Accuracy of radial arterial pressure measurement during surgery under controlled hypotension.
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.
- Anesthesiology 04/1981; 54(3):227-36. · 5.16 Impact Factor
- Anesthesia & Analgesia 01/1983; 61(12):1016-9. · 3.30 Impact Factor
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ABSTRACT: Objective. To examine the validity of interchanging arterial sites and their responses to graded doses of epinephrine during human cardiopulmonary resuscitation (CPR). Design. Consecutive case series. Setting. Large, urban Emergency Department. Patients. Adult, normothermic, nonhemor-rhagic cardiac arrest patients. Interventions. While receiving advanced cardiac life support, patients received right atrial (n = 40), aortic (n = 40), radial (n = 40), and femoral (n = 17) artery catheters. Pressures were measured simultaneously at baseline, after 0.01 mg/ kg and 0.2 mg/kg of epinephrine. Measurements and Main Results. The mean aortic compression-phase pressure was 9.3 +/- 10 (SD), 8.1 +/- 11, and 4.4 +/- 9.5 mm Hg higher than radial artery pressure at baseline, after 0.01 mg/ kg, and 0.2 mg/kg of epinephrine, respectively (all statistically significant). When compared with the femoral artery at the same time points, the mean aortic compression-phase pressure was also 3.0 +/- 6.8,1.9 +/- 8, and 0.6 +/- 7.7 mm Hg higher, respectively (none statistically significant). The aortic relaxation-phase pressure was 1.3 +/- 3.6, 1.1 +/- 3.8, and 1.6 +/- 2.5 mm Hg lower than the radial artery at baseline, after 0.01 mg/kg and 0.2 mg/kg of epinephrine, respectively (all statistically significant). When compared with the femoral artery at the same time points, the aortic relaxation-phase pressure was 0.6 +/- 2.0,0.3 +/- 3.3, and 0.3 +/- 2A mm Hg lower, respectively (none statistically significant). Conclusions. Radial artery relaxation-phase pressure, although statistically higher, correlated with aortic relaxation-phase pressure. Femoral artery relaxation-phase pressure was not statistically different from aortic relaxation-phase pressure. Aortic pressure was statistically higher and had a lower correlation with radial artery pressures during compression phase. The aortic to radial artery and aortic to femoral artery compression-phase gradients abated with increasing doses of epinephrine therapy. Caution must be used when substituting compression-phase pressure obtained at radial or femoral artery sites for aortic pressure during human CPR. Coronary artery perfusion pressures obtained with radial and femoral arteries correlate with aortic pressure when measuring the response to vasopressor therapy during CPU when an interpretable waveform exists. (Crit Care Med 1993; 21:878-883) (C) Williams & Wilkins 1993. All Rights Reserved.Critical Care Medicine 05/1993; 21(6). · 6.12 Impact Factor