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Oscillometry and direct blood pressure: A comparative clinical study during deliberate hypotension

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Abstract

Oscillometry using an automatic monitor was compared with invasive blood pressure monitoring in 21 patients scheduled for surgery under general anaesthesia with deliberate hypotension. Six ranges of mean blood pressure measurements were studied, two of which were hypotensive. An excellent correlation was found between the two methods (systolic: r = 0.94; mean: r = 0.93; diastolic: r = 0.88) but there was a large variability among individual subjects. For systolic, diastolic and mean intra-arterial readings above an approximative value of 10.64 KPa (80 mmHg), the oscillometric monitor was found to underestimate blood pressure. Inversely, it was found to overestimate blood pressure for intra-arterial readings under the approximative value of 10.8 KPa (80 mmHg).

We conclude that the non-invasive monitor represents a good trend estimation of the invasive radial blood pres-sure technique, but that wide inter-individual variability and the overestimation of blood pressure below an approximative value of 10.64 KPa (80 mmHg) precludes interchange of techniques when absolute values are considered, especially during controlled hypotension. However, oscillometry could represent a better estimate of central aortic pressure.

Résumé

Chez 21 patients qui subissaient une chirurgie sous hypotension contrôlée, nous avons comparé l’oscillomé-trie avec la pression artérielle sanglante. Six niveaux de pression artérielle moyenne dont deux étaient dans des valeurs hypotensives ont été étudiés. Nous avons trouvé une bonne corrélation entre les deux techniques (systole: r = 0.94; moyenne: r = 0.93; diastole: r = 0.88), avec cependant beaucoup de variations individuelles. Pour les valeurs de systole, de diastole et de moyenne au-dessus d’une valeur approximative de 10.64 KPa (80 mmHg), l’oscillométrie sousestime la pression artérielle. Au contraire, pour une pression intra-artérielle en-dessous d’une valeur approximative de 10.84 KPa (80 mmHg), l’oscillométrie surestime la pression.

Nous concluons que le moniteur non envahissant donne une bonne tendance de la pression radiale sanglante, mais que de grandes variations entre individus et une surestimation de la pression en bas d’une valeur approximative 10.64 KPa (80 mmHg) par cet appareil oscillométrique nous empechent ad’interchanger ces deux types de monitorage depression artérielle en hypotension artérielle contrôlée. Cependant, il se peut que l’oscillométrie soil un meilleur reflet de la pression aortique que la tension radiale sanglante.

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Correspondence to M. Gourdeau or R. Martin or Y. Lamarche or L. Tetreault.

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Gourdeau, M., Martin, R., Lamarche, Y. et al. Oscillometry and direct blood pressure: A comparative clinical study during deliberate hypotension. Can Anaesth Soc J 33, 300–307 (1986). https://doi.org/10.1007/BF03010741

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Key words

  • Monitoring: blood pressure
  • Measurement technique: blood pressure
  • Invasive
  • non-invasive
  • oscillometry