动脉内与无创血压监测:系统回顾和荟萃分析。

IF 2.2 3区 医学 Q2 CRITICAL CARE MEDICINE
Lauren Becker, Vera Bzhilyanskaya, Arjun Sharman, Madison Moran, Jasjot Sayal, Anandita Gaur, Anna Shaw, Emily Gorman, Ali Pourmand, Quincy K Tran
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引用次数: 0

摘要

背景:有创动脉内血压(IABP)监测在重症监护中很常见。然而,如果无创血压(NIBP)测量与IABP测量相似,则IABP可能是不必要的。目的:探讨IABP和NIBP测量值的差异及其临床意义。方法:通过系统评价和荟萃分析,检索了多个数据库从成立到2023年9月的符合条件的研究。主要和次要结果分别是有创和无创测量收缩压(SBP)和平均动脉压(MAP)之间的差异。第三期结局是IABP和NIBP测量的收缩压和MAP相差10毫米汞柱或更大。结果以标准化平均差异和95% ci表示。评估研究质量和异质性。该研究已在PROSPERO注册(CRD42022383924)。结果:meta分析纳入23项观察性研究(6549例患者)。IABP和NIBP测量值的标准化平均差异为0.238 (95% CI, 0.121-0.355;P < .001;I2 = 87%)和0.062 (95% CI, -0.065 ~ 0.189;P = .34;I2 = 87%)表示MAP。Bland-Altman图显示,NIBP测量的收缩压值通常低于IABP测量值。收缩压(SBP)和MAP (MAP)差异大于等于10 mm Hg的患病率(95% CI)分别为0.500(0.415-0.584)和0.330(0.227-0.452)。结论:NIBP测量可能低估收缩压;10毫米汞柱或更大的差异相对频繁。这些差异的临床意义尚不清楚。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Intra-Arterial Versus Noninvasive Blood Pressure Monitoring: A Systematic Review and Meta-Analysis.

Background: Invasive intra-arterial blood pressure (IABP) monitoring is common in critical care. However, IABP might be unnecessary if noninvasive blood pressure (NIBP) measurements are similar to IABP measurements.

Objectives: To investigate differences between IABP and NIBP measurements and their clinical relevance.

Methods: In a systematic review and meta-analysis, multiple databases were searched for eligible studies from inception to September 2023. Primary and secondary outcomes were differences between invasive and noninvasive measurements of systolic blood pressure (SBP) and mean arterial pressure (MAP), respectively. Tertiary outcomes were differences of 10 mm Hg or greater in SBP and MAP between IABP and NIBP measurements. Outcomes were expressed as standardized mean differences and 95% CIs. Study quality and heterogeneity were assessed. The study was registered with PROSPERO (CRD42022383924).

Results: The meta-analysis included 23 observational studies (6549 patients). Standardized mean differences between IABP and NIBP measurements were 0.238 (95% CI, 0.121-0.355; P < .001; I2 = 87%) for SBP and 0.062 (95% CI, -0.065 to 0.189; P = .34; I2 = 87%) for MAP. Bland-Altman plots demonstrated that SBP values were often lower with NIBP than with IABP measurements. The prevalence (95% CI) of differences of 10 mm Hg or greater was 0.500 (0.415-0.584) for SBP and 0.330 (0.227-0.452) for MAP.

Conclusions: Measurement via NIBP may underestimate SBP; differences of 10 mm Hg or greater are relatively frequent. The clinical relevance of these differences remains unclear.

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来源期刊
CiteScore
4.30
自引率
3.70%
发文量
103
审稿时长
6-12 weeks
期刊介绍: The editors of the American Journal of Critical Care (AJCC) invite authors to submit original manuscripts describing investigations, advances, or observations from all specialties related to the care of critically and acutely ill patients. Papers promoting collaborative practice and research are encouraged. Manuscripts will be considered on the understanding that they have not been published elsewhere and have been submitted solely to AJCC.
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