The Influence Of Body Position And The Way To Measure Blood Pressure To The Value Of Blood Pressure And The Study Of The Relationship Between CBP And NIBP

Objective: Blood pressure is the main physiological parameters of human body.The accuracy of measuring blood pressure affects the treatment to the patients.Non-invasive blood pressure measurement is convenient.But it can be affected by many factors,including the statue of patient psychological,cuff width and position of patient,etc.Among them,the different position of patient is worthy of attention.In clinical situation,not all patients are in standard position.The recent study has shown that there is no significant difference between the blood pressure on right latericumbent position and on supine position.Another study has shown that there is significant difference between the blood pressure on left latericumbent position and on supine position.However,there are also reversed studies.In order to find the discipline and mechanism of non-invasive blood pressure on different position,we have studied the difference of non-invasive blood pressure on different position.Invasive blood pressure which is a measurement that is real time,continuous and dynamic can timely find the instant changes of arterial blood pressure.It can reflect the actual state of blood pressure in critically ill patients.Patient position can also affect the value of invasive blood pressure.There are no related reports in the domestic and overseas.In order to find the discipline and mechanism of invasive blood pressure on different position,we have studied the difference of invasive blood pressure on different position.And we also studied the difference between invasive blood pressure and non-invasive blood pressure on difference positions.In order to find the relationship between non-invasive blood pressure and central blood pressure,we studied the difference between non-invasive blood pressure and central blood pressure.Methods:40 patients which there are no obvious narrow in bilateral subclavian artery proved by CAG were enrolled in our study during 2014.10-2015.4 in the third hospital of Hebei medical university.We measured the value of central pressure and the value of non-invasive blood pressure in catheterization room.The patients were retained right artery catheterization after CAG.When patients backed to the ward,we measured the blood pressure value on left latericumbent position,right latericumbent position,supine position through invasive and non-invasive way.Results:1 The mean value of invasive blood pressure on supine position is 154.32±24.32mmHg/76.89±14.39 mmHg.The mean value of non-invasive blood pressure on supine position is 141.30±20.60mmHg/86.19±11.23 mmHg.There is significant difference in the SBP and DBP of the above two rows,both P<0.01.2 The mean value of invasive blood pressure on left latericumbent position is 137.46±20.73/60.92±11.98 mmHg.The mean value of non-invasive blood pressure on left latericumbent position is 127.35±19.08/71.22±11.56 mmHg.There is significant difference in the SBP and DBP of the above two rows,both P<0.01.3 The mean value of invasive blood pressure on right latericumbent position is 157.51±27.09mmHg/78.32±17.94 mmHg.The mean value of non-invasive blood pressure on right latericumbent position is 139.21±23.19mmHg/85.32±13.35 mmHg.There is significant difference in the SBP and DBP of the above two rows,both P<0.01.4 The mean values of invasive blood pressure on supine position,left latericumbent position and right latericumbent position are 154.32±24.32mmHg/76.89±14.39 mmHg,137.46±20.73/60.92±11.98 mmHg,157.51±27.09mmHg/78.32±17.94 mmHg.There is significant difference in SBP and DBP between left-row and right-row,P<0.01.There is significant difference in SBP and DBP between left-row and supine-row,P<0.01.There is no significant difference in SBP and DBP between right row and supine row,P>0.05.5 The mean values of non-invasive blood pressure on supine position,left latericumbent position and right latericumbent position are 154.32±24.32mmHg/76.89±14.39 mmHg,137.46±20.73/60.92±11.98 mmHg,157.51±27.09mmHg/78.32±17.94 mmHg.There is significant difference in SBP and DBP between left-row and right-row,P<0.01.There is significant difference in SBP and DBP between left-row and supine-row,P<0.01.There is no significant difference in SBP and DBP between right row and supine row,P>0.05.6 The mean values of central blood pressure and non-invasive blood pressure are 158.41 ± 24.815mmHg/85.19 ± 12.65 mmHg and 148.43 ±19.315mmHg/77.00±10.67 mmHg.There is significant difference in SBP and DBP between the central blood pressure and non-invasive blood pressure.Conclusions:1 On the supine position,the invasive blood pressure is higher than non-invasive blood pressure on an average of 13.3mmHg in SBP,and the invasive blood pressure is lower than non-invasive blood pressure on an average of 9.30 mmHg in DBP.On the left latericumbent position,the invasive blood pressure is higher than non-invasive blood pressure on an average of 10.11 mmHg in SBP,and the invasive blood pressure is lower than non-invasive blood pressure on an average of 10.30 mmHg in DBP.On the right latericumbent position,the invasive blood pressure is higher than non-invasive blood pressure on an average of 18.3mmHg in SBP,and the invasive blood pressure is lower than non-invasive blood pressure on an average of 7.00 mmHg in DBP.2 There is no significant difference in SBP and DBP right-row and supine-row through the invasive way.The SBP of invasive blood on left row are lower than the supine-row and right-row on an average of 16.86 mmHg and 10.05 mmHg.The DBP of invasive blood on the left-row are lower than the supine-row and the right-row on an average of 15.97 mmHg and 17.4mmHg.3 There is no significant difference in SBP and DBP right-row and supine-row through the non-invasive way.The SBP of invasive blood on left row are lower than the supine-row and right-row on an average of 13.95 mmHg and 11.86 mmHg.The DBP of invasive blood on the left-row are lower than the supine-row and the right-row on an average of 14.97 mmHg and 14.1mmHg.4 There is significant difference in SBP and DBP between the central blood pressure and non-invasive blood pressure.The SBP of central blood pressure is higher than the non-invasive blood pressure on an average of 9.97 mmHg.The DBP of central blood pressure is higher than the non-invasive blood pressure on an average of 8.19 mmHg.The DBP of central blood pressure is higher than the non-invasive blood pressure on an average of 8.78 mmHg.