 |
|
Accuracy of an Automated Blood Pressure Device in Stable Inpatients
Optimum vs Routine Use
Cathryn L. Shuler, MD;
Nancy Allison, RN, ANP;
Scott Holcomb, MS;
Marquette Harlan, RN;
Joe McNeill, RN;
Germaine Robinett, RN;
Susan P. Bagby, MD
Arch Intern Med. 1998;158:714-721.
Background Despite widespread use of the automated blood pressure (BP) device (IVAC model 4200, IVAC Corporation, San Diego, Calif), there is little formal validation in the literature on its accuracy.
Objective To assess the accuracy of the IVAC 4200 device, both under standardized conditions and as routinely used by ward staff, compared with the true indirect BP measured by mercury manometer (MM).
Methods One hundred forty-five stable inpatients were randomly selected for BP measurements by 3 randomly ordered protocols: (1) MM performed by certified investigators, (2) IVAC 4200 BP performed by trained investigators (research automated [RA]), and (3) IVAC 4200 BP performed by ward personnel (ward automated [WA]).
Results For RA compared with MM ("true" indirect BP), 59% of systolic and 54% of diastolic readings were within 5 mm Hg and 83% of systolic and 86% of diastolic were within 10 mm Hg for a British Hypertension Society grade C for both. For WA compared with MM, 40% of systolic and 50% of diastolic readings were within 5 mm Hg and 70% of systolic and 80% of diastolic readings were within 10 mm Hg for British Hypertension Society grades D and C, respectively. The presence of arrhythmias and/or low K5 values (fifth phase of Korotkoff sounds <30 mm Hg) significantly increased the inaccuracy for diastolic values. Inappropriate cuff selection significantly increased inaccuracy of systolic BP (WA vs MM).
Conclusions The IVAC 4200 yields substandard estimates of systolic and diastolic BP even under standardized, thus optimum conditions. The presence of arrythmias or low K5 values and the selection of inappropriate cuff size by the ward staff also contributed to inaccuracy.
From the Medical Center/Portland Division, Department of Veterans Affairs (Drs Shuler and Bagby, Mss Allison, Harlan, and Robinett, and Mr McNeil), and the Oregon Health Sciences University (Mr Holcomb), Portland.
RELATED LETTER
Evaluation of a Blood Pressure Monitoring Device
Myron L. Cohen, Alan S. Berson, Bruce Alpert, and Richard P. Avoy
Arch Intern Med. 1999;159(4):407-408.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Evaluation of Methods for Improving Precision of Blood Pressure Measurements in Phase I Clinical Trials
Terra et al.
J Clin Pharmacol 2004;44:457-463.
ABSTRACT
| FULL TEXT
The head-up tilt test with haemodynamic instability score in diagnosing chronic fatigue syndrome
Naschitz et al.
QJM 2003;96:133-142.
ABSTRACT
| FULL TEXT
Evaluation of a Blood Pressure Monitoring Device
Cohen et al.
Arch Intern Med 1999;159:407-408.
FULL TEXT
Accuracy of an Automated Blood Pressure Device Under Conditions of the Head-up Tilt Test
Naschitz et al.
Arch Intern Med 1999;159:317-317.
FULL TEXT
|
