Department of Women's Anesthesia, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore.
Duke-NUS Medical School, 100 Bukit Timah Road, Singapore, 229899, Singapore.
BMC Anesthesiol. 2020 Aug 31;20(1):218. doi: 10.1186/s12871-020-01131-6.
Accurate blood pressure (BP) measurement depends on appropriate cuff size and shape in relation to the arm. Arm dimensions outside the recommended range of cuff sizes or trunco-conical arms may result in inaccurate BP measurements. Measuring BP using finger cuffs is a potential solution. Arm cuff size is based on mid-arm circumference (MAC), and trunco-conicity is quantified by conicity index. We aimed to determine the correlation of MAC, body mass index (BMI), and weight with conicity index.
A prospective cohort study was conducted in the KK Women's and Children's Hospital where third trimester parturients scheduled for cesarean delivery were recruited after obtaining informed consent. Parturients were asked to rate their experience with time taken to obtain BP readings, cuff popping off during measurement, need to move the cuff from the upper arm to lower arm or leg, and need to change to a different cuff. Our primary outcome was the correlation between MAC and conicity index, calculated using Pearson's correlation. The correlation between BMI and weight with conicity index was also determined.
We enrolled 300 parturients. Moderate correlation was found between left MAC and left conicity index (r = 0.41, 95% CI 0.32 to 0.51), and right MAC and right conicity index (r = 0.39, 95% CI 0.29 to 0.48). Weight (r = 0.35 to 0.39) and BMI (r = 0.41 to 0.43) correlated with conicity index in this study. MAC of 1 parturient fell outside the recommended range for arm cuffs, but all parturients fit into available finger cuffs. Obese parturients had increased problems with arm cuffs popping off and needing a change of cuff.
BMI better correlated with conicity index compared to MAC or weight. Standard finger cuffs were suitable for all parturients studied and may be a suitable alternative.
Clinicaltrials.gov NCT04012151 . Registered 9 Jul 2019.
准确的血压（BP）测量取决于袖带相对于手臂的尺寸和形状。手臂尺寸超出袖带尺寸推荐范围或呈截圆锥形可能会导致血压测量不准确。使用手指袖带测量血压是一种潜在的解决方案。臂袖带尺寸基于中臂周长（MAC），而截锥形通过锥形指数来量化。我们旨在确定 MAC、体重指数（BMI）和体重与锥形指数的相关性。
这是一项在 KK 妇女儿童医院进行的前瞻性队列研究，在获得知情同意后，招募计划行剖宫产分娩的第三孕期产妇。让产妇评价测量血压时获取读数所花费的时间、测量过程中袖带弹出、需要将袖带从上臂移到下臂或腿部以及需要更换不同袖带的体验。我们的主要结局是使用 Pearson 相关系数计算 MAC 与锥形指数之间的相关性。还确定了 BMI 和体重与锥形指数的相关性。
我们共纳入 300 名产妇。左侧 MAC 与左侧锥形指数之间存在中度相关性（r=0.41，95%CI 0.32 至 0.51），右侧 MAC 与右侧锥形指数之间存在中度相关性（r=0.39，95%CI 0.29 至 0.48）。在这项研究中，体重（r=0.35 至 0.39）和 BMI（r=0.41 至 0.43）与锥形指数相关。1 名产妇的 MAC 超出了手臂袖带的推荐范围，但所有产妇都适合使用现有的手指袖带。肥胖产妇的袖带弹出和需要更换袖带的问题更严重。
与 MAC 或体重相比，BMI 与锥形指数相关性更好。标准手指袖带适合所有研究产妇，可能是一种合适的替代方案。
Clinicaltrials.gov NCT04012151。2019 年 7 月 9 日注册。
