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动脉瘤性蛛网膜下腔出血患者无创动脉血压测量的可靠性。

Reliability of non-invasive arterial blood pressure measurement in patients with aneurysmal subarachnoid haemorrhage.

机构信息

Department of Neuroanaesthesiology, The Neuroscience Centre, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.

Department of Neurorehabilitation/Traumatic Brain Injury Unit, The Neuroscience Centre, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.

出版信息

Physiol Meas. 2022 Jul 7;43(7). doi: 10.1088/1361-6579/ac77d3.

Abstract

. Invasively measured arterial blood pressure (ABP) is associated with complications, while non-invasively measured ABP is generally considered risk-free. This study aimed to investigate the reliability of non-invasive ABP measured using finger-cuff volume-clamp device compared to invasive ABP measured by an arterial catheter in patients with aneurysmal subarachnoid haemorrhage (SAH).. In 30 patients admitted for neurointensive care with SAH, invasive and non-invasive ABP were recorded simultaneously. Reliability was assessed for mean, diastolic and systolic ABP separately using intraclass correlation coefficient (ICC) agreement for each full period and each 3 s average.A median of 3 (IQR: 2-3) periods were included for each participant. The full periods ( = 81) showed an ICC of 0.34 (95% CI: 0.14-0.52), 0.31 (95% CI: 0.10-0.49), and 0.20 (95% CI: 0.00-0.39) for mean, diastolic, and systolic ABP, respectively. Three-second averages ( = 33 786) for mean (ICC: 0.35; 95% CI: 0.33-0.36), diastolic (ICC: 0.25; 95% CI: 0.25-0.28), and systolic ABP (ICC: 0.26; 95% CI: 0.18-0.33) yielded similar findings. Pearson's correlation coefficient showed anof 0.15 ( < 0.001), 0.15 ( < 0.001), 0.06 ( = 0.027) for mean, diastolic and systolic ABP, respectively.In patients with SAH, non-invasive measurement of ABP using the widely used Nano system from Finapres Medical Systems-a finger-cuff volume-clamp device (Finapres, Chennai, India) showed poor reliability and therefore cannot be used interchangeably with invasively measured ABP.

摘要

. 有创测量的动脉血压(ABP)与并发症相关,而无创测量的 ABP 通常被认为是无风险的。本研究旨在探讨使用手指套容积钳夹装置无创测量 ABP 与通过动脉导管有创测量 ABP 在蛛网膜下腔出血(SAH)患者中的可靠性。. 在 30 名因蛛网膜下腔出血而接受神经重症监护的患者中,同时记录有创和无创 ABP。使用每个完整周期和每个 3 秒平均值的组内相关系数(ICC)评估平均、舒张压和收缩压的可靠性。每位参与者纳入中位数为 3(IQR:2-3)个周期。完整周期(n=81)显示平均 ABP 的 ICC 为 0.34(95%CI:0.14-0.52)、0.31(95%CI:0.10-0.49)和 0.20(95%CI:0.00-0.39),舒张压 ABP 的 ICC 为 0.25(95%CI:0.25-0.28),收缩压 ABP 的 ICC 为 0.26(95%CI:0.18-0.33)。平均 ABP(ICC:0.35;95%CI:0.33-0.36)、舒张压(ICC:0.25;95%CI:0.25-0.28)和收缩压(ICC:0.26;95%CI:0.18-0.33)的 3 秒平均值也得出类似结果。Pearson 相关系数显示平均 ABP 的 r 值为 0.15(<0.001)、舒张压 ABP 的 r 值为 0.15(<0.001)、收缩压 ABP 的 r 值为 0.06(=0.027)。在 SAH 患者中,广泛使用的 Finapres 医疗系统(印度钦奈的 Finapres,一种手指套容积钳夹装置)的无创测量 ABP 显示出较差的可靠性,因此不能与有创测量的 ABP 互换使用。

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