Abstract Body: Introduction: NIBP monitoring is commonly used for BP measurement but only measures MAP while algorithmically assigning SBP/DBP. We sought to understand agreement between SBP, DBP and MAP measured by NIBP with manual BP and A-lines in acute ICH.
Methods: A prospective observational study was conducted in acute ICH patients using standardized, evidence-based measurement methods for BP by NIBP, A-line, and manual cuffs with dual auscultatory stethoscopes. Methods mirrored the ANSI/AAMI/ISO standard protocol for BP device validation. Data were analyzed using Bland-Altman analyses and Lin Concordance correlation coefficient.
Results: 650 paired manual and NIBP measurements were obtained, and no agreement was found in SBP, DBP, and MAP. DBP (p = <.001) showed the least agreement between methods, followed by SBP (p = .005), with MAP having the best agreement. Percentage of measurements within the ANSI/AAMI/ISO recommended guideline (10 mmHg difference) was 58% SBP, 63% DBP, and 76% MAP. A total of 25 paired A-line, manual, and NIBP measures were obtained with no agreement found between the three different techniques; MAP showed the closest agreement, followed by DBP and SBP.
Conclusion: Our study findings mirror those in systemic thrombolysis patients, showing no agreement in SBP and DBP values taken by NIBP compared to other BP methods. Since NIBP only measures MAP, future work should focus on setting MAP parameters in ICH patients. Additionally, the validity of recommended BP values for acute ICH patients should be carefully considered in relation to measurement and device heterogeneity.