Article

Accuracy of radial arterial pressure measurement during surgery under controlled hypotension.

Anesthesia and Intensive Care Department, Hotel-Dieu de France Hospital, Saint-Joseph University, Beirut, Lebanon.
Acta Anaesthesiologica Scandinavica (impact factor: 2.19). 02/2002; 46(2):173-5. pp.173-5
Source: PubMed

ABSTRACT Radial arterial pressure underestimates the pressure in the aorta in several clinical situations. A central-to-radial pressure gradient was attributed to intense vasodilation. The aim of this study was to evaluate the accuracy of radial pressure monitoring during controlled hypotension achieved with profound arterial vasodilation.
Ten patients with ASA physical status I and II undergoing maxillofacial surgery under general anesthesia were enrolled in this prospective study. Radial and femoral arteries were cannulated and connected to a pressure monitoring system. Controlled hypotension was achieved with an infusion of nicardipine titrated to maintain MAP between 50 and 60 mmHg. Simultaneous radial and femoral systolic, mean and diastolic arterial pressures were recorded before, during and after controlled hypotension. Results were expressed as mean +/- SD. Concomitant radial and femoral pressures were compared by a paired Student's test, P < 0.05 being significant.
In all, 150 sets of arterial pressures measurement were obtained. There were no statistically significant differences between radial and femoral arterial pressures measured before, during or after controlled hypotension.
Radial arterial pressure is an accurate measure of central arterial pressure during controlled hypotension achieved with arterial vasodilation.

0 0
 · 
0 Bookmarks
 · 
19 Views
  • Source
    Article: Peripheral arterial blood pressure monitoring adequately tracks central arterial blood pressure in critically ill patients: an observational study.
    Mariano Alejandro Mignini, Enrique Piacentini, Arnaldo Dubin
    [show abstract] [hide abstract]
    ABSTRACT: Invasive arterial blood pressure monitoring is a common practice in intensive care units (ICUs). Accuracy of invasive blood pressure monitoring is crucial in evaluating the cardiocirculatory system and adjusting drug therapy for hemodynamic support. However, the best site for catheter insertion is controversial. Lack of definitive information in critically ill patients makes it difficult to establish guidelines for daily practice in intensive care. We hypothesize that peripheral and central mean arterial blood pressures are interchangeable in critically ill patients. This is a prospective, observational study carried out in a surgical-medical ICU in a teaching hospital. Fifty-five critically ill patients with clinical indication of invasive arterial pressure monitoring were included in the study. No interventions were made. Simultaneous measurements were registered in central (femoral) and peripheral (radial) arteries. Bias and precision between both measurements were calculated with Bland-Altman analysis for the whole group. Bias and precision were compared between patients receiving high doses of vasoactive drugs (norepinephrine or epinephrine >0.1 microg/kg/minute or dopamine >10 microg/kg/minute) and those receiving low doses (norepinephrine or epinephrine <0.1 microg/kg/minute or dopamine <10 microg/kg/minute). Central mean arterial pressure was 3 +/- 4 mmHg higher than peripheral mean arterial pressure for the whole population and there were no differences between groups (3 +/- 4 mmHg for both groups). Measurement of mean arterial blood pressure in radial or femoral arteries is clinically interchangeable. It is not mandatory to cannulate the femoral artery, even in critically ill patients receiving high doses of vasoactive drugs.
    Critical care (London, England) 01/2006; 10(2):R43. · 4.61 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

accurate measure
 
arterial pressures measurement
 
ASA physical status
 
central arterial pressure
 
central-to-radial pressure gradient
 
clinical situations
 
Concomitant radial
 
Controlled hypotension
 
diastolic arterial pressures
 
femoral arterial pressures
 
general anesthesia
 
nicardipine titrated
 
paired Student's test
 
pressure monitoring system
 
profound arterial vasodilation
 
prospective study
 
Radial arterial pressure
 
radial pressure monitoring
 
Simultaneous radial
 
statistically significant differences
 

A Yazigi