SynthesisCritical care explorations2024
Comparison of Central and Peripheral Arterial Blood Pressure Gradients in Critically Ill Patients: A Systematic Review and Meta-Analysis.
Synthesis in Critical care explorations, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Risk factors for a central-to-peripheral arterial blood pressure gradient in adults: a systematic review.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2025Pooled it
- Should Aggressive Blood Pressure Management of Spontaneous Intracerebral Hemorrhage Be Guided with Invasive Blood Pressure Monitoring?Neurocritical care · 2026Article
- Effects of Continuous Positive Airway Pressure for Hypertension in Patients with Obstructive Sleep Apnoea: A Structured Narrative Review of Randomised Controlled Trials.Journal of clinical medicine · 2026Review
- Femoral artery cannulation for arterial pressure measurement in the intensive care unit: current evidence and description of the technique.Anaesthesiology intensive therapy · 2026Review
- Article
- Comparison between invasive radial and femoral arterial pressures and carotid tonometry in ICU patients: A physiological study.Annals of intensive care · 2026Article
- Comparison of invasive and noninvasive blood pressure measurements in critically ill patients receiving norepinephrine.BMC anesthesiology · 2025Observational
- Applied physiology at the bedside: using invasive blood pressure as a true monitoring tool.Annals of intensive care · 2025Review
- A predictable 2:1 ratio in average systolic to diastolic arterial pressure at the radial and femoral arteries in ICU patients.British journal of anaesthesia · 2025Article
- Article
- Comparison of Non-Invasive Estimation of Central Aortic Blood Pressure and Biomarkers of Vascular Health Measured by Two Devices Using Brachial Cuff Waveforms.Pulse (Basel, Switzerland)Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesMeasurement of blood pressure taken from different anatomical sites, are often perceived as interchangeable, despite them representing different parts of the systemic circulation. We aimed to perform a systematic review and meta-analysis on blood pressure differences between central and peripheral arterial cannulation in critically ill patients. DATA SOURCES: We searched MEDLINE, Cochrane Central Register of Controlled Trials, and Embase from inception to December 26, 2023, using Medical Subject Headings (MeSH) terms and keywords. STUDY SELECTION: Observation study of adult patients in ICUs and operating rooms who underwent simultaneous central (femoral, axillary, or subclavian artery) and peripheral (radial, brachial, or dorsalis pedis artery) arterial catheter placement in ICUs and operating rooms. DATA EXTRACTION: We screened and extracted studies independently and in duplicate. We assessed risk of bias using the revised Quality Assessment for Studies of Diagnostic Accuracy tool. DATA SYNTHESIS: Twenty-four studies that enrolled 1598 patients in total were included. Central pressures (mean arterial pressure [MAP] and systolic blood pressure [SBP]) were found to be significantly higher than their peripheral counterparts, with mean gradients of 3.5 and 8.0 mm Hg, respectively. However, there was no statistically significant difference in central or peripheral diastolic blood pressure (DBP). Subgroup analysis further highlighted a higher MAP gradient during the on-cardiopulmonary bypass stage of cardiac surgery, reperfusion stage of liver transplant, and in nonsurgical critically ill patients. SBP or DBP gradient did not demonstrate any subgroup specific changes.
conclusionsSBP and MAP obtained by central arterial cannulation were higher than peripheral arterial cannulation; however, clinical implication of a difference of 8.0 mm Hg in SBP and 3.5 mm Hg in MAP remains unclear. Our current clinical practices preferring peripheral arterial lines need not change.
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