Oscillometric devices vs Arterial lines. New data.

Why is it important to stay up to date? There’s a pendulum in medicine but there’s a time when the pendulum swing is going to bite you in the butt and you’re going to be wrong. Seems like I’m wrong.

I have an extremely popular post and YouTube video regarding how oscillometric devices are correct with regards to their MAP but not their SBP and DBP. I hadn’t found any studies to validate how the SBP and DBP applied. Now we have data. And I may have to eat my words. I’m cool with that, though. This study was published earlier today. I cannot get my hands on it to take it apart, but the data is compelling. They did some fancy statistics that I can’t admit to understand including Bland-Altman and error grid analyses. Although the averages seem to be close, the variations are as follows:
SAP 0.8 mmHg (±15.7 mmHg, −30.2 to 31.7 mmHg)
DAP −2.9 mmHg (±11.0 mmHg, −24.5 to 18.6 mmHg)
MAP −1.0 mmHg (±10.2 mmHg, −21.0 to 18.9 mmHg)

The interesting part is that the ICU is a world of details and although the differences were small. The variation between the two, radial arterial line and oscillometric cuff, was enough though to cause additional treatment changes in more than 20% of patients.

I despise reading abstracts and coming to conclusions but at this point I have no choice. Maybe tomorrow I’ll be able to take this apart entirely.

Link to abstract

EJ

Kaufmann T, Cox EGM, Wiersema R, et al. Non-invasive oscillometric versus invasive arterial blood pressure measurements in critically ill patients: A post hoc analysis of a prospective observational study [published online ahead of print, 2020 Feb 22]. J Crit Care. 2020;57:118–123. doi:10.1016/j.jcrc.2020.02.013

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