A Direct Assessment of Noninvasive Continuous Blood Pressure Monitoring in the Emergency Department and Intensive Care Unit

IF 1.8 4区 医学 Q2 EMERGENCY MEDICINE
Landon D. Hamilton PhD, Scott Binns RN, MS, Kim McFann PhD, Nikiah Nudell MS, Julie A. Dunn MD
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引用次数: 0

Abstract

Introduction

Noninvasive continuous blood pressure monitoring has the potential to improve patient treatment in the hospital setting. Such noninvasive devices can be applied earlier in the treatment process to empower nurses and clinicians to react more quickly to patient deterioration with the added benefit of eliminating the risks associated with invasive monitoring. However, emerging technologies must be capable of reproducing current clinical measures for medical decision making.

Methods

This study aimed to determine the usability and willingness of nurses to implement a noninvasive continuous blood pressure monitoring device. The secondary aim directly compared the systolic blood pressure, diastolic blood pressure, and mean arterial pressure values recorded by the device (VitalStream; CareTaker Medical LLC, Charlottesville, VA) with the “gold standard” brachial cuff and arterial line measures recorded in the emergency department and intensive care unit settings.

Results

VitalStream was similarly received by nurses in the emergency department and intensive care setting, but ultimately had greater promotion from emergency nurses. Despite some statistical similarity between measurement methodologies, all direct comparisons were found to not meet the Association for the Advancement of Medical Instrumentation 2008 and Association for the Advancement of Medical Instrumentation / European Society of Hypertension / International Organization for Standardization 2019 consensus statement criteria for acceptable blood pressure measure differences between the VitalStream and “gold standard” clinical measures. In all instances, the standard deviation of the Bland-Altman bias exceeded 8 mm Hg with less than 85% of paired differences falling within 10 mm Hg of the “gold standard.”

Discussion

Taken together, the tested device requires additional postprocessing for medical decision making in trauma or emergent care.

急诊科和重症监护室无创连续血压监测的直接评估。
导言无创连续血压监测具有改善医院环境中患者治疗的潜力。这种无创设备可以在治疗过程的早期应用,使护士和临床医生能够更快地对患者病情的恶化做出反应,同时还能消除与有创监测相关的风险。本研究旨在确定无创连续血压监测设备的可用性以及护士实施该设备的意愿。次要目的是将该设备(VitalStream;CareTaker Medical LLC,弗吉尼亚州夏洛茨维尔市)记录的收缩压、舒张压和平均动脉压值与急诊科和重症监护室记录的 "黄金标准 "肱动脉袖带和动脉导管测量值进行直接比较。尽管测量方法在统计学上有一定的相似性,但所有直接比较结果均不符合 2008 年美国医学仪器促进协会和 2019 年美国医学仪器促进协会/欧洲高血压学会/国际标准化组织关于 VitalStream 与 "金标准 "临床测量方法之间可接受血压测量差异的共识声明标准。在所有情况下,布兰-阿尔特曼偏差的标准偏差都超过 8 毫米汞柱,只有不到 85% 的配对差异在 "黄金标准 "的 10 毫米汞柱以内。
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来源期刊
CiteScore
3.10
自引率
11.80%
发文量
132
审稿时长
46 days
期刊介绍: The Journal of Emergency Nursing, the official journal of the Emergency Nurses Association (ENA), is committed to the dissemination of high quality, peer-reviewed manuscripts relevant to all areas of emergency nursing practice across the lifespan. Journal content includes clinical topics, integrative or systematic literature reviews, research, and practice improvement initiatives that provide emergency nurses globally with implications for translation of new knowledge into practice. The Journal also includes focused sections such as case studies, pharmacology/toxicology, injury prevention, trauma, triage, quality and safety, pediatrics and geriatrics. The Journal aims to mirror the goal of ENA to promote: community, governance and leadership, knowledge, quality and safety, and advocacy.
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