The effect of cuff size on the blood pressure in individuals with large arm diameter

Öz

Objective: The aim of this study was to compare the blood pressure measurements obtained using 22x32 cm standard and 32x42 cm wide cuffs in individuals with large arm circumferences. Method: A descriptive and cross sectional study was carried out in the obesity clinics of a university hospital between April and November 2011. The study included 122 adult individuals with 32 cm or larger arm circumference, without any physical interference on the measured arm such as mastectomy, burn, fistula or deformity and who accepted to participate in the study. After written informed consents were taken from the individuals participating in the study, a blood pressure measurement was first performed from the left arms of the individuals in the sitting position with the larger cuff of the sphygmomanometer, and then they were let to rest for 3 minutes. The measurement was repeated by using the smaller cuff of the sphygmomanometer. Wilcoxon paired two-sample test was used for the comparison of the blood pressure data obtained by using standard and large cuffs. Results: The blood pressure measurements performed by the standard cuff were higher than these performed by the large cuff p0.05 . Conclusion: The selection of proper sized cuffs for the measurement of blood pressure would prevent inaccurate results

Anahtar Kelimeler

• Blood pressure,arm circumference,cuff size,sphygmomanometer

Kol çevresi geniş bireylerde manşon çapının kan basıncına etkisi

Öz

Amaç: Bu çalışmanın amacı kol çevresi geniş olan hastalarda 22x32 cm standart ve 32x42 cm geniş çapında manşon kullanarak elde edilen kan basıncı ölçümlerinin karşılaştırılmasıdır. Yöntem: Bu araştırma Nisan ve Kasım 2011 tarihleri arasında bir üniversite hastanesinin obezite kliniğinde yürütülmüş tanımlayıcı ve kesitsel bir araştırmadır. Araştırma ölçülen kolda herhangi bir fiziksel engel mastektomi, yanık, fistül ve deformite vb. bulunmayan ve araştırmaya katılmayı kabul eden kol çevresi 32 cm ya da daha fazla olan122 bireyi kapsamıştır. Araştırmaya katılan bireylerden yazılı onam alındıktan sonra, kan basıncı ölçümü önce oturma pozisyonundaki bireylerin sol kollarından manşonu daha geniş olan tansiyon aleti ile yapılmış, daha sonra birey 3 dakika dinlendirilmiştir. Ölçüm daha dar manşonlu tansiyon aleti ile tekrarlanmıştır. Standart ve geniş manşonlu tansiyon aletlerinden elde edilen kan basıncı verilerinin karşılaştırılmasında Wilcoxon eşleştirilmiş iki örnek testi kullanılmıştır. Bulgular: Standart manşonlu tansiyon aleti ile ölçülen kan basıncı değerleri geniş manşonlu tansiyon aleti ile yapılan değerlerden daha fazla bulunmuştur p0.05 . Sonuç: Kan basıncı ölçümü için uygun manşonlu tansiyon aletinin kullanılması hatalı sonuçları önleyebilir

Anahtar Kelimeler

• Kan basıncı,kol çapı,manşon genişliği,sfigmomanometre

Kaynakça

1. Anderson DJ, Anderson MA, Hill PD. Location of blood measurement. Medsurg Nursing 2010; 19(5):287-295.
2. Akpolat T. Obesity, hypertension and home sphygmomanometer cuffs. Eur J Intern Med 2010; 21(4):338-340.
3. Stergiou GS, Tzamouranis EG, Nasohimiou EG, Protogerou AD. Can an electronic device with a single cuff be accurate in a wide range of arm size? Validation of the visomat comfort 20/40 device for home blood pressure monitoring. J Hum Hypertens 2008; 22(11): 796-800.
4. McFarlane J. Blood pressure measurement in obese patients. Crit Care Nurse 2012; 32(6): 70-73.
5. Machado JP, Veiga EV, Ferreira PAC, Martins JCA, Daniel ACQGD, Oliveira AS, Silva PCS. Theoretical and practical
6. knowledge of nursing professionals on indirect blood pressure measurement a coronary at a coronary care unit. Einstein 2014; 12(3): 330-335.
7. Manzoli L, Simonetti V, D’ Errico MM, De Vito C, Flacco ME, Forni C, La Torre G, Liguori G, Messina G, Mezzetti A
8. Panella M, Pizzi C, Siliquini R, Villari P, Cicolini G.(In)accuracy of blood pressure measurement in 14 Italian Hospitals. J Hypertens 2012; 30(10): 1955-1960.

9. Minor D, Butler KR, Artman KL, Adair C, Wang W, Mcnair V, Wofford MR, Griswold M.Evaluation of blood pressure
10. measurement and agreement in an academic health sciences center. J Clin Hypertens 2012; 14(4): 222-227.
11. Almeida TC, Lamas JL. Nurses of adult intensive care unit: evaluation about direct and indirect blood pressure measurement. Rev Esc Enferm USP 2013; 47(2): 369-376.
12. Armstrong RS. Nurses’ knowledge or error in blood pressure measurement tecqnique. Int J Nurs Pract 2002; 8(3): 118- 126.
13. Robello CC, Pierrin AM, Mion D. Health care professionals’ knowledge of blood pressure measurement. Rev Esc Enferm USP 2004; 38(2): 127-134.
14. Dickson BK, Hajjar I. Blood pressure measurement education and evaluation program improves measurement accuracy in community-based nurses: a pilot study. J Am Acad Nurs Pract 2007; 19(2): 93-102.
15. Veiga EV, Arcuri EAM, Cloutier L, Santos JLF. Blood pressure measurement:arm circumference and cuff size availability. Rev Lat Am Enfermagem 2009; 17(4):455-461.
16. Perry AG, Potter AG. Vital signs, Fetzer SJ. (Ed.), Nursing Interventions and Clinical Skills.5th edition, St. Louis: Elsevier Mosby, 2012;103-107.
17. Berman AJ, Snyder S. Vital signs, Berman AJ, Snyder S. (Eds.), Kozier&Erb’s Fundamentals of Nursing Concepts, Process, and Practice. 9th edition, Edinburgh Gate: Pearson Education Ltd., 2014;558-572.
18. The Seventh Report of the Joint National Committie of Prevention, Detection, Evaluation and Treatment of High Blood
19. Pressure (İnternet). Ulaşım adresi: http://www.ncbi.nlm.nih.gov/books/NBK9630/pdf/TOC.pdf, (Ulaşım tarihi: 05.08.2013).
20. Report of a WHO Expert Committee. Arterial hypertension. World Health Organization Technical Report Series No.628. 1978; 3:11-12.
21. Atabek TA, Karadağ A. (Çeviri ed.), Yaşam Bulguları, Öztür D. Klinik Uygulama Becerileri ve Yöntemleri, Adana: Adana Nobel Kitabevi, 2010;517-531.
22. Munro BH. Statistical Methods for Health Care Research. 5 th. Edition, Boston: Lippincott Williams&Wilkins, 2004;121.
23. Perloff D, Grim C, Flack J, Frohlich ED, Hill M, McDonald M, Morgenstern BZ. Human blood pressure determination by sphygmomanometer. Circulation1993; 88(5 Pt 1): 2460-2470.
24. Fonseca-Reeyes S, de Alba-Garcia JG, Parra-Carillo JZ, Paczka-Zapata JA.Effect of standard cuff on blood pressure readings in patients with obese arms. Blood Press Monit 2003; 8:101-106.
25. Sprafka JM, Strickland D, Gomez-Marin O, Prineas RJ. The effect of cuff size on blood pressure measurement in adults. Epidemiology 1991; 2(3): 214-217.
26. O’Brien E. Review: a century of confusion; which bladder for accurate blood pressure measurement? J Hum Hypertens 1996 10(9): 556-572.
27. Kirkendal WM, Burton AC, Epstein FH, Freis ED. Recommendations for human blood pressure determination by sphygmomanometers. Circulation 1967; 36(6):980-988.
28. Frohlich ED, Grim C, Labarthe DR, Maxwell MH, Perloff D, Weidman WH. Recommendations for human blood pressure determination by sphygmomanometers: report of a special task force appointed by the Steering Committee, American Heart Association. Hypertension 1988; 11: 201A-221A.
29. Petrie JC, O’Brien ET, Littler WA, Swiet M. Recommandations on blood pressure measurement. Br Med J 1986; 293(6547):611-615.
30. Bonso E, Dorigatti F, Palatini P. Accuracy of the BP A100 blood pressure measuring device coupled with a single cuff with standard-size bladder over a wide range of arm circumferences. Blood Press Monit 2009; 14(5):216-219.