• Thomas Kaufmann, Eline G M Cox, Renske Wiersema, Bart Hiemstra, Ruben J Eck, Geert Koster, Scheeren Thomas W L TWL Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands., Frederik Keus, Bernd Saugel, van der Horst Iwan C C ICC Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Department of Intensive , and SICS Study Group.
• Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. Electronic address: t.kaufmann@umcg.nl.
• J Crit Care. 2020 Jun 1; 57: 118-123.

PurposeThe aim was to compare non-invasive blood pressure measurements with invasive blood pressure measurements in critically ill patients.MethodsNon-invasive blood pressure was measured via automated brachial cuff oscillometry, and simultaneously the radial arterial catheter-derived measurement was recorded as part of a prospective observational study. Measurements of systolic arterial pressure (SAP), diastolic arterial pressure (DAP), and mean arterial pressure (MAP) were compared using Bland-Altman and error grid analyses.ResultsPaired measurements of blood pressure were available for 736 patients. Observed mean difference (±SD, 95% limits of agreement) between oscillometrically and invasively measured blood pressure was 0.8 mmHg (±15.7 mmHg, -30.2 to 31.7 mmHg) for SAP, -2.9 mmHg (±11.0 mmHg, -24.5 to 18.6 mmHg) for DAP, and -1.0 mmHg (±10.2 mmHg, -21.0 to 18.9 mmHg) for MAP. Error grid analysis showed that the proportions of measurements in risk zones A to E were 78.3%, 20.7%, 1.0%, 0%, and 0.1% for MAP.ConclusionNon-invasive blood pressure measurements using brachial cuff oscillometry showed large limits of agreement compared to invasive measurements in critically ill patients. Error grid analysis showed that measurement differences between oscillometry and the arterial catheter would potentially have triggered at least low-risk treatment decisions in one in five patients.Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.

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