New Oscillometric BP Machine!

RE: New Oscillometric BP Machine!

Courtney Scales — Mon, 25 Jun 2018 17:56:42 GMT

RE: New Oscillometric BP Machine!

Catriona88 — Mon, 25 Jun 2018 07:12:22 GMT

You guys are so smart :-) Thank you for all this information, it's been very helpful.

We deal with hypotension quite commonly under GA but I don't think I've ever had a hypertenison case under GA. What can cause this and what steps would you take to correct it?

RE: New Oscillometric BP Machine!

Courtney Scales — Sun, 10 Jun 2018 17:16:53 GMT

RE: New Oscillometric BP Machine!

Susanna Taylor — Wed, 06 Jun 2018 13:01:41 GMT

Agree with everything already said. MAP should stay over 60mmHg to protect the kidneys, so if it is heading down towards that way you should start to act...

That said, depending on the machine they are not always that accurate so keep in mind the big picture. Also, pay attention to the trend, and the readings relation to the surgery; if a reading is suddenly much higher than the last, and its a painful bit of the surgery - its probably a true reaction. If a reading is suddenly very low but everything else is stable, check the cuff position and rerun the cycle to double check.

If your BP machine is accurate (and it sounds like it should be) it can be interesting comparing BPs of cases that have received ACP vs (Dex)Medetomidine. You should see a difference between the diastolic pressures, but if the case is well managed, MAPs should be similar!

RE: New Oscillometric BP Machine!

James Colver Cert. Ed, RVN — Tue, 05 Jun 2018 20:47:55 GMT

Oscillometric machines tend to be a bit less reliable than the doppler, particularly in small patients (<5kg). Appropriate cuff size should be used and ideally machine placed level with the patient.

As you know many patients will become hypotensive under GA so it's important to know about it, and act. Normal MAP range is considered to be ~60 to ~120mmHg and if it falls below this then the person monitoring the GA needs to speak to the surgeon about what to do about it - usually looking at ways to turn the iso down (perhaps considering local blocks / other analgesia) and if this doesn't improve the BP then IVFT boluses are often considered (to help boost the circulating volume and raise the BP) - usually up to 10ml/kg over 15 minutes, repeating if necessary.

https://www.aaha.org/public_documents/professional/guidelines/fluid_therapy_guidelines.pdf

RE: New Oscillometric BP Machine!

V E S — Mon, 04 Jun 2018 19:12:48 GMT

I would regard the following as 'normal' for anaesthesia;

Systolic AP = 90-120mmHg

Systolic represents ventricular contraction & reflects myocardial contractility.

MAP = 60-100mmHg

Mean is the average AP during 1 cardiac cycle, and is regarded as equal to organ perfusion (hence is usually most important under anaesthesia!)

Diastolic = 55-90mmHg

Diastolic represents ventricular relaxation and is determines by systemic vascular resistance and blood volume. E.g. if a vasodilator is given this reduces vascular resistance and decreases your diastolic pressure.

Also check out anursethesia - there is a guideline of parameters on the website.

I would start to worry about hypertension if systolic is >150mmHg as over this point you start to get organ damage to eyes, kidneys, brain etc.