Thesis (MMed)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: OBJECTIVE: The aim of this study was to compare the accuracy of non-invasive
brachial blood pressure measurements, using automated and manual devices, to
invasive brachial intra-arterial blood pressure measurements in patients with preeclampsia,
during acute severe hypertension.
STUDY DESIGN: A prospective descriptive cross sectional study was conducted in
the Obstetrics Critical Care Unit (OCCU) of Tygerberg Hospital. Pre-eclamptic
patients with acute severe hypertension, who required the placement of brachial
intra-arterial lines due to failed radial intra-arterial line placement, were included in
the study. Both automated oscillometric and blinded manual aneroid
sphygmomanometric blood pressures were recorded during hypertensive peaks and
after stabilization of BP using intravenous Labetalol or Nepresol. These two noninvasive
methods of blood pressure measurements were compared to brachial intraarterial
blood pressure measurements.
RESULTS:
There was weak correlation between manual and intra-arterial SBP (r = 0.27, p =
0.048) for SBP≥160mmHg. The calculated mean difference between manual SBP
compared to the intra-arterial SBP in this group was -23.19mmHg (+/- 19.40). There
was moderate correlation between automated and intra-arterial SBP (r = 0.69, p <
0.05). The calculated mean difference between automated SBP compared to the
intra-arterial SBP in this group was -16.85mmHg (+/- 11.58).
CONCLUSION:
This study of pre-eclamptic women demonstrated that both non-invasive methods of
BP measurement were inaccurate measures of the true systolic intra-arterial BP and
significantly underestimated SBP≥160mmHg when compared to brachial intra-arterial measurements. The SBP was also underestimated, to a lesser degree, for mild
moderate hypertension.
This study also demonstrated that direct invasive BP monitoring using the brachial
artery is a safe method for accurate haemodynamic monitoring.
We recommend the use of intra-arterial BP monitoring in pre-eclamptic women with
acute severe hypertension. Radial arterial cannulation should be used as the first
option and the brachial artery should be used if the first option fails. / AFRIKAANSE OPSOMMING: DOELWIT: Die doel van hierdie studie was om die akuraatheid van nie indringende
bragiale bloeddruk metings, wat met outomatiese en manuele aparate geneem is, te
vergelyk met bragiale intra-arteriele bloeddruk metings gedurend akute erge
hipertensie in pasiente met pre-eklampsie,
STUDIE ONTWERP: ʼn Prospektiewe beskrywende dwarssnit studie was in die
Obstetriese Kritiese Sorg Eenheid (OCCU) van Tygerberg Hospitaal uit gevoer. Preeklamptiese
pasiente met akute erge hipertensie, wat bragiale intra-arteriele lyne
nodig gehad het, as gevolg van gefaalde radiale intra-arteriele lyn plasing, was in
hierdie studie ingesluit. Beide outomatiese ossilometriese en geblinde aneroide
sfigmomanometriese bloeddrukke, tydens hipertensiewe pieke en na stabilisering
van bloeddrukke met binneaarse Labetalol of Nepresol, was aangeteken, Die twee
nie indringende metodes van bloeddruk meting was met bragiale intra-arteriele
bloeddruk metings vergelyk.
RESULTATE:
Daar was ʼn swak korrelasie tussen manuele en intra-arteriele sistoliese bloedrukke
SBP (r = 0.27, p = 0.048) vir SBP≥160mmHg. Die berekende gemiddelde verskil
tussen manuele SBP en intra-arteriele SBP was -23.19mmHg (+/- 19.40) in hierdie
groep. Daar was ʼn matige korrelasie tussen outomatiese en intra-arteriele SBP (r =
0.69, p < 0.05). Die berekende gemiddelde verskil tussen outomaties SBP vergelyk
met intra-arteriele SBP was -16.85mmHg (+/- 11.58) in hierdie groep.
GEVOLGTREKKING:
Hierdie studie van pre-eklamptiese vrouens, het getoon dat beide nie indringende
metodes van bloeddruk meting, nie akurate metings van ware sistoliese intraarteriele
bloeddruk is nie, en SBP≥160mmHg word aansienlik onderskat wanneer dit met bragiale intra-arteriele metings vergelyk word. Die SBP was ook tot ʼn minder
mate onderskat vir matige hipertensie.
Die studie het ook getoon dat die direkte bragiale intra-arteriele metode van
bloeddruk monitering, ʼn veilige metode van hemodinamiese monitering is.
Ons beveel die gebruik van intra-arteriele bloeddruk monitering aan, in preeklamptiese
vrouens met akute erge hipertensie. Radiale arteriele kanulasie moet
gebruik word as die eerste opsie en die bragiale arterie moet gebruik word as die
eerste opsie faal.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/95901 |
| Date | 12 1900 |
| Creators | Jacobs, Samier |
| Contributors | Langenegger, Eduard, Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Obstetrics and Gynaecology. |
| Publisher | Stellenbosch : Stellenbosch University |
| Source Sets | South African National ETD Portal |
| Language | en_ZA |
| Detected Language | Unknown |
| Type | Thesis |
| Format | 57 p. |
| Rights | Stellenbosch University |
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