CJH, Kerr JH. Automatic blood pressure monitors: A clinical evaluation of five models in adults. Anaesthesia. 1985;40:471-478.
Moyle JTB. Non-Invasive Monitoring in Anaesthesia. Anaesthesia Review II. 1984:200-213.
Gourdeau M, Martin R, Lamarche T. Oscillometry and direct blood pressure: a comparative clinical study during deliberate hypotension. Can Anaesth Soc J. 1986;33:300-307.
Gloyna DF, Huber P, Abston P. A comparison of blood pressure measurement techniques in the hypotensive patient. Anesth Analg. 1984;63:222.
Geddes LA, Tivey R. The importance of cuff width in measurement of blood pressure indirectly. Cardiovasc Res Cen Bul. 1976;14:69-79.
Carpenter RL, Caplan RA, Brown DL. Incidence and risk factors for side effects of spinal anesthesia. Anesthesiology. 1992;76:906-916.
Auroy Y, Naschi P, Messiah A. Severe complications related to regional anesthesia: Results of a prospective survey in France. Anesthesiology. 1997;87:479-486.
Carvalho JCA, Cardoso MMSC, Amaro AR. Low doses of subarachnoid morphine and fentanyl combined with rectal diclofenac for postoperative pain control after cesarean delivery. Rev Bras Anestesiol. 1999;49:103-106.
Delfino J, Pontes S, Gondim D et al. Isobaric 0.5% bupivacaine and 0.5% ropivacaine in spinal anesthesia for orthopedic surgery: A comparative study. Rev Bras Anestesiol. 1999;49:160-164.
Delfino J, Vale NB. Spinal anesthesia with 0.5% isobaric ropivacaine or levobupivacaine for lower limb surgeries. Rev Bras Anestesiol. 2001;51:91-97.
Imbelloni LE, Carneiro ANG. Comparison of 1.5% and 2% lidocaine with dextrose for spinal anesthesia. Rev Bras Anestesiol. 1999;49:9-13.
Imbelloni LE, Carneiro ANG. Comparison of 2% lidocaine with or without glucose for spinal anesthesia. Rev Bras Anestesiol. 1999;49:98-102.
Neves JFNP, Monteiro GA, Almeida JR. Spinal anesthesia for cesarean section: headache evaluation with 25G and 27G Quincke and Whitacre needles. Rev Bras Anestesiol. 1999;49:173-175.
Alves TCA, Braz JRC, Ganem EM. Influence of pre-anesthetic medication with clonidine on the association of sufentanil and bupivacaine in spinal anesthesia. Rev Bras Anestesiol. 1999;49:320-326.
Delfino J, Vale NB, Magalhães Filho E. Comparative study between 0. 5% and 0.75% isobaric ropivacaine in spinal anesthesia for orthopedic surgery. Rev Bras Anestesiol. 2000;50:207-211.
Imbelloni LE, Beato L. Comparative study between 0.5% isobaric bupivacaine and 0.5% isobaric mixture of 75% S(-) bupivacaine and 25% R(+) bupivacaine in spinal anesthesia for orthopedic surgery. Rev Bras Anestesiol. 2001;51:369-376.
Imbelloni LE. Spinal anesthesia with 2% plain lidocaine for short orthopedic surgery: Study in 250 patients. Rev Bras Anestesiol. 2002;52:24-33.
Imbelloni LE, Vieira EM, Beato L. Spinal anesthesia for outpatient pediatric surgery in 1-5 years old children with 0.5% isobaric enantiomeric mixture of bupivacaine (S75: R25). Rev Bras Anestesiol. 2002;52:286-293.
Imbelloni LE, Vieira EM, Beato L. Isobaric 0.5% bupivacaine for spinal anesthesia in pediatric outpatient surgery of 6 to 12 year old children: A prospective study. Rev Bras Anestesiol. 2002;52:402-409.
Cardoso MMSC. Hipotensão arterial materna em raquianestesia para cesárea. Cedar. 2002;VI:20:4-6.
RamseyIII M. Blood pressure monitoring: automated oscillometric devices. J Clin Monitoring. 1991;7:56-67.
Datta S, Alper MH, Ostheimer GW. Method of ephedrine administration and nausea and hypotension during spinal anesthesia during cesarean section. Anesthesiology. 1982;56:68-70.
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email