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Accuracy of invasive arterial pressure monitoring in cardiovascular patients: an observational study

Overview of attention for article published in Critical Care, November 2014
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (95th percentile)
  • High Attention Score compared to outputs of the same age and source (93rd percentile)

Mentioned by

news
1 news outlet
twitter
34 tweeters
facebook
2 Facebook pages
googleplus
1 Google+ user

Citations

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51 Dimensions

Readers on

mendeley
107 Mendeley
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Title
Accuracy of invasive arterial pressure monitoring in cardiovascular patients: an observational study
Published in
Critical Care, November 2014
DOI 10.1186/s13054-014-0644-4
Pubmed ID
Authors

Stefano Romagnoli, Zaccaria Ricci, Diego Quattrone, Lorenzo Tofani, Omar Tujjar, Gianluca Villa, Salvatore M Romano, A Raffaele De Gaudio

Abstract

IntroductionCritically ill patients and patients undergoing high-risk and major surgery, are instrumented with intra-arterial catheters and invasive blood pressure is considered the ¿gold standard¿ for arterial pressure monitoring. Nonetheless, artifacts due to inappropriate dynamic response of the fluid-filled monitoring systems may lead to clinically relevant differences between actual and displayed pressure values. We sought to analyze the incidence and causes of resonance/underdamping phenomena in patients undergoing major vascular and cardiac surgery.MethodsArterial pressures were measured invasively and, according to the fast-flush Gardner¿s test, each patient was attributed to one of two groups depending on the presence (R-group) or absence (NR-group) of resonance/underdamping. Invasive pressure values were then compared with the non-invasive ones.ResultsA total of 11,610 pulses and 1,200 non-invasive blood pressure measurements were analyzed in 300 patients. Ninety-two out of 300 (30.7%) underdamping/resonance arterial signals were found. In these cases (R-group) systolic invasive blood pressure (IBP) average overestimation of non-invasive blood pressure (NIBP) was 28.5 (15.9) mmHg (P <0.0001) while in the NR-group the overestimation was 4.1(5.3) mmHg (P <0.0001). The mean IBP-NIBP difference in diastolic pressure in the R-group was ¿2.2 (10.6) mmHg and, in the NR-group ¿1.1 (5.8) mmHg. The mean arterial pressure difference was 7.4 (11.2) mmHg in the R-group and 2.3 (6.4) mmHg in the NR-group. A multivariate logistic regression identified five parameters independently associated with underdamping/resonance: polydistrectual arteriopathy (P =0.0023; OR¿=¿2.82), history of arterial hypertension (P =0.0214), chronic obstructive pulmonary disease (P =0.198; OR¿=¿2.09), arterial catheter diameter (20 vs. 18 gauge) (P <0.0001; OR¿=¿0.34) and sedation (P =0.0131; OR¿=¿0.5). The ROC curve for the maximal pressure¿time ratio, showed an optimum selected cut-off point of 1.67 mmHg/msec with a specificity of 97% (95% CI: 95.13 to 99.47%) and a sensitivity of 77% (95% CI: 67.25 to 85.28%) and an area under the ROC curve by extended trapezoidal rule of 0.88.ConclusionPhysicians should be aware of the possibility that IBP can be inaccurate in a consistent number of patients due to underdamping/resonance phenomena. NIBP measurement may help to confirm/exclude the presence of this artifact avoiding inappropriate treatments.

Twitter Demographics

The data shown below were collected from the profiles of 34 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 107 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Brazil 2 2%
Italy 2 2%
Belgium 1 <1%
United States 1 <1%
Unknown 101 94%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 15 14%
Other 14 13%
Researcher 14 13%
Student > Bachelor 14 13%
Student > Master 11 10%
Other 26 24%
Unknown 13 12%
Readers by discipline Count As %
Medicine and Dentistry 51 48%
Engineering 17 16%
Nursing and Health Professions 11 10%
Mathematics 3 3%
Veterinary Science and Veterinary Medicine 3 3%
Other 4 4%
Unknown 18 17%

Attention Score in Context

This research output has an Altmetric Attention Score of 30. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 14 August 2018.
All research outputs
#696,663
of 15,605,862 outputs
Outputs from Critical Care
#633
of 4,929 outputs
Outputs of similar age
#14,325
of 305,991 outputs
Outputs of similar age from Critical Care
#16
of 229 outputs
Altmetric has tracked 15,605,862 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 95th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 4,929 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 15.5. This one has done well, scoring higher than 87% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 305,991 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 95% of its contemporaries.
We're also able to compare this research output to 229 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 93% of its contemporaries.