eISSN: 1731-2531
ISSN: 1642-5758
Anaesthesiology Intensive Therapy
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5/2022
vol. 54
 
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abstract:
Review paper

Accuracy and precision of oscillometric noninvasive blood pressure measurement in critically ill patients: systematic review and meta-analysis

Wagner Luis Nedel
1, 2
,
Alessandro Tonin Vasconcellos
1
,
Karoline Ariane Gunsch
3
,
Pedro Henrique Rigotti Soares
1, 4

1.
Intensive Care Unit, Grupo Hospitalar Conceição, Porto Alegre, Brazil
2.
Programa de Pós-Graduação em Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
3.
Hospital Regional Bruno Born, Lajeado, Brazil
4.
Programa de Pós-Graduação em Neurociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
Anaesthesiol Intensive Ther 2022; 54, 5: 425–431
Online publish date: 2022/12/30
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Mean arterial pressure (MAP) is a key haemodynamic variable monitored in critically ill patients. The advantages of oscillometric noninvasive blood pressure (NIBP) measurement are its easy and fast methodology; however, the accuracy and the precision of this measurement in critically ill patients is constantly debated. We performed a systematic review and meta-analysis of observational studies comparing oscillometric NIBP methods with invasive arterial pressure (IAP) measurements. We included studies of adult critically ill patients, which evaluated MAP in the same patient by both NIBP and IAP at any site. We included only studies comparing simultaneous measurements of arterial pressure by NIBP and IAP, reporting their results using mean difference and SD of agreement. The main outcome was to define the bias of the MAP measured by NIBP over the IAP measurement. The quality of the studies was analysed by the QUADAS 2 tool. Seven studies and 1593 patients were included in the main analysis. The oscillometric NIBP method had a mean value of -1.50 mmHg when compared with IAP (95% CI: –3.34 to 0.35; I2 = 96% for random effects model, P < 0.01). The limits of agreement for MAP varied between –14.6 mmHg and +40.3 mmHg. NIBP had an adequate accuracy regarding MAP measurements by oscillometry. Limits of agreement may thus narrow the clinical applicability in scenarios in which there is a need for a more precise management of blood pressure.
keywords:

intensive care unit, blood pressure, invasive blood pressure, mean arterial pressure, noninvasive blood pressure, oscillometry

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