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RADIAL TO FEMORAL ARTERIAL BLOOD PRESSURE DIFFERENCES IN SEPTIC SHOCK PATIENTS RECEIVING HIGH-DOSE NOREPINEPHRINE THERAPY

Title
RADIAL TO FEMORAL ARTERIAL BLOOD PRESSURE DIFFERENCES IN SEPTIC SHOCK PATIENTS RECEIVING HIGH-DOSE NOREPINEPHRINE THERAPY
Author
전종헌
Keywords
Femoral artery; radial artery; arterial pressure monitoring; measurement techniques; vasoconstrictor agents; sepsis
Issue Date
2013-12
Publisher
LIPPINCOTT WILLIAMS & WILKINS, 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA
Citation
SHOCK, 권: 40, 호: 6, 페이지: 527-531
Abstract
Objectives: The accuracy of arterial blood pressure (ABP) monitoring is crucial in treating septic shock patients. Clinically significant differences in central to peripheral ABP could develop into sepsis during vasopressor therapy. The aim of this study was to investigate the difference between radial (peripheral) and femoral (central) ABP in septic shock patients receiving high-dose norepinephrine (NE) therapy. Methods and Results: This prospective observational study comparing simultaneous intra-arterial measurements of radial and femoral ABP was performed at a university-affiliated, tertiary referral center between October 2008 and March 2009. Patients with septic shock who needed continuous blood pressure monitoring and high-dose NE therapy 0.1 mu g/kg per minute or greater to maintain mean arterial pressure (MAP) of 65 mmHg or greater were included. Statistical analysis was conducted using the Bland-Altman method for comparison of repeated measures. In total, 250 sets of systolic, mean, and diastolic femoral and radial ABP were recorded at baseline and after NE titration. Arterial blood pressure readings from the radial artery were underestimated compared with those from the femoral artery. Overall bias (mean difference between simultaneous measurements) between radial and femoral MAP was +4.9 mmHg; however, during high-dose NE therapy, the bias increased to +6.2 mmHg (95% limits of agreement: -6.0 to +18.3 mmHg). Clinically significant radial-femoral MAP differences (MAP >= 5 mmHg) occurred in up to 62.2% of patients with high-dose NE therapy. Conclusions: Radial artery pressure frequently underestimates central pressure in septic shock patients receiving high-dose NE therapy. Femoral arterial pressure monitoring may be more appropriate when high-dose NE therapy is administered.
URI
https://journals.lww.com/shockjournal/Abstract/2013/12000/Radial_to_Femoral_Arterial_Blood_Pressure.13.aspxhttp://hdl.handle.net/20.500.11754/46012
ISSN
1073-2322
DOI
10.1097/SHK.0000000000000064
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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