Variability in blood pressure assessment in patients supported with HeartMate 3
The Journal of Heart and Lung Transplantation Apr 07, 2020
Cowger JA, Estep JD, Rinde-Hoffman DA, et al. - BP values obtained using arterial line (A-Line) and noninvasive measures in patients on HeartMate 3 support were compared. Researchers obtained paired BP values from A-Line and Doppler opening pressure (DOP) (354 readings in 277 patients) and A-Line and automated cuff (296 readings in 256 patients) (> 90% ≤ 7 days postop) in the MOMENTUM 3 Continued Access Protocol. Observations revealed moderate correlations between A-Line systolic blood pressure (SBP) and DOP and A-Line mean arterial pressure (MAP) and DOP. Relative to A-Line MAP, DOP was 4±10 mmHg higher and relative to A-Line SBP, it was 8±11 mmHg lower. They suggest interpreting DOP as the MAP as reasonable in patients with DOP ≤ 90 mmHg or without a radial pulse. DOP accuracy decreases but cuff MAP accuracy increases in the presence of a palpable pulse or high pulse pressure. They recommend not interpreting DOP as MAP when DOP is > 90 mmHg; cuff measures may yield greater accuracy.
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