3. Old stuff
          3.2. Old physio stuff (around 2005)
              3.2.4. Clinical measurement
                  3.2.4.2. Measurements
                      3.2.4.2.4. Manometers
                          3.2.4.2.4.1. Blood pressure measurement
 3.2.4.2.4.1.3. Oscillometric blood pressure measurement 

Oscillometric blood pressure measurement

[Ref: KB Primary course May 2005]

Originally introduced in DINAMAP monitors.
* "Device for Indirect Noninvasive Automatic Mean Arterial Pressure" measurement

DINAMAP is only one example of oscillometric manometer.

Principle

  • When cuff pressure > systolic BP
    --> no fluctuations in cuff pressure
  • When cuff pressure = SBP
    --> small pressure fluctuations
  • When cuff pressure falls
    --> pressure fluctuations increase in amplitude
  • When cuff pressure = mean arterial BP
    --> amplitude of fluctuations peaks
  • When cuff pressure < DBP
    --> pressure fluctuation disappears

Setup

  • Cuff
  • Tubing
  • Device for inflation
  • Device for gradual deflation
  • Transducer for measuring pressure and oscillation in cuff
  • Display

Method

The cuff is applied around the arm and inflated above systolic pressure. The cuff is then deflated in steps of 3 to 6 mmHg

Accuracy

  • MABP is the most accurate.
  • DBP is least accurate.

Sources of errors

  • Inappropriate cuff size
  • Irregular heart rhythm (e.g. AF)
  • Patient movement (esp. shivering)
  • Low output state
  • Inaccurate calibration

Disadvantage

  • No continuous readings
  • Tend to overestimate at low arterial pressures

 

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@@Optimal cuff size is??????

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