Limits...
Limitations of the of the oscillometric method for blood pressure measurements in dialyzed patients.

Czarkowski M, Staszkow M, Kostyra K, Shebani Z, Rozanowski K, Matuszkiewicz-Rowinska J, Niemczyk S - Med. Sci. Monit. (2011)

Bottom Line: No difference was found in systolic BP measured before and after HD (SBP before HD: REF -147.3 ± 27.3, OSC -147.5 ± 25.0 mmHg, p>0.05, SBP after HD: REF-141.1 ± 33.9, OSC-141.2 ± 31.5 mmHg, p>0.05, respectively), but diastolic BP (DBP) was significantly higher both before and after HD during REF measurement in comparison with OSC (DBP before HD: REF -79.0 ± 17.0, OSC -76.7 ± 15.0 mmHg, DBP after HD: REF -78.6 ± 18.8, OSC -76.7 ± 16.7 mmHg, p<0.001, respectively).However, a significant correlation between differences in BP measured by REF and OSC before HD and differences in BP measured by REF and OSC after HD was observed (Spearman's rank correlation coefficients: for SBP 0.502 and for DBP 0.557, p<0.000001).Our study found that individual features, not HD, determine the accuracy of OSC for BP measurement in hemodialysed patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland. mczark@gmail.com

ABSTRACT

Background: Despite more frequent use of the oscillometric method (OSC) for arterial blood pressure (BP) measurement, little is known about OSC's accuracy when used with hemodialysed patients. This study was undertaken to determine if hemodialysis (HD) and individual features in examined patients can affect the accuracy of OSC for BP measurement.

Material/methods: In 54 hemodialysed patients (57 ± 15 years), during 2 sessions (before and after HD), 3 pairs of BP measurements each were performed on arms, alternately employing OSC and auscultatory method, with mercury manometers by 2 observers (REF).

Results: No difference was found in systolic BP measured before and after HD (SBP before HD: REF -147.3 ± 27.3, OSC -147.5 ± 25.0 mmHg, p>0.05, SBP after HD: REF-141.1 ± 33.9, OSC-141.2 ± 31.5 mmHg, p>0.05, respectively), but diastolic BP (DBP) was significantly higher both before and after HD during REF measurement in comparison with OSC (DBP before HD: REF -79.0 ± 17.0, OSC -76.7 ± 15.0 mmHg, DBP after HD: REF -78.6 ± 18.8, OSC -76.7 ± 16.7 mmHg, p<0.001, respectively). No significant correlation between loss of body weight caused by HD and differences in BP measured by REF and OSC after HD was indicated (Pearson's correlation coefficients: for SBP -0.041, for DBP 0.030). However, a significant correlation between differences in BP measured by REF and OSC before HD and differences in BP measured by REF and OSC after HD was observed (Spearman's rank correlation coefficients: for SBP 0.502 and for DBP 0.557, p<0.000001).

Conclusions: Our study found that individual features, not HD, determine the accuracy of OSC for BP measurement in hemodialysed patients.

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Related in: MedlinePlus

Correlation between the differences in the systolic blood pressure (SBP) measured by REF and OSC before HD (δSBP before HD) and the differences in the systolic blood pressure (SBP) measured by REF and OSC after HD (δSBP after HD).
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f1-medscimonit-17-4-mt35: Correlation between the differences in the systolic blood pressure (SBP) measured by REF and OSC before HD (δSBP before HD) and the differences in the systolic blood pressure (SBP) measured by REF and OSC after HD (δSBP after HD).

Mentions: A significant correlation between δBP before HD and δBP after HD was found: respectively, for SBP (Pearson’s correlation coefficient 0.427, p<0.05 – Figure 1) and for DBP (Pearson’s correlation coefficient 0.480, p<0.05 – Figure 2). Taking into consideration an insignificant deviation from assumption as far as employing parametric tests is concerned, the analysis was repeated employing nonparametric test (Spearman’s rank correlation coefficient). The results were similar, respectively: for SBP 0.502 (p<0.000001) and for DBP 0.557, (p<0.000001).


Limitations of the of the oscillometric method for blood pressure measurements in dialyzed patients.

Czarkowski M, Staszkow M, Kostyra K, Shebani Z, Rozanowski K, Matuszkiewicz-Rowinska J, Niemczyk S - Med. Sci. Monit. (2011)

Correlation between the differences in the systolic blood pressure (SBP) measured by REF and OSC before HD (δSBP before HD) and the differences in the systolic blood pressure (SBP) measured by REF and OSC after HD (δSBP after HD).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3539525&req=5

f1-medscimonit-17-4-mt35: Correlation between the differences in the systolic blood pressure (SBP) measured by REF and OSC before HD (δSBP before HD) and the differences in the systolic blood pressure (SBP) measured by REF and OSC after HD (δSBP after HD).
Mentions: A significant correlation between δBP before HD and δBP after HD was found: respectively, for SBP (Pearson’s correlation coefficient 0.427, p<0.05 – Figure 1) and for DBP (Pearson’s correlation coefficient 0.480, p<0.05 – Figure 2). Taking into consideration an insignificant deviation from assumption as far as employing parametric tests is concerned, the analysis was repeated employing nonparametric test (Spearman’s rank correlation coefficient). The results were similar, respectively: for SBP 0.502 (p<0.000001) and for DBP 0.557, (p<0.000001).

Bottom Line: No difference was found in systolic BP measured before and after HD (SBP before HD: REF -147.3 ± 27.3, OSC -147.5 ± 25.0 mmHg, p>0.05, SBP after HD: REF-141.1 ± 33.9, OSC-141.2 ± 31.5 mmHg, p>0.05, respectively), but diastolic BP (DBP) was significantly higher both before and after HD during REF measurement in comparison with OSC (DBP before HD: REF -79.0 ± 17.0, OSC -76.7 ± 15.0 mmHg, DBP after HD: REF -78.6 ± 18.8, OSC -76.7 ± 16.7 mmHg, p<0.001, respectively).However, a significant correlation between differences in BP measured by REF and OSC before HD and differences in BP measured by REF and OSC after HD was observed (Spearman's rank correlation coefficients: for SBP 0.502 and for DBP 0.557, p<0.000001).Our study found that individual features, not HD, determine the accuracy of OSC for BP measurement in hemodialysed patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland. mczark@gmail.com

ABSTRACT

Background: Despite more frequent use of the oscillometric method (OSC) for arterial blood pressure (BP) measurement, little is known about OSC's accuracy when used with hemodialysed patients. This study was undertaken to determine if hemodialysis (HD) and individual features in examined patients can affect the accuracy of OSC for BP measurement.

Material/methods: In 54 hemodialysed patients (57 ± 15 years), during 2 sessions (before and after HD), 3 pairs of BP measurements each were performed on arms, alternately employing OSC and auscultatory method, with mercury manometers by 2 observers (REF).

Results: No difference was found in systolic BP measured before and after HD (SBP before HD: REF -147.3 ± 27.3, OSC -147.5 ± 25.0 mmHg, p>0.05, SBP after HD: REF-141.1 ± 33.9, OSC-141.2 ± 31.5 mmHg, p>0.05, respectively), but diastolic BP (DBP) was significantly higher both before and after HD during REF measurement in comparison with OSC (DBP before HD: REF -79.0 ± 17.0, OSC -76.7 ± 15.0 mmHg, DBP after HD: REF -78.6 ± 18.8, OSC -76.7 ± 16.7 mmHg, p<0.001, respectively). No significant correlation between loss of body weight caused by HD and differences in BP measured by REF and OSC after HD was indicated (Pearson's correlation coefficients: for SBP -0.041, for DBP 0.030). However, a significant correlation between differences in BP measured by REF and OSC before HD and differences in BP measured by REF and OSC after HD was observed (Spearman's rank correlation coefficients: for SBP 0.502 and for DBP 0.557, p<0.000001).

Conclusions: Our study found that individual features, not HD, determine the accuracy of OSC for BP measurement in hemodialysed patients.

Show MeSH
Related in: MedlinePlus