Vol.:(0123456789) 1 3 J Clin Monit Comput DOI 10.1007/s10877-017-0067-2 ORIGINAL RESEARCH Non-invasive blood pressure monitoring with an oscillometric brachial cuf: impact of arrhythmia Karim Lakhal 1  · Maëlle Martin 1  · Stephan Ehrmann 2,3  · Sofan Faiz 4  · Bertrand Rozec 1  · Thierry Boulain 4   Received: 18 April 2017 / Accepted: 20 September 2017 © Springer Science+Business Media B.V. 2017 higher, in 89 patients with arrhythmia, than that observed in 127 patients with regular rhythm (p = 0.93 for mean BP). Averaging three measurements overcame the higher within-subject variability of NIBP measurements during arrhythmia, and yielded similar agreement between the two techniques in patients with arrhythmia and with regular rhythm. The international organization for standardization criteria (mean bias < 5 and SD < 8 mmHg) were satisfed neither during arrhythmia nor during regular rhythm: for mean BP, mean bias of − 8.0 ± 6.5 and − 7.5 ± 6.1 mmHg, respectively. The detection of hypotension (systolic inva- sive BP < 90 mmHg or mean invasive BP < 65 mmHg) or hypertension (systolic invasive BP > 140 mmHg) by NIBP was similar during arrhythmia and regular rhythm [areas under the receiver operating characteristic curves (AUC ROC ) of 0.88–0.92, p > 0.13]. The detection of a 10% increase in mean invasive BP after cardiovascular intervention was also associated with similar AUC ROC s between the two groups. Provided that triplicates are averaged, the agreement between NIBP measured with the tested device and invasive measurements was not worse during arrhythmia than during regular rhythm. Keywords Atrial fbrillation (MeSH) · Blood pressure determination (MeSH) · Intensive care units (MeSH) · Oscillometry · Sphygmomanometer Abbreviations AUC ROC Area under the receiver operating characteristic curve BP Blood pressure ICU Intensive care unit ISO International organization for standardization Abstract Arrhythmia-induced beat-to-beat variability of blood pressure (BP) is deemed to hinder the reliability of non-invasive oscillometric measurements (NIBP) but few data support this belief. We assessed the impact of arrhyth- mia on a NIBP device never tested for this purpose. We compared, in intensive care unit patients with and without arrhythmia, the agreement between three pairs of NIBP (Infnity™ Delta monitor, Dräger medical systems) and inva- sive readings. For systolic, diastolic and mean BP, the mean bias between NIBP and invasive measurements was not * Karim Lakhal lakhal_karim@yahoo.fr Maëlle Martin maellemart1@gmail.com Stephan Ehrmann stephanehrmann@gmail.com Sofan Faiz sofan44@hotmail.fr Bertrand Rozec bertrand.rozec@chu-nantes.fr Thierry Boulain thierry.boulain@chr-orleans.fr 1 Réanimation Chirurgicale Polyvalente, Service d’anesthésie-Réanimation, Hôpital Laënnec, Centre Hospitalier Universitaire, Boulevard Jacques Monod, Saint Herblain, 44093 Nantes, France 2 Médecine Intensive Réanimation, CHRU de Tours, 37044 Tours, France 3 INSERM, Centre d’Étude des Pathologies Respiratoires, UMR, 1100, Aérosolthérapie et Biomédicaments à Visée Respiratoire, Faculté de Médecine, Université François Rabelais, 37032 Tours, France 4 Service de Réanimation Médicale, Hôpital La Source, Centre Hospitalier Régional, 45067 Orléans, France