Monitoring arterial blood pressure during whole body hyperthermia.
BACKGROUND
For monitoring of arterial blood pressure (ABP) during whole body hyperthermia (WBH) different methods have been recommended. This investigation was performed to evaluate the agreement of invasive measurements at various sites, and to compare invasive and non-invasive methods of ABP monitoring under conditions of a heat-induced extreme vasodilation.


METHODS
In 19 patients, 48 treatments with WBH were performed. Measurements of ABP in the radial and femoral artery by oscillometry and by sphygmomanometry were taken at four temperature levels during WBH (37, 40, 41.8 and 39 degrees C).


RESULTS
Significant differences were observed between invasive and non-invasive methods for systolic ABP, with higher values for non-invasive measurements. When compared with both invasive measurements for diastolic blood pressures, sphygmomanometry gave higher values and oscillometry gave lower values. Sphygmomanometry also showed higher values for mean ABP compared with all other techniques, while measurements in radial and femoral artery and by oscillometry only differed by approximately 5 mmHg.


CONCLUSIONS
The mean arterial pressure and not the systolic and/or diastolic pressure should guide hemodynamic management during WBH. The sphygmomanometric technique is not recommended for use during hyperthermia.
Kerner
T
T
Department of Anesthesiology and Critical Care Medicine, Charité Medical Center, Virchow Hospital, Humboldt University, Berlin. thoralf.kerner@charite.de
Deja
M
M
Ahlers
O
O
Hildebrandt
B
B
Dieing
A
A
Riess
H
H
Wust
P
P
Gerlach
H
H
D000328:Adult; D000758:Anesthesia; D001794:Blood Pressure / Q000502:physiology*; D001831:Body Temperature / Q000502:physiology; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009369:Neoplasms / Q000628:therapy; D019722:Sphygmomanometers; D014664:Vasodilation / Q000502:physiology