Marie-Ève Leblanc1,2, Audrey Auclair1, Jacinthe Leclerc1,3,4, Jean Bussières1,5, Mohsen Agharazii5,6, Frédéric-Simon Hould1,5, Simon Marceau1,5, Patrice Brassard1,7, Christian Godbout1, Audrey Grenier1, Lyne Cloutier3, Paul Poirier1,2. 1. Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada. 2. Faculty of pharmacy, Laval University, Québec, Canada. 3. Nursing department, Université du Québec à Trois-Rivières, Québec, Canada. 4. Faculty of Medicine, McGill University, Montreal, Canada. 5. Faculty of medicine, Laval University, Québec, Canada. 6. Research Center, Division of Nephrology, Centre Hospitalier Universitaire de Québec, Hôtel-Dieu de Québec, Quebec, Canada. 7. Department of Kinesiology, Laval University, Québec, Canada.
Abstract
BACKGROUND: Blood pressure measurement in severe obesity may be technically challenging as the cuff of the device may not fit adequately around the upper arm. The aim of the study was to assess the agreement between intra-arterial blood pressure values (gold standard) compared with forearm blood pressure measurements in severely obese patients in different arm positions. METHODS: Thirty-three severely obese patients and 21 controls participated in the study. Pairs of intra-arterial blood pressures were compared with simultaneous forearm blood pressure measurement using an oscillometric device in 4 positions: (i) supine, (ii) semi-fowler with the forearm resting at heart level, (iii) semi-fowler with the arm downward, and (iv) semi-fowler with the arm raised overhead. Degree of agreement between measurements was assessed. RESULTS: Overall, correlations of systolic and diastolic blood pressure measurements between the gold standard and forearm blood pressure were 0.95 (n = 722; P < 0.001) and 0.89 (n = 482; P < 0.001), respectively. Systolic blood pressure measured using the forearm approach in the supine and the semi-fowler positions with arm downward showed the best agreement when compared with the gold standard (-4 ± 11 (P < 0.001) and 2 ± 14 mm Hg (P = 0.19), respectively). In the control group, better agreement was found between the supine and semi-fowler positions with the arm resting at heart level (1 ± 9 mm Hg (P = 0.29) and -3 ± 10 mm Hg (P = 0.01), respectively). CONCLUSIONS: Forearm systolic blood pressure consistently agreed with the gold standard in the supine position. This method can be of use in clinical settings when upper-arm measurement is challenging in severe obesity.
BACKGROUND: Blood pressure measurement in severe obesity may be technically challenging as the cuff of the device may not fit adequately around the upper arm. The aim of the study was to assess the agreement between intra-arterial blood pressure values (gold standard) compared with forearm blood pressure measurements in severely obesepatients in different arm positions. METHODS: Thirty-three severely obesepatients and 21 controls participated in the study. Pairs of intra-arterial blood pressures were compared with simultaneous forearm blood pressure measurement using an oscillometric device in 4 positions: (i) supine, (ii) semi-fowler with the forearm resting at heart level, (iii) semi-fowler with the arm downward, and (iv) semi-fowler with the arm raised overhead. Degree of agreement between measurements was assessed. RESULTS: Overall, correlations of systolic and diastolic blood pressure measurements between the gold standard and forearm blood pressure were 0.95 (n = 722; P < 0.001) and 0.89 (n = 482; P < 0.001), respectively. Systolic blood pressure measured using the forearm approach in the supine and the semi-fowler positions with arm downward showed the best agreement when compared with the gold standard (-4 ± 11 (P < 0.001) and 2 ± 14 mm Hg (P = 0.19), respectively). In the control group, better agreement was found between the supine and semi-fowler positions with the arm resting at heart level (1 ± 9 mm Hg (P = 0.29) and -3 ± 10 mm Hg (P = 0.01), respectively). CONCLUSIONS: Forearm systolic blood pressure consistently agreed with the gold standard in the supine position. This method can be of use in clinical settings when upper-arm measurement is challenging in severe obesity.
Authors: Hailey N Miller; Miriam B Berger; Sandy Askew; Elizabeth Trefney; Crystal Tyson; Laura Svetkey; Gary G Bennett; Dori M Steinberg Journal: J Cardiovasc Nurs Date: 2022-04-23 Impact factor: 2.468
Authors: Ulf Lorenzen; Gunnar Elke; Jonathan Hansen; Markus Pohlmann; Jan H Beckmann; Phil Klose; Matthias Gruenewald; Jochen Renner Journal: BMC Anesthesiol Date: 2022-03-28 Impact factor: 2.217