Navpreet Kamboj1, Kristina Chang2, Kelly Metcalfe3, Charlene H Chu4, Aaron Conway5. 1. Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada. Electronic address: navpreet.kamboj@mail.utoronto.ca. 2. Peter Munk Cardiac Centre, University Health Network, Toronto, Canada. 3. Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada; Women's College Research Institute, Toronto, Canada. 4. Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada; KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada. 5. Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada; Peter Munk Cardiac Centre, University Health Network, Toronto, Canada; School of Nursing, Queensland University of Technology (QUT), Brisbane, Australia.
Abstract
OBJECTIVE: To summarize the evidence regarding the accuracy of continuous non-invasive arterial pressure measurements in adult critical care patients. RESEARCH METHODOLOGY: Medline, EMBASE, and CINAHL were searched for studies that included adult critical care patients reporting the agreement between continuous non-invasive and invasive arterial pressure measurements. The studies were selected and assessed for risk of bias using the Revised Quality Assessment of Diagnostic Accuracy Studies tool by two independent reviewers. The Grading of Recommendations, Assessment, Development and Evaluations approach was used. Pooled estimates of the mean bias and limits of agreement with outer 95% confidence intervals (termed population limits of agreement) were calculated. RESULTS: Population limits of agreement for systolic blood pressure were wide, spanning from -36.13 mmHg to 28.28 mmHg (18 studies; 785 participants). Accuracy of diastolic blood pressure measurements was highly inconsistent across studies, resulting in imprecise estimates for the population limits of agreement. Population limits of agreement for mean arterial pressure spanned from -39.96 mmHg to 44.36 mmHg (17 studies; 765 participants). The evidence was rated as very low-quality due to very serious concerns about heterogeneity and imprecision. CONCLUSION: Substantial differences in blood pressure were identified between measurements taken from continuous non-invasive and invasive monitoring devices. Clinicians should consider this broad range of uncertainty if using these devices to inform clinical decision-making in critical care.
OBJECTIVE: To summarize the evidence regarding the accuracy of continuous non-invasive arterial pressure measurements in adult critical care patients. RESEARCH METHODOLOGY: Medline, EMBASE, and CINAHL were searched for studies that included adult critical care patients reporting the agreement between continuous non-invasive and invasive arterial pressure measurements. The studies were selected and assessed for risk of bias using the Revised Quality Assessment of Diagnostic Accuracy Studies tool by two independent reviewers. The Grading of Recommendations, Assessment, Development and Evaluations approach was used. Pooled estimates of the mean bias and limits of agreement with outer 95% confidence intervals (termed population limits of agreement) were calculated. RESULTS: Population limits of agreement for systolic blood pressure were wide, spanning from -36.13 mmHg to 28.28 mmHg (18 studies; 785 participants). Accuracy of diastolic blood pressure measurements was highly inconsistent across studies, resulting in imprecise estimates for the population limits of agreement. Population limits of agreement for mean arterial pressure spanned from -39.96 mmHg to 44.36 mmHg (17 studies; 765 participants). The evidence was rated as very low-quality due to very serious concerns about heterogeneity and imprecision. CONCLUSION: Substantial differences in blood pressure were identified between measurements taken from continuous non-invasive and invasive monitoring devices. Clinicians should consider this broad range of uncertainty if using these devices to inform clinical decision-making in critical care.
Authors: Peter H Charlton; Panicos A Kyriaco; Jonathan Mant; Vaidotas Marozas; Phil Chowienczyk; Jordi Alastruey Journal: Proc IEEE Inst Electr Electron Eng Date: 2022-03-11 Impact factor: 10.961
Authors: Peter H Charlton; Birutė Paliakaitė; Kristjan Pilt; Martin Bachler; Serena Zanelli; Dániel Kulin; John Allen; Magid Hallab; Elisabetta Bianchini; Christopher C Mayer; Dimitrios Terentes-Printzios; Verena Dittrich; Bernhard Hametner; Dave Veerasingam; Dejan Žikić; Vaidotas Marozas Journal: Am J Physiol Heart Circ Physiol Date: 2021-12-24 Impact factor: 4.733