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Blood pressure measurement in patients with cardiogenic shock: The effect of norepinephrine

Blood Pressure Monitoring Sep 18, 2019

Hromádka M, et al. - Researchers investigated if non-invasive blood pressure is comparable to invasive measurement in critically ill patients because it is associated with the use of norepinephrine in patients with cardiogenic shock. This study was performed on 85 patients admitted to the Coronary-Care Unit for cardiogenic shock. Comparisons were performed between initial blood pressure measurement (just following radial artery cannulation) and blood pressure recorded during the first 72 hours following admission. The reference method was invasive blood pressure. Findings revealed good agreement between initial invasive mean and systolic arterial pressures and oscillometric blood pressure; mean differences were −0.4 ± 8.8 and +6.1 ± 14.4 mmHg with correlation coefficients of 0.76 and 0.74. Significant negative determinants of invasive/oscillometric blood pressure differences were norepinephrine doses. A steep increase in mean arterial pressures and SBP invasive/oscillometric differences were seen in correlation with treatment with very high doses of norepinephrine. Findings revealed the adequacy of non-invasive BP as a proxy for invasive measurement in cardiogenic shock patients; the only exception is those taking very high doses of norepinephrine.
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