Results of a survey of blood pressure monitoring by intensivists in critically ill patients: a preliminary study.
OBJECTIVE
Maintenance of mean arterial pressure>65 mm Hg has been associated with improved clinical outcomes in many studies of critically ill patients. Current guidelines for the management of septic shock and guidelines for managing other critical illnesses suggest intra-arterial blood pressure measurement is preferred over automated oscillometric noninvasive blood pressure measurement. Despite these recommendations, anecdotal experience suggested that the use of noninvasive blood pressure measurement in our institution and others in preference to intra-arterial blood pressure measurement remained prevalent.


METHODS
We designed an online survey and sent it by e-mail.


METHODS
Intensive care units.


METHODS
A randomly selected group from the membership of the Society for Critical Care Medicine.


METHODS
None.


RESULTS
Use of non-invasive and invasive blood pressure devices. Eight hundred eighty individuals received an invitation to complete the survey and 149 responded. We found that 71% (105 of 149) of intensivists estimated the correct cuff size rather than measuring arm circumference directly. In hypotensive patients, 73% of respondents (108 of 149) reported using noninvasive blood pressure measurement measurements for patient management. In patients on a vasopressor medication, 47% (70 of 149) of respondents reported using noninvasive blood pressure measurement for management.


CONCLUSIONS
The use of noninvasive blood pressure measurement measurements in critically ill patients is common despite the paucity of evidence validating its accuracy in critically ill patients. Given this widespread use, accuracy and precision validation studies comparing noninvasive blood pressure measurement with intra-arterial blood pressure measurement in critically ill patients should be performed.
Chatterjee
Arjun
A
Department of Internal Medicine, Section on Pulmonary, Critical Care, Allergy, and Immunologic Disease, Wake Forest University School of Medicine, Winston-Salem, NC, USA. achatter@wfubmc.edu
DePriest
Kirk
K
Blair
Russell
R
Bowton
David
D
Chin
Robert
R
D000328:Adult; D001795:Blood Pressure Determination / Q000295:instrumentation* / Q000379:methods; D015924:Blood Pressure Monitors; D003422:Critical Care / Q000379:methods; D016638:Critical Illness; D003625:Data Collection; D034742:Electronic Mail; D005260:Female; D017144:Focus Groups; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D010819:Physician's Role; D010818:Practice Patterns, Physicians'; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires