A comparison of intra-arterial and auscultatory blood pressure readings

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Abstract

Although fairly large individual discrepancies were noted between the systolic and diastolic readings obtained through intra-arterial and auscultatory methods, the mean differences in these readings were not found to be significant. In agreement with AHA standards, the disappearance of sound was found to be a better indicator of intra-arterial diastolic pressure than was muffling. The only hemodynamic variable that had a significant relationship (p < 0.001) with the discrepancy in diastolic readings was heart rate. The level of systolic and diastolic pressure readings, pulse pressure, and PVR varied minimally in this sample. Extremely high and low values were present when these parameters were correlated with discrepancies in other studies. While CO/CI and SV were depressed in most of the sample, in this limited number of subjects, these parameters alone, were not found to be associated with a discrepancy. The findings of this study suggest the following implications for clinical practice and further research: 1. Cuff size needs to be individualized for each patient. 2. Palpatory readings should be obtained before auscultation. 3. A way to determine the frequency response and damping coefficient should be available and used when comparing intra-arterial and auscultatory readings. 4. Simultaneous auscultatory and intra-arterial pressures should be taken in the same arm when assessing any discrepancy. In addition, auscultatory and palpatory, brachial and forearm pressures should be compared with an intra-arterial reading. Measurements of brachial and radial blood flow in the forearm would be useful in seeking to explain a discrepancy between measurement methods.

Original languageEnglish (US)
Pages (from-to)223-227
Number of pages5
JournalHeart and Lung: Journal of Acute and Critical Care
Volume14
Issue number3
StatePublished - 1985

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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