ABSTRACT
Objective:To figure out the timing of zeroing and the location of the zero line in the central venous pressure (CVP) monitoring and invasive arterial blood pressure (IBP) monitoring, and to provide scientific and accurate data for patients management.Methods:The liquid vessel models were used to simulate the pressure measurement process of the continuous pressure monitoring system. Based on the theory of fluid mechanics and the knowledge of blood pressure physiology and cardiovascular anatomy, the composition and influencing factors of the pressure in the fluid-filled catheter system during the zeroing and placing the transducer in the zero line of CVP and IBP, were analyzed.Results:The pressure in the liquid-filled catheter system was composed of atmospheric pressure, the pressure of pumping bag, the gravity of the water column (the vertical distance between the liquid level of Murphy's dropper and pressure transducer, ΔH), and the resistance of tube wall. This pressure value is set as a pressure of 0 mmHg (1 mmHg ≈ 0.133 kPa). In the process of pressure measurement, when the pressure transducer was placed at a horizontal position of 10 cm below the highest liquid level of the vessel, the pressure measured at different catheter tip positions was all 10 cmH 2O (1 cmH 2O ≈ 0.098 kPa); When the pressure transducer was placed at the horizontal position of the highest liquid level of the vessel, the measured pressure is 0 mmHg. Conclusion:Zeroing should repeatedly be performed only when one or more conditions (atmospheric pressure, pressure of pumping bag, gravity of ΔH water column and resistance of tube wall) are changed. In the measurement process, the pressure transducer should be placed at the zero line position at any time to eliminate the influence of hydrostatic pressure and to ensure the objective and accurate value.
ABSTRACT
Objective:To evaluate the effect of invasive arterial blood pressure (IBP) monitoring on the prognosis of patients with sepsis.Methods:Patients with sepsis from the MIMIC-Ⅳ database were collected and divided into IBP and non-invasive blood pressure monitoring (NIBP) groups according to whether IBP monitoring was performed. Baseline variables that were considered clinically relevant or showed a univariate relationship with the outcome were entered into a multivariate logistic regression model as covariates.Propensity score matching(PSM) and inverse probability of treatment weighing(IPTW) were used to adjust confounders to ensure the robustness of findings.Subgroup analysis were conducted to evaluate the effect of differences in IBP onset and duration on outcome.Results:The 28-day mortality is lower in IBP group compared with NIBP group( OR=0.54, 95% CI 0.46-0.62, P<0.001), the conclusion maintain robust after PSM and IPTW.Then we conducted a series of logistic regression regarding to different initial IBP time(<24 h,24 h-48 h,>48 h) and the initial IBP time within 24 h showed the same results compared to primary outcoms( OR=0.42, 95% CI: 0.36-0.49, P<0.001). IBP duration varied (≤1day, ≤2days, ≤3days, ≤4days, >4days) all showed a statistically significant association with decreased 28-day mortality in the IBP group. Conclusions:IBP is associated with decreased 28-day mortality in patients with sepsis, and the optimal time of IBP is within 24 hours.
ABSTRACT
Objective To explore the feasibility of monitoring blood pressure via superficial temporal artery catheterization in neonates,which may provide more ways to monitor arterial blood pressure of neonates.Methods By lottery method,64 neonates from NICU who met inclusion criteria and needed arterial blood pressure monitoring were randomly divided into two groups.Thirty-two cases in the experimental group were treated with superficial temporal artery catheterization,while 32 cases in the control group were treated with radial artery catheterization.The success rate of one-time catheterization,indwelling time of catheter,blood pressure and the rate of complications were compared between two groups.Results There were no significant differences between two groups in the success rate of one-time catheterization,indwelling time of catheter,systolic blood pressure and the rate of complications (P＞0.05).Results showed there was significant difference in diastolic blood pressure between two groups(P＜ 0.05).Conclusion Compared with radial artery blood catheterization,neonatal superficial temporal artery catheterization showed equivalent effect,which made it more convenient for observing condition of neonates.
ABSTRACT
Objective To explore the feasibility of monitoring blood pressure via superficial temporal artery catheterization in neonates,which may provide more ways to monitor arterial blood pressure of neonates.Methods By lottery method,64 neonates from NICU who met inclusion criteria and needed arterial blood pressure monitoring were randomly divided into two groups.Thirty-two cases in the experimental group were treated with superficial temporal artery catheterization,while 32 cases in the control group were treated with radial artery catheterization.The success rate of one-time catheterization,indwelling time of catheter,blood pressure and the rate of complications were compared between two groups.Results There were no significant differences between two groups in the success rate of one-time catheterization,indwelling time of catheter,systolic blood pressure and the rate of complications (P＞0.05).Results showed there was significant difference in diastolic blood pressure between two groups(P＜ 0.05).Conclusion Compared with radial artery blood catheterization,neonatal superficial temporal artery catheterization showed equivalent effect,which made it more convenient for observing condition of neonates.
ABSTRACT
Objective To study the applied value of invasive arterial blood pressure monitoring in the diagnose and treatment of coronary artery intervention. Methods The dynamic changes of ECG, the non-invasive blood pressure, the invasive arterial blood pressure monitoring and the clinical performance were ob-served in 163 patients in the process of coronary artery intervention (CAI). Then the invasive arterial blood pressure change and the non-invasive blood pressure change were compared. Results The change rates of invasive arterial blood pressure were higher than that of non-invasive arterial blood pressure. The difference of both changes had statistical significance. The invasive blood pressure decreased and wave forms changed in 26 cases. These reflected sensitively the patients' condition and the issues in the process of CAI. Conclusions To strengthen the invasive arterial blood pressure monitoring can improve the success rate of CAI more effec-tively and reduce the complication.