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Blood pressure measurement in the obese patient: a comparison between non-invasive proximal forearm and radial arterial blood pressure measurement
Thesis (MMed)--Stellenbosch University, 2017.
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| Format: | Thesis |
| Language: | en_ZA |
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Stellenbosch : Stellenbosch University
2017
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| _version_ | 1867613988865441792 |
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| access_status_str | Open Access |
| author | Verkhovsky, Anna |
| author2 | Smit, Marli |
| author_browse | Smit, Marli Verkhovsky, Anna |
| author_facet | Smit, Marli Verkhovsky, Anna |
| author_sort | Verkhovsky, Anna |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (MMed)--Stellenbosch University, 2017. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/102645 |
| institution | Stellenbosch University (South Africa) |
| language | en_ZA |
| last_indexed | 2026-06-10T12:44:53.996Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2017 |
| publishDateRange | 2017 |
| publishDateSort | 2017 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/102645 Blood pressure measurement in the obese patient: a comparison between non-invasive proximal forearm and radial arterial blood pressure measurement Verkhovsky, Anna Smit, Marli Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Anesthesiology and Critical Care. Invasive intra-arterial blood pressure Blood pressure -- Measurement Blood pressure -- Monitoring Overweight persons UCTD Thesis (MMed)--Stellenbosch University, 2017. ENGLISH ABSTRACT: ABSTRACT Background: South Africa has a high prevalence of obese adults. When these (obese) individuals present to a health care facility, blood pressure measurement will play an important role during routine medical evaluation. Accurate non-invasive blood pressure monitoring is a challenge in obese individuals secondary to inaccurate readings associated with inappropriate cuff size, structural differences of the upper arm as well as short upper arm length. Our aim was to identify an accurate, affordable, minimally invasive and low-risk blood pressure measurement modality in obese patients. Methods: This study included 30 patients with a body mass index of greater or equal to 30 kg/m2 presenting for surgery or staying in a High Care Unit at Tygerberg Hospital. In all of these patients, an intra-arterial line was included as part of their routine care. We compared the non-invasive (mean, systolic and diastolic) blood pressures readings from the proximal forearm, with the gold standard, being intra-arterial blood pressure readings. Results: There was poor agreement between the mean intra-arterial blood pressure measurement and the noninvasive blood pressure (NIBP) measured at the forearm. The mean NIBP measured at the forearm overestimated the intra-arterial blood pressure reading by 2% (±8.1 %. P 0.031). The computed upper and lower levels of agreement between the 2 methods ranged from -19.3 to 15.2%. Systolic NIBP measurements at the forearm over-estimated the IABP measurements by 0.9% (P 0.295). Upper and lower levels of agreement between the 2 methods ranged from -16.4 to 14.7%. Larger discrepancies between the two methods were observed for diastolic blood pressure measurements with a mean difference of -5.8% (P <0.0001). Conclusion: We cannot recommend that the forearm NIBP reading be used as an accurate, non-invasive and cost effective substitute to measure blood pressure in obese patients. AFIKAANS OPSOMMING: Agtergrond: Suid-Afrika het 'n hoë insidensie van vetsugtige volwassenes. Wanneer hierdie (vetsugtige) individue 'n gesondheidsorgfasiliteit besoek, sal bloeddrukmeting 'n belangrike rol tydens roetine mediese evaluering speel. Akkurate, nie-indringende bloeddrukmonitering is 'n uitdaging in vetsugtige individue. Ontoepaslike bloeddrukband grootte, anatomiese verskille van die boarm, asook kort boarmlengte lei tot onakkurate lesings. Ons doel was om 'n akkurate, bekostigbare, minimaal indringende en lae risiko bloeddrukmoniteringmodaliteit by vetsugtige pasiënte te identifiseer. Metodes: Hierdie studie sluit 30 pasiënte in met 'n liggaamsmassa-indeks van meer as of gelyk aan 30 kg / m2 wat geskeduleer is vir chirurgie of wie in 'n hoësorgeenheid by Tygerberg Hospitaal opgeneem is. In al hierdie pasiënte is 'n intra-arteriële lyn ingesluit as deel van hul roetine sorg. Nie-indringende (gemiddelde, sistoliese en diastoliese) bloeddruklesings vanaf die proksimale voorarm, is met die goudstandaard, intra-arteriële bloeddruklesings, vergelyk. Resultate: Daar was ‘n swak ooreenkoms tussen die gemiddelde intra-arteriële bloeddrukmeting en die nieindringende bloeddruk (NIBD), wat by die voorarm gemeet is. Die gemiddelde NIBD wat by die voorarm gemeet is, het die intra-arteriële bloeddruklesing met 2% oorskat (± 8.1%, P 0.031). Die berekende boonste en onderste vlakke van ooreenkoms tussen die 2 metodes het gewissel van -19.3 tot 15.2%. Systoliese NIBD-metings aan die voorarm het die IABD-metings oorskat met 0.9% (P 0.295). Bo en onderste vlakke van ooreenkoms tussen die 2 metodes het gewissel van -16.4 tot 14.7%. Met betrekking tot diastoliese bloeddrukmetings, is groter verskille tussen die twee metodes met 'n gemiddelde verskil van -5,8% (P <0,0001), waargeneem. Gevolgtrekking: Ons kan nie die voorarm NIBD-lesings as 'n akkurate, nie-indringende en koste-effektiewe plaasvervanger om bloeddruk in vetsugtige pasiënte te meet, aanbeveel nie. Masters 2017-11-21T06:54:22Z 2017-12-11T10:36:16Z 2018-11-01T03:00:04Z 2017-12 Thesis http://hdl.handle.net/10019.1/102645 en_ZA Stellenbosch University 28 pages application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Invasive intra-arterial blood pressure Blood pressure -- Measurement Blood pressure -- Monitoring Overweight persons UCTD Verkhovsky, Anna Blood pressure measurement in the obese patient: a comparison between non-invasive proximal forearm and radial arterial blood pressure measurement |
| title | Blood pressure measurement in the obese patient: a comparison between non-invasive proximal forearm and radial arterial blood pressure measurement |
| title_full | Blood pressure measurement in the obese patient: a comparison between non-invasive proximal forearm and radial arterial blood pressure measurement |
| title_fullStr | Blood pressure measurement in the obese patient: a comparison between non-invasive proximal forearm and radial arterial blood pressure measurement |
| title_full_unstemmed | Blood pressure measurement in the obese patient: a comparison between non-invasive proximal forearm and radial arterial blood pressure measurement |
| title_short | Blood pressure measurement in the obese patient: a comparison between non-invasive proximal forearm and radial arterial blood pressure measurement |
| title_sort | blood pressure measurement in the obese patient a comparison between non invasive proximal forearm and radial arterial blood pressure measurement |
| topic | Invasive intra-arterial blood pressure Blood pressure -- Measurement Blood pressure -- Monitoring Overweight persons UCTD |
| url | http://hdl.handle.net/10019.1/102645 |
| work_keys_str_mv | AT verkhovskyanna bloodpressuremeasurementintheobesepatientacomparisonbetweennoninvasiveproximalforearmandradialarterialbloodpressuremeasurement |