Kaufmann M A, Pargger H, Drop L J
Department of Anesthesia, Massachusetts General Hospital, Boston 02114, USA.
Anesth Analg. 1996 Feb;82(2):377-81. doi: 10.1097/00000539-199602000-00029.
Blood pressure (BP) is frequently measured in patients by noninvasive blood pressure (NIBP) monitors. Values obtained by oscillometric devices of different brands may appear in one patient's record as if they were interchangeable; their concordance, however, has not been established. In 25 patients with major depression who were treated with electroconvulsive therapy (ECT) BP was measured on either arm by devices manufactured by SpaceLabs (SpL, 12 patients, 182 data points) and Marquette (Marq, 13 patients, 193 data points), respectively, and comparisons were made with simultaneous measurements on the opposite arm by Dinamap 1846SX (DIN), during the awake state and at 1-min intervals up to 5-7 min after ECT. Because ECT is associated with an intense, but short-lasting hyperdynamic state, comparisons of BP values could be made over a wide range of pressures. Bland-Altman plots were constructed to show the distribution of pressure differences at all pressures. Agreements between two instruments were judged according to guide lines by the American Association for Advancement of Medical Instrumentation (AAMI). The standard deviation of the difference (SDD) between two DIN devices was 7 mm Hg for systolic (SBP) and 6.3 mm Hg for diastolic blood pressure (DBP), whereas mean differences were 0.9 and 0.2 mm Hg, respectively (P = not significant [NS]), thus showing reproducibility. Corresponding SDD values SpL versus DIN were 9.1 for SBP and 8.3 mm Hg for DBP, while the mean differences were 1.6 (P = 0.026) and 7.3 (P = 0.0001) mm Hg, respectively. Corresponding SDD values for Marq versus DIN were 11.8 and 9.7 mm Hg with mean differences of 0.8 (P = NS) and 0.3 (P = NS) mm Hg. Whereas SBP differences DIN versus DIN exceeded 10 mm Hg in only 10% of observations, they exceeded that threshold in 31% and 32% of observations for SpL versus DIN and Marq versus DIN, respectively. In view of the variability that exceeds the AAMI guidelines and the one out of three occurrence of individual SBP differences exceeding 10 mm Hg for comparisons of SpL or Marq versus DIN, measurements by these three oscillometric devices are not interchangeable.
无创血压（NIBP）监测仪常用于测量患者的血压（BP）。不同品牌示波测量设备所测得的值在患者记录中可能看似可以互换使用；然而，它们之间的一致性尚未得到证实。对25例接受电休克治疗（ECT）的重度抑郁症患者，分别使用太空实验室（SpL，12例患者，182个数据点）和马奎特（Marq，13例患者，193个数据点）生产的设备测量其两侧手臂的血压，并与使用迪纳迈普1846SX（DIN）在清醒状态下同时测量对侧手臂的血压进行比较，测量间隔为1分钟，直至ECT后5 - 7分钟。由于ECT会引发强烈但持续时间较短的高动力状态，因此可以在较宽的血压范围内比较血压值。绘制布兰德 - 奥特曼图以显示所有血压下压力差值的分布情况。根据美国医学仪器促进协会（AAMI）的指南判断两种仪器之间的一致性。两台DIN设备之间收缩压（SBP）差值的标准差（SDD）为7毫米汞柱，舒张压（DBP）为6.3毫米汞柱，而平均差值分别为0.9和0.2毫米汞柱（P = 无显著性差异[NS]），表明具有可重复性。SpL与DIN相比，SBP的相应SDD值为9.1，DBP为8.3毫米汞柱，而平均差值分别为1.6（P = 0.026）和7.3（P = 0.0001）毫米汞柱。Marq与DIN相比，相应的SDD值为11.8和9.7毫米汞柱，平均差值分别为0.8（P = NS）和0.3（P = NS）毫米汞柱。DIN与DIN之间SBP差值超过10毫米汞柱的情况仅在10%的观察中出现，而SpL与DIN以及Marq与DIN相比，分别有31%和32%的观察中超过了该阈值。鉴于这种变异性超过了AAMI指南，并且在SpL或Marq与DIN的比较中，个体SBP差值超过10毫米汞柱的情况每三个中就会出现一个，这三种示波测量设备的测量结果不可互换。
