Abstract:
Accurate arm circumference (AC) measurement is required for accurate blood pressure (BP) readings. Standards stipulate measuring arm circumference at the midpoint between the acromion process (AP) and the olecranon process. However, which part of the AP to use is not stipulated. Furthermore, BP is measured sitting but arm circumference is measured standing. We sought to understand how landmarking during AC measurement and body position affect cuff size selection. Two variations in measurement procedure were studied. First, AC was measured at the top of the acromion (TOA) and compared to the spine of the acromion (SOA). Second, standing versus seated measurements using each landmark were compared. AC was measured to the nearest 0.1 cm at the mid-point of the upper arm by two independent observers, blinded from each other\'s measurements. In 51 participants, the mean (±SD) mid-AC measurement using the anchoring landmarks TOA and SOA in the standing position were 32.4 cm (±6.18) and 32.1 cm (±6.07), respectively (mean difference of 0.3 cm). In the seated position, mean arm circumference was 32.2 (±6.10) using TOA and 31.1 (±6.03) using SOA (mean difference 1.1 cm). Kappa agreement for cuff selection in the standing position between TOA and SOA was 0.94 (p < 0.001). The landmark on the acromion process can change the cuff selection in a small percentage of cases. The overall impact of this landmark selection is small. However, standardizing landmark selection and body position for AC measurement could further reduce variability in cuff size selection during BP measurement and validation studies.
摘要:
准确的血压(BP)读数需要准确的臂围(AC)测量。标准规定在肩峰过程(AP)和鹰嘴过程之间的中点测量臂围。然而,没有规定使用AP的哪一部分。此外,血压是坐着测量的,但臂围是站着测量的。我们试图了解AC测量和身体位置期间的界标如何影响袖带尺寸选择。研究了测量程序中的两种变化。首先,在肩峰(TOA)的顶部测量AC,并与肩峰(SOA)的脊柱进行比较。第二,比较了使用每个界标的站立和坐着测量值.AC由两个独立的观察者在上臂的中点测量到最接近的0.1厘米,对彼此的测量结果视而不见。在51名参与者中,在站立位置使用锚定标志TOA和SOA的平均(±SD)中AC测量值分别为32.4cm(±6.18)和32.1cm(±6.07),分别(平均差0.3厘米)。在就座位置,使用TOA的平均臂围为32.2(±6.10),使用SOA的平均臂围为31.1(±6.03)(平均差1.1cm).在TOA和SOA之间的站立位置中选择袖带的Kappa一致性为0.94(p<0.001)。肩峰过程上的地标可以在一小部分情况下改变袖带选择。这个地标选择的整体影响很小。然而,将AC测量的界标选择和体位标准化,可以进一步减少BP测量和验证研究过程中袖带尺寸选择的变异性.