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Nov 12, 2021

Invasive blood pressure monitoring

Measuring blood pressure can be done in two different ways. The first, the most common and well-known, is noninvasive and is performed by applying a pneumatic cuff to the arm.

The second, however, is carried out with invasive method, and involves the cannulation of an artery through an arterial cannula, connected to a closed circuit set and a transduction system communicating with a monitor (where to display the pressure wave and its numerical value).

In this article, let's see when and how to measure blood pressure with invasive method.

When to use invasive blood pressure monitoring

Invasive blood pressure monitoring is usually used for patients in intensive care or otherwise for those who require constant monitoring.

Some case may be:

  • patient with unstable hemodynamics, severe hypotensive states or possible sudden instability;
  • evaluation of ABG analysis values related to respiratory insufficiency;
  • evaluation of the effect of particular drugs, to determine the most appropriate therapy;
  • inability to use the non-invasive method, due to skin or joint lesions.

Generally, the most commonly used arteries for cannulation are the radial and the femoral. Arterial access with blood-sparing system, therefore, allows not only to obtain blood pressure monitoring, but also to reduce the number of punctures of arteries (for blood gas analysis) and venous ones (for other laboratory tests).

These are important aspects, to avoid greater discomfort to the patient and reduce the risk of induced arterial injury.

Invasive blood pressure monitoring

Invasive blood pressure monitoring can also be associated with complications, both during insertion and maintenance of the device. In addition to the milder ones (i.e., hematomas, localized pain, or infection at the insertion site), the more serious ones may involve:

  • hemorrhage from the injury;
  • thrombosis or embolism;
  • vasospasm;
  • intrarterial drug administration.

For this reason, it is important that healthcare personnel are specialized and follow precisely the operational steps, namely:

  • place the transducer at the height of the right atrium (middle axillary line);
  • fill the system with the physiological solution present in the pressure bag;
  • temporarily close the arterial line, turning the tap to the closed position and thus isolating the artery;
  • put the control system in contact with room air.
  • press the reset button (0) on the monitor (to start the automatic procedure);
  • turn the tap to reopen it and restore the connection between transducer, patient and monitoring kit.

After the arterial catheter insertion procedure, the patient should be monitored for any early symptoms (e.g., pain, local infection, etc.).

To learn more, you may also be interested in the following article: Arterial catheterization, accesses and positioning techniques.

Delta Med arterial catheters, from the Alfacath line, are devices designed to ensure safe placement, avoid puncture of the peripheral arteries and complications.

Made of Teflon or Pebax, they provide excellent pressure wave detection throughout patient monitoring. To learn more, go to the dedicated page or contact us here to get more information from one of our professionals.

 

Sources:

- Monitoraggio pressione arteriosa cruenta: Sistema invasivo, nurse24.it

- Cateteri Arteriosi: utilità, tipologie e posizionamento, cardiologiaoggi.com

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