Accuracy of blood pressure measurement using auscultatory method and noninvasive arterial blood pressure monitoring compared to invasive arterial blood pressure monitoring in hypotensive patients

Abstract Background: Invasive arterial blood pressure monitoring is the gold standard, but it is costly and expertise is required. Parallel noninvasive methods such as automated arterial blood pressure monitoring and auscultatory methods are available. Objective: To study the accuracy of blood pressure measurement using auscultatory method and noninvasive arterial blood pressure monitoring compared to invasive arterial blood pressure monitoring in hypotensive patients. Materials and Methods: Single-center, hospital-based and prospective study was carried out among 50 cases of hypotension. For each case, systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial blood pressure were measured with the help of noninvasive as well as invasive methods. For arterial line either radial artery or femoral artery was used whichever was accessible. Results: Males were more than females 64% versus 36%. Similarly, patients <60 years were more compared to the elderly i.e., 66% versus 34%. Only SBP measurement was significantly lowest by auscultatory method compared to noninvasive and invasive methods. However, DBP and mean arterial blood pressure (MAP) were similar at admission. Only SBP by auscultatory method and noninvasive method were significantly lower compared to invasive method. However, SBP by auscultatory and noninvasive was similar. DBP was similar across all categories except noninvasive and invasive methods and same thing can be seen for MAP also. Conclusion: Invasive arterial blood pressure monitoring is a better choice of technique for blood pressure monitoring. Map rather than SBP is preferred metric in the emergency department to guide therapy in hypotensive patients.