دورية أكاديمية
أعرض في EDS

Discrepancy Between Invasive and Noninvasive Blood Pressure Measurements in Patients with Sepsis by Vasopressor Status

التفاصيل البيبلوغرافية
العنوان: Discrepancy Between Invasive and Noninvasive Blood Pressure Measurements in Patients with Sepsis by Vasopressor Status
المؤلفون: Quincy K. Tran, Dominique Gelmann, Zain Alam, Richa Beher, Emily Engelbrecht-Wiggans, Matthew Fairchild, Emily Hart, Grace Hollis, Allison Karwoski, Jamie Palmer, Alison Raffman, Daniel J. Haase
المصدر: Western Journal of Emergency Medicine, Vol 23, Iss 3 (2022)
بيانات النشر: eScholarship Publishing, University of California, 2022.
سنة النشر: 2022
المجموعة: LCC:Medicine
LCC:Medical emergencies. Critical care. Intensive care. First aid
مصطلحات موضوعية: Medicine, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
الوصف: Introduction: Blood pressure (BP) monitoring is an essential component of sepsis management. The Surviving Sepsis Guidelines recommend invasive arterial BP (IABP) monitoring, although the benefits over non-invasive BP (NIBP) monitoring are unclear. This study investigated discrepancies between IABP and NIBP measurement and their clinical significance. We hypothesized that IABP monitoring would be associated with changes in management among patients with sepsis requiring vasopressors. Methods: We performed a retrospective study of adult patients admitted to the critical care resuscitation unit at a quaternary medical center between January 1–December 31, 2017. We included patients with sepsis conditions AND IABP monitoring. We defined a clinically significant BP discrepancy (BPD) between NIBP and IABP measurement as a difference of > 10 millimeters of mercury (mm Hg) AND change of BP management to maintain mean arterial pressure ≥ 65 mm Hg. Results: We analyzed 127 patients. Among 57 (45%) requiring vasopressors, 9 (16%) patients had a clinically significant BPD vs 2 patients (3% odds ratio [OR] 6.4; 95% CI: 1.2–30; P = 0.01) without vasopressors. In multivariable logistic regression, higher Sequential Organ Failure Assessment (SOFA) score (OR 1.33; 95% CI: 1.02–1.73; P = 0.03) and serum lactate (OR 1.27; 95% CI: 1.003–1.60, P = 0.04) were associated with increased likelihood of clinically significant BPD. There were no complications (95% CI: 0–0.02) from arterial catheter insertions. Conclusion: Among our population of septic patients, the use of vasopressors was associated with increased odds of a clinically significant blood pressure discrepancy between IABP and NIBP measurement. Additionally, higher SOFA score and serum lactate were associated with higher likelihood of clinically significant blood pressure discrepancy. Further studies are needed to confirm our observations and investigate the benefits vs the risk of harm of IABP monitoring in patients with sepsis.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 1936-9018
Relation: https://escholarship.org/uc/item/61w0x67j; https://doaj.org/toc/1936-9018
DOI: 10.5811/westjem.2022.1.53211
URL الوصول: https://doaj.org/article/f0fc1df4eeb7446486069fddf61ead77
رقم الأكسشن: edsdoj.f0fc1df4eeb7446486069fddf61ead77
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:19369018
DOI:10.5811/westjem.2022.1.53211