Oscillometric blood pressure measurement used for calibration of the arterial tonometry method contributes significantly to error.

BACKGROUND AND OBJECTIVE

We have investigated the accuracy of the Colin tonometry module, a non-invasive alternative to intra-arterial blood pressure (BP) measurement. The claims of previous publications range between good agreement to significant discrepancies between the Colin tonometry and intra-arterial methods. The Colin method relies on calibration of the tonometry module using an oscillometric method. Our aim was to look at the effect of this calibration on the accuracy.

METHODS

Ten conscious patients who already had an indwelling arterial catheter were studied. The Colin monitor was set to perform ten calibration cycles first with the oscillometric cuff on the same arm as the tonometry module and secondly on the opposite arm. Simultaneous recording of BP wave forms from the intra-arterial BP transducer and the Colin monitor allowed comparison of beat-by-beat systolic, diastolic and mean BP.

RESULTS

There was considerable inter- and intra-patient variation. In the worst case, the error range was 41 mmHg over ten calibrations. Analysis of variance showed that contra- and ipsilateral calibrations gave a significantly different bias while the multiple calibrations accounted for a significant proportion of the variability in systolic BP error.

CONCLUSIONS

The Colin Tonometry method is not accurate enough to be used with confidence in clinical practice. The main reason for this is its reliance on an oscillometric method for calibration of the tonometry module. Single BP measurements, using either manual or semiautomatic instruments may vary considerably from the 'true' BP due to short-term perturbations of BP.