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The Scientific World Journal
Volume 2014, Article ID 353628, 8 pages
http://dx.doi.org/10.1155/2014/353628
Research Article

Noninvasive Techniques for Blood Pressure Measurement Are Not a Reliable Alternative to Direct Measurement: A Randomized Crossover Trial in ICU

1School of Nursing, University of Trieste, 34100 Trieste, Italy
2Intensive Care Unit, University Hospital of Trieste, 34100 Trieste, Italy
3Department of Anesthesia 1, University Hospital of Udine, 33100 Udine, Italy
4Emilia-Romagna Regional Agency for Health and Social Care, 40100 Bologna, Italy

Received 26 August 2013; Accepted 13 November 2013; Published 30 January 2014

Academic Editors: F. Hammarqvist, A. Kotanidou, and B. Laviolle

Copyright © 2014 Sara Ribezzo et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Noninvasive blood pressure (NIBP) monitoring methods are widely used in critically ill patients despite poor evidence of their accuracy. The erroneous interpretations of blood pressure (BP) may lead to clinical errors. Objectives. To test the accuracy and reliability of aneroid (ABP) and oscillometric (OBP) devices compared to the invasive BP (IBP) monitoring in an ICU population. Materials and Methods. Fifty adult patients (200 comparisons) were included in a randomized crossover trial. BP was recorded simultaneously by IBP and either by ABP or by OBP, taking IBP as gold standard. Results. Compared with ABP, IBP systolic values were significantly higher (mean difference ± standard deviation ; ). Both diastolic ( ; ) and mean ( ; ) IBP were instead lower. Compared with OBP, systolic ( ; ) and mean ( ; ) IBP were higher, while diastolic IBP ( ; ) was lower. Bland-Altman plots showed wide limits of agreement in both NIBP-IBP comparisons. Conclusions. BP measurements with different devices produced significantly different results. Since in critically ill patients the importance of BP readings is often crucial, noninvasive techniques cannot be regarded as reliable alternatives to direct measurements.