Clinical education resources
Information, documents and clinical resources to help you work most effectively and accurately with our products and solutions.
Clinical support for blood pressure management and non-invasive blood pressure measurement
The scientific community has called for more training and education on blood pressure (BP) measurement as hemodynamic management continues to be linked to patient outcomes [1]. Understanding measurement limitations and references, device configuration and patient setup are important factors in obtaining accurate BP measurements. Studies show regardless of the method used to measure BP, initial and ongoing training of technicians and healthcare providers and the use of validated and calibrated devices are critical for obtaining accurate BP measurements [2].
Blood pressure methodologies
There are three primary methods for measuring blood pressure:
Intra-arterial line NBP measurement
- Direct measurement
- Invasive
Illustration showing an intra-arterial line
Automated oscillometric NBP measurement
- Indirect measurement
- Non-invasive
An illustration showing automated oscillometric NBP measurement
Fully-manual auscultatory NBP measurement
- Indirect measurement
- Non-invasive
Illustration showing fully-manual auscultatory NBP measurement
Which method do Philips monitors use?
Philips IntelliVue monitors use the automated oscillometric NIBP technique to measure the systolic, diastolic, and mean arterial pressures. The only direct method for measuring BP is an invasive arterial line. Oscillometric methods estimate blood pressure. All NIBP oscillometric devices use proprietary algorithms known only to the manufacturer. The algorithms can be modified by the device manufacturer and there are no requirements for such changes to be reported. Therefore, different devices, even from the same manufacturer are not interchangeable. Philips IntelliVue monitors can be configured to be interchangeable by selecting the same reference standard algorithm on all devices.
Application Note: Non-invasive blood pressure principles
Oscillometry has become the preferred method for automated non-invasive blood pressure (NIBP) monitoring [3, 4] in most clinical settings. It is increasingly used as an alternative to the invasive blood pressure measurement. Studies show that, especially in critical cases (arrhythmia, vasoconstriction, hypertension, shock), oscillometric devices are in general more accurate and consistent than devices using other non-invasive measuring techniques. However, the oscillometric measurement method does have its limitations.
Figure 1: Oscillometric method
An algorithm analyzes the oscillation envelope and computes the systolic, mean, and diastolic pressures.
Application note: Clinical Validation of NIBP measurement
This Application Note discusses the technical developments in the Philips IntelliVue non-invasive blood pressure measurements (NIBP). This includes the choices of reference standards, and the clinical validation of measurement accuracy for available reference standards.
Downloads (both application notes)
Reference standard algorithms
IntelliVue monitors offer two algorithm reference settings, Auscultatory and Invasive. Both algorithms conform to ISO 81060-2 and correspond to a traditional method of measuring blood pressure. Configuration of the NIBP reference on Philips monitors is a clinical decision that should be made by clinical leadership at the clinical facility.
- The Auscultatory setting is the factory default for IntelliVue monitors and provides NIBP values that closely approximate to values measured using the manual cuff and stethoscope method.
- The Invasive setting provides NIBP values that closely approximate to values measured using the intra-arterial method.
Proper NIBP measurement using Philips IntelliVue patient monitors
An overview of non-invasive blood pressure measurement using Philips IntelliVue patient monitors, including measurement references, monitor configuration, pre-measurement bedside and patient setup, and measurement taking.
Useful documents
- Turan A, Chang C, Cohen B, et al. Incidence, Severity, and Detection of Blood Pressure Perturbations after Abdominal Surgery: A Prospective Blinded Observational Study. Anesthesiology. 2019;130(4):550-559. doi:10.1097/ALN.0000000000002626
- Muntner P, Shimbo D, Carey RM, et al. Measurement of Blood Pressure in Humans: A Scientific Statement From the American Heart Association. Hypertension. 2019;73(5):e35-e66. doi:10.1161/HYP.0000000000000087
- Celler BG, Le P, Basilakis J, Ambikairajah E. Improving the quality and accuracy of non-invasive blood pressure measurement by visual inspection and automated signal processing of the Korotkoff sounds. Physiol Meas. 2017;38(6):1006-1022. doi:10.1088/1361-6579/aa6b7e
- McLean B. Comparing blood pressure measures: does one measurement equal another?. Crit Care Nurse. 2015;35(1):75-81. doi:10.4037/ccn2015557