Evidence map›Paper›PMID 37527376›Full record

Observational studyThe western journal of emergency medicine2023

Arterial Monitoring in Hypertensive Emergencies: Significance for the Critical Care Resuscitation Unit.

Quincy K Tran, Dominique Gelmann, Manahel Zahid, Jamie Palmer, Grace Hollis, Emily Engelbrecht-Wiggans, Zain Alam, Ann Elizabeth Matta, Emily Hart, Daniel J Haase

Abstract readObservational Study
In one paragraph

Observational study in The western journal of emergency medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Quincy K TranUniversity of Maryland School of Medicine, Department of Emergency Medicine, The Research Associate Program in Emergency Medicine and Critical Care, Baltimore, Maryland.
Dominique GelmannUniversity of Maryland School of Medicine, Baltimore, Maryland.
Manahel ZahidUniversity of Maryland School of Medicine, Department of Emergency Medicine, The Research Associate Program in Emergency Medicine and Critical Care, Baltimore, Maryland.
Jamie PalmerUniversity of Maryland School of Medicine, Baltimore, Maryland.
Grace HollisUniversity of Maryland School of Medicine, Department of Emergency Medicine, The Research Associate Program in Emergency Medicine and Critical Care, Baltimore, Maryland.
Emily Engelbrecht-WiggansUniversity of Maryland School of Medicine, Baltimore, Maryland.
Zain AlamUniversity of Maryland School of Medicine, Department of Emergency Medicine, The Research Associate Program in Emergency Medicine and Critical Care, Baltimore, Maryland.
Ann Elizabeth MattaUniversity of Maryland School of Medicine, Program in Trauma, The R Adams Cowley Shock Trauma Center, Baltimore, Maryland.
Emily HartUniversity of Maryland School of Medicine, Program in Trauma, The R Adams Cowley Shock Trauma Center, Baltimore, Maryland.
Daniel J HaaseUniversity of Maryland School of Medicine, Program in Trauma, The R Adams Cowley Shock Trauma Center, Baltimore, Maryland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionBlood pressure measurement is important for treating patients. It is known that there is a discrepancy between cuff blood pressure vs arterial blood pressure measurement. However few studies have explored the clinical significance of discrepancies between cuff (CPB) vs arterial blood pressure (ABP). Our study investigated whether differences in CBP and ABP led to change in management for patients with hypertensive emergencies and factors associated with this change.

methodsThis prospective observational study included adult patients admitted between January 2019-May 2021 to a resuscitation unit with hypertensive emergencies. We defined clinical significance of discrepancies as a discrepancy between CBP and ABP that resulted in change of clinical management. We used stepwise multivariable logistic regression to measure associations between clinical factors and outcomes.

resultsOf 212 patients we analyzed, 88 (42%) had change in management. Mean difference between CBP and ABP was 17 milligrams of mercury (SD 14). Increasing the existing rate of antihypertensive infusion occurred in 38 (44%) patients. Higher body mass index (odds ratio [OR] 1.04, 95% confidence Interval [CI] 1.0001-1.08, P-value <0.05) and history of peripheral arterial disease (OR 0.16, 95% CI 0.03-0.97, P-value <0.05) were factors associated with clinical significance of discrepancies.

conclusionApproximately 40% of hypertensive emergencies had a clinical significance of discrepancy warranting management change when arterial blood pressure was initiated. Further studies are necessary to confirm our observations and to investigate the benefit-risk ratio of ABP monitoring.

Indexed as

HypertensionAdultBlood PressureBlood Pressure DeterminationBlood Pressure Monitoring, AmbulatoryCritical CareEmergenciesHumans

Identifiers

PMID37527376
PMCPMC10393462

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.