XÁC ĐỊNH ĐỘ LỆCH GIÁ TRỊ HUYẾT ÁP GIỮA PHƯƠNG PHÁP ĐO HUYẾT ÁP ĐỘNG MẠCH XÂM LẤN VỚI PHƯƠNG PHÁP ĐO HUYẾT ÁP ĐỘNG MẠCH KHÔNG XÂM LẤN TRÊN BỆNH NHÂN PHẪU THUẬT VI PHẪU CẮT U NÃO TẠI BỆNH VIỆN NHI ĐỒNG THÀNH PHỐ

Abstract

Background: Non-invasive blood pressure measurement is commonly used in clinical practice. However, there had not been much research on the accuracy of this method compared to invasive arterial blood pressure measurement. Objectives: To determine the deviation between 02 blood pressure measurement methods: invasive and non-invasive blood pressure. Materials and methods: We recorded 550 pairs of blood pressure indices in 22 patients undergoing brain tumor microsurgery at CCH. Mean of bias, standard deviation (SD), and limit of agreement (LoA) between the two methods were calculated based on the measurement results during the surgery. At the same time, we looked for the correlation between blood pressure (BP) value deviation and other conditions such as: surgical stages, hypertension, hypotension and vasopressor infusion. Results: BP value deviations were: SBP -2.0 mmHg (SD 9.32 mmHg, LoA -20.3 to 16.3 mmHg), DBP -4.3 mmHg (SD 10.52 mmHg, LoA -24.9 to 16.3 mmHg), MBP -3.5 mmHg (SD 9.15 mmHg, LoA -21.4 mmHg to 14.4 mmHg). The non-invasive BP value was smaller than the invasive one when the patients had hypertension, and larger when the patients underwent hypotension. The use of vasopressors reduces the deviation between the two methods while the surgical stages have no effect. Conclusions: The deviations of all blood pressure indices met the AAMI standard, suggesting the potential for using the NIBP as an alternative to the IBP in some cases such as monitoring patients in stable stages or during inserting blood pressure catheter. However, the SD did not meet the AAMI standard, suggesting the instability of the NIBP measurement, especially during emergency situations or shock patients using inotropes.