{"title":"根据肱动脉袖带充气时的 Korotkoff 音测量血压,平均比袖带放气时的血压值要高。","authors":"Branko G. Celler, A. Argha","doi":"10.1088/1361-6579/ad39a2","DOIUrl":null,"url":null,"abstract":"OBJECTIVES\n In this study, we test the hypothesis that if, as demonstrated in a previous study, brachial arteries exhibit hysteresis as the occluding cuff is deflated and fail to open until cuff pressure (CP) is well below true intra-arterial blood pressure (IAPB), estimating systolic (SBP) and diastolic blood pressure (DBP) from the presence of Korotkoff sounds as CP increases may eliminate these errors and give more accurate estimates of SBP and DBP relative to IABP readings. Approach. In 62 subjects of varying ages (45.1±19.8, range 20-6 - 75.8 years), including 44 men (45.3±19.4, range 20.6 - 75.8 years) and 18 women (44.4±21.4, range 20.9 - 75.3 years), we sequentially recorded SBP and DBP both during cuff inflation and cuff deflation using Korotkoff sounds. Results. There was a significant (p<0.0001) increase in SBP from 122.8±13.2 to 127.6±13.0 mmHg and a significant (p=0.0001) increase in DBP from 70.0±9.0 to 77.5±9.7 mmHg. Of the 62 subjects, 51 showed a positive increase in SBP (0 to 14 mmHg) and 11 subjects showed a reduction (-0.3 to -7 mmHg). The average differences for SBP and DBP estimates derived as the cuff inflates and those derived as the cuff deflates were 4.8±4.6 mmHg and 2.5±4.6mmHg, not dissimilar to the differences reported between IABP and NIBP measurements. Although we could not develop multiparameter linear or non-linear models to explain this phenomenon we have clearly demonstrated through ANOVA tests that both body mass index (BMI) and pulse wave velocity (PWV) are implicated, supporting the hypothesis that the phenomenon is associated with age, higher BMI and stiffer arteries. Significance. The implications of this study are that brachial sphygmomanometry carried out during cuff inflation could be more accurate than measurements carried out as the cuff deflates. Further research is required to validate these results with intra-arterial blood pressure measurements. .","PeriodicalId":2,"journal":{"name":"ACS Applied Bio Materials","volume":"19 14","pages":""},"PeriodicalIF":4.6000,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Measuring blood pressure from Korotkoff sounds as the brachial cuff inflates on average provides higher values than when the cuff deflates.\",\"authors\":\"Branko G. Celler, A. Argha\",\"doi\":\"10.1088/1361-6579/ad39a2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"OBJECTIVES\\n In this study, we test the hypothesis that if, as demonstrated in a previous study, brachial arteries exhibit hysteresis as the occluding cuff is deflated and fail to open until cuff pressure (CP) is well below true intra-arterial blood pressure (IAPB), estimating systolic (SBP) and diastolic blood pressure (DBP) from the presence of Korotkoff sounds as CP increases may eliminate these errors and give more accurate estimates of SBP and DBP relative to IABP readings. Approach. In 62 subjects of varying ages (45.1±19.8, range 20-6 - 75.8 years), including 44 men (45.3±19.4, range 20.6 - 75.8 years) and 18 women (44.4±21.4, range 20.9 - 75.3 years), we sequentially recorded SBP and DBP both during cuff inflation and cuff deflation using Korotkoff sounds. Results. There was a significant (p<0.0001) increase in SBP from 122.8±13.2 to 127.6±13.0 mmHg and a significant (p=0.0001) increase in DBP from 70.0±9.0 to 77.5±9.7 mmHg. Of the 62 subjects, 51 showed a positive increase in SBP (0 to 14 mmHg) and 11 subjects showed a reduction (-0.3 to -7 mmHg). The average differences for SBP and DBP estimates derived as the cuff inflates and those derived as the cuff deflates were 4.8±4.6 mmHg and 2.5±4.6mmHg, not dissimilar to the differences reported between IABP and NIBP measurements. Although we could not develop multiparameter linear or non-linear models to explain this phenomenon we have clearly demonstrated through ANOVA tests that both body mass index (BMI) and pulse wave velocity (PWV) are implicated, supporting the hypothesis that the phenomenon is associated with age, higher BMI and stiffer arteries. Significance. The implications of this study are that brachial sphygmomanometry carried out during cuff inflation could be more accurate than measurements carried out as the cuff deflates. Further research is required to validate these results with intra-arterial blood pressure measurements. .\",\"PeriodicalId\":2,\"journal\":{\"name\":\"ACS Applied Bio Materials\",\"volume\":\"19 14\",\"pages\":\"\"},\"PeriodicalIF\":4.6000,\"publicationDate\":\"2024-04-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ACS Applied Bio Materials\",\"FirstCategoryId\":\"5\",\"ListUrlMain\":\"https://doi.org/10.1088/1361-6579/ad39a2\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MATERIALS SCIENCE, BIOMATERIALS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ACS Applied Bio Materials","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1088/1361-6579/ad39a2","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MATERIALS SCIENCE, BIOMATERIALS","Score":null,"Total":0}
Measuring blood pressure from Korotkoff sounds as the brachial cuff inflates on average provides higher values than when the cuff deflates.
OBJECTIVES
In this study, we test the hypothesis that if, as demonstrated in a previous study, brachial arteries exhibit hysteresis as the occluding cuff is deflated and fail to open until cuff pressure (CP) is well below true intra-arterial blood pressure (IAPB), estimating systolic (SBP) and diastolic blood pressure (DBP) from the presence of Korotkoff sounds as CP increases may eliminate these errors and give more accurate estimates of SBP and DBP relative to IABP readings. Approach. In 62 subjects of varying ages (45.1±19.8, range 20-6 - 75.8 years), including 44 men (45.3±19.4, range 20.6 - 75.8 years) and 18 women (44.4±21.4, range 20.9 - 75.3 years), we sequentially recorded SBP and DBP both during cuff inflation and cuff deflation using Korotkoff sounds. Results. There was a significant (p<0.0001) increase in SBP from 122.8±13.2 to 127.6±13.0 mmHg and a significant (p=0.0001) increase in DBP from 70.0±9.0 to 77.5±9.7 mmHg. Of the 62 subjects, 51 showed a positive increase in SBP (0 to 14 mmHg) and 11 subjects showed a reduction (-0.3 to -7 mmHg). The average differences for SBP and DBP estimates derived as the cuff inflates and those derived as the cuff deflates were 4.8±4.6 mmHg and 2.5±4.6mmHg, not dissimilar to the differences reported between IABP and NIBP measurements. Although we could not develop multiparameter linear or non-linear models to explain this phenomenon we have clearly demonstrated through ANOVA tests that both body mass index (BMI) and pulse wave velocity (PWV) are implicated, supporting the hypothesis that the phenomenon is associated with age, higher BMI and stiffer arteries. Significance. The implications of this study are that brachial sphygmomanometry carried out during cuff inflation could be more accurate than measurements carried out as the cuff deflates. Further research is required to validate these results with intra-arterial blood pressure measurements. .
期刊介绍:
ACS Applied Bio Materials is an interdisciplinary journal publishing original research covering all aspects of biomaterials and biointerfaces including and beyond the traditional biosensing, biomedical and therapeutic applications.
The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrates knowledge in the areas of materials, engineering, physics, bioscience, and chemistry into important bio applications. The journal is specifically interested in work that addresses the relationship between structure and function and assesses the stability and degradation of materials under relevant environmental and biological conditions.