Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
BMC Anesthesiol. 2020 Apr 4;20(1):76. doi: 10.1186/s12871-020-00994-z.
Arm conicity is associated with non-invasive blood pressure (NIBP) measurement error and may be avoided by using finger cuffs. Predicting arm conicity may help decisions regarding NIBP measurement techniques.
We obtained upper limb measurements of adults presenting to the Pre-Anesthetic Clinic to determine: the suitability of arm and finger cuff sizes; the best anthropometric predictor of arm conicity based on the right arm slant angle; the incidence of a right arm slant angle < 83 degrees. Right mid-arm circumference (MAC) was compared to recommended cuff sizes and finger circumference compared to available cuffs. Slant angle was calculated from the measurements obtained. Linear regression was used to determine the better predictor of right arm slant angle. Correlation coefficients were calculated and R values compared.
Four hundred fifty-four patients participated and 453 had cone-shaped arms. One participant (0.2, 95% CI 0.0-1.2) had a MAC outside the recommended cuff range. Twenty-five participants (5.5, 95% CI 3.6-8.0) had a middle finger circumference greater than the largest ClearSight™ cuff. Body mass index (BMI), weight and right MAC all had low to moderate correlation with right arm slant angle (r = - 0.49, - 0.39, - 0.48, all p < 0.001) and regression revealed R values of 0.24, 0.15 and 0.23. Six participants (1.3, 95% CI 0.5-2.9) had a slant angle < 83 degrees.
Current NIBP equipment caters for most patients, based on the traditional measure of MAC. The utility of finger cuffs is limited by cuff size. BMI and right MAC showed the most promise in predicting arm conicity.
手臂的锥形与无创血压（NIBP）测量误差有关，使用手指袖带可以避免这种情况。预测手臂的锥形度可以帮助决策使用哪种 NIBP 测量技术。
我们对前来麻醉前诊所就诊的成年人上肢进行了测量，以确定：手臂和手指袖带尺寸的适用性；根据右臂倾斜角，预测手臂锥形度的最佳人体测量指标；右臂倾斜角<83 度的发生率。比较右手中臂周长（MAC）与推荐袖带尺寸，以及手指周长与可用袖带。从获得的测量值计算倾斜角。使用线性回归确定更好的预测右臂倾斜角的指标。计算相关系数并比较 R 值。
共有 454 名患者参加，其中 453 名患者的手臂呈锥形。有 1 名患者（0.2，95%置信区间 0.0-1.2）的 MAC 超出了推荐袖带范围。有 25 名患者（5.5，95%置信区间 3.6-8.0）的中指周长大于最大的 ClearSight™袖带。体重指数（BMI）、体重和右 MAC 与右臂倾斜角均呈低度至中度相关（r=-0.49，-0.39，-0.48，均 p<0.001），回归显示 R 值分别为 0.24、0.15 和 0.23。有 6 名患者（1.3，95%置信区间 0.5-2.9）的倾斜角<83 度。
目前的 NIBP 设备基于传统的 MAC 测量方法，适合大多数患者。手指袖带的实用性受到袖带尺寸的限制。BMI 和右 MAC 在预测手臂锥形度方面显示出最大的潜力。
