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dc.contributor.authorTran, Quincy K
dc.contributor.authorGelmann, Dominique
dc.contributor.authorAlam, Zain
dc.contributor.authorBeher, Richa
dc.contributor.authorEngelbrecht-Wiggans, Emily
dc.contributor.authorFairchild, Matthew
dc.contributor.authorHart, Emily
dc.contributor.authorHollis, Grace
dc.contributor.authorKarwoski, Allison
dc.contributor.authorPalmer, Jamie
dc.contributor.authorRaffman, Alison
dc.contributor.authorHaase, Daniel J
dc.date.accessioned2022-06-13T13:47:37Z
dc.date.available2022-06-13T13:47:37Z
dc.date.issued2022-05-05
dc.identifier.urihttp://hdl.handle.net/10713/19128
dc.description.abstractWest J Emerg Med. 2022 May 5;23(3):358-367. doi: 10.5811/westjem.2022.1.53211. ABSTRACT INTRODUCTION: Blood pressure (BP) monitoring is an essential component of sepsis management. The Surviving Sepsis Guidelines recommend invasive arterial BP (IABP) monitoring, although the benefits over non-invasive BP (NIBP) monitoring are unclear. This study investigated discrepancies between IABP and NIBP measurement and their clinical significance. We hypothesized that IABP monitoring would be associated with changes in management among patients with sepsis requiring vasopressors. METHODS: We performed a retrospective study of adult patients admitted to the critical care resuscitation unit at a quaternary medical center between January 1-December 31, 2017. We included patients with sepsis conditions AND IABP monitoring. We defined a clinically significant BP discrepancy (BPD) between NIBP and IABP measurement as a difference of > 10 millimeters of mercury (mm Hg) AND change of BP management to maintain mean arterial pressure ≥ 65 mm Hg. RESULTS: We analyzed 127 patients. Among 57 (45%) requiring vasopressors, 9 (16%) patients had a clinically significant BPD vs 2 patients (3% odds ratio [OR] 6.4; 95% CI: 1.2-30; P = 0.01) without vasopressors. In multivariable logistic regression, higher Sequential Organ Failure Assessment (SOFA) score (OR 1.33; 95% CI: 1.02-1.73; P = 0.03) and serum lactate (OR 1.27; 95% CI: 1.003-1.60, P = 0.04) were associated with increased likelihood of clinically significant BPD. There were no complications (95% CI: 0-0.02) from arterial catheter insertions. CONCLUSION: Among our population of septic patients, the use of vasopressors was associated with increased odds of a clinically significant blood pressure discrepancy between IABP and NIBP measurement. Additionally, higher SOFA score and serum lactate were associated with higher likelihood of clinically significant blood pressure discrepancy. Further studies are needed to confirm our observations and investigate the benefits vs the risk of harm of IABP monitoring in patients with sepsis.en_US
dc.description.urihttps://doi.org/10.5811/westjem.2022.1.53211en_US
dc.language.isoenen_US
dc.publisherUniversity of California Pressen_US
dc.relation.ispartofWestern Journal of Emergency Medicineen_US
dc.titleDiscrepancy Between Invasive and Noninvasive Blood Pressure Measurements in Patients with Sepsis by Vasopressor Status.en_US
dc.typeArticleen_US
dc.identifier.doi10.5811/westjem.2022.1.53211
dc.identifier.pmid35679499
dc.source.journaltitleThe western journal of emergency medicine
dc.source.volume23
dc.source.issue3
dc.source.beginpage358
dc.source.endpage367
dc.source.countryUnited States


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