Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-28T00:34:57.606Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  24 May 2006

S. Hansen  and
M. Staber
S. Hansen
Affiliation:
Institute of Neurological Sciences, Southern General Hospital, Department of Clinical Physics, Glasgow, UK
M. Staber
Affiliation:
Institute of Neurological Sciences, Southern General Hospital, Department of Neuroanaesthesia, Glasgow, UK
Get access

Abstract

Summary

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.

Keywords

BLOOD PRESSURE DETERMINATIONMANOMETRY, tonometryEQUIPMENT AND SUPPLIES, accuracy, comparisons
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 9 , September 2006 , pp. 781 - 787
Copyright
2006 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Staessen JA, O'Brien ET, Thijs L, Fagard RH. Modern approaches to blood pressure measurement [Review] [165 refs]. Occup Environ Med 2000; 57 (8): 510–520.Google Scholar
Peñáz J. Photoelectric measurement of blood pressure, volume and flow in the finger. Digest 10th Int Conf on Medical and Biological Engineering, Dresden 1973; 104.Google Scholar
Kemmotsu O, Yokota S, Yamamura T, Takahashi T, Winter DC, Eckerle JS. A noninvasive blood pressure monitor based on arterial tonometry. Anesth Analg 1989; 68: S145; Abstract.Google Scholar
Kemmotsu O, Ueda M, Otsuka H, Yamamura T, Winter DC, Eckerle JS. Arterial tonometry for noninvasive, continuous blood pressure monitoring during anesthesia [see comments]. Anesthesiology 1991; 75 (2): 333–340.Google Scholar
Burkhardt D, Kinnealey E, Ford-Carleton P, Meyer M, Cooper J. Comparison of arterial tonometry with invasive pressure monitoring. Anesthesiology 1992; 77 (3): A479.Google Scholar
Searle NR, Perrault J, Ste-Marie H, Dupont C. Assessment of the arterial tonometer (N-CAT) for the continuous blood pressure measurement in rapid atrial fibrillation. Can J Anaesth 1993; 40 (4): 388–393.Google Scholar
Siegel LC, Brock-Utne JG, Brodsky JB. Comparison of arterial tonometry with radial artery catheter measurements of blood pressure in anesthetized patients [see comments]. Anesthesiology 1994; 81 (3): 578–584.Google Scholar
Kemmotsu O, Ohno M, Takita Ket al. Noninvasive, continuous blood pressure measurement by arterial tonometry during anesthesia in children. Anesthesiology 1994; 81 (5): 1162–1168.Google Scholar
Zorn EA, Wilson MB, Angel JJ, Zanella J, Alpert BS. Validation of an automated arterial tonometry monitor using Association for the Advancement of Medical Instrumentation standards. Blood Press Monit 1997; 2 (3–4): 185–188.Google Scholar
AAMI. American national standard. Electronic or automated sphygmomanometers.Arlington, VA: AAMI, 1993.
Lane D, Beevers M, Barnes N, Bourne J, John A, Malins S, Beevers DG. Inter-arm differences in blood pressure: when are they clinically significant? J Hypertens 2002; 20 (6): 1089–1095.Google Scholar
Pickering TG, Hall JE, Appel LJet al. Recommendations for blood pressure measurement in humans and experimental animals: Part 1: Blood pressure measurement in humans – A statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on high blood pressure research. Circulation 2005; 111 (5): 697–716.Google Scholar
O'Brien E, Waeber B, Parati G, Staessen J, Myers MG. Blood pressure measuring devices: recommendations of the European Society of Hypertension. BMJ 2001; 322 (7285): 531–536.Google Scholar
Singh NK, Jaiswal AK, Misra S, Srivastava PK. Assessment of autonomic dysfunction in Guillain-Barre syndrome and its prognostic implications. Acta Neurol Scand 1987; 75 (2): 101–105.Google Scholar
Kemmotsu O, Ueda M, Otsuka Het al. Blood pressure measurement by arterial tonometry in controlled hypotension. Anesthesia & Analgesia 1991; 73 (1): 54–58.Google Scholar