Conventional sphygmomanometry with cuff deflation is used to calibrate all noninvasive BP (NIBP) instruments and the International Standard makes no mention of calibrating methods specifically for NIBP instruments, which estimate systolic and diastolic pressure during cuff inflation rather than cuff deflation. There is however increasing interest in inflation-based NIBP (iNIBP) instruments on the basis of shorter measurement time, reduction in maximal inflation pressure and improvement in patient comfort and outcomes. However, we have previously demonstrated that SBP estimates based on the occurrence of the first K1 Korotkoff sounds during cuff deflation can underestimate intra-arterial SBP (IA-SBP) by an average of 14 ± 10 mmHg. In this study, we compare the dynamics of intra-arterial blood pressure (IABP) measurements with sequential measurement of Korotkoff sounds during both cuff inflation and cuff deflation in the same individual. In 40 individuals aged 64.1 ± 9.6 years (range 36-86 years), the overall dynamic responses below the cuff were similar, but the underestimation error was significantly larger during inflation than deflation, increasing from 14 ± 10 to 19 ± 12 mmHg (P < 0.0001). No statistical models were found which could compensate for this error as were found for cuff deflation. The statistically significant BP differences between inflation and deflation protocols reported in this study suggest different behaviour of the arterial and venous vasculature between arterial opening and closing which warrant further investigation, particularly for iNIBP devices reporting estimates during cuff inflation. In addition, measuring Korotkoff sounds during cuff inflation represents significant technical difficulties because of increasing pump motor noise.

中文翻译：

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以动脉血压为参考的袖带充气和袖带放气肱动脉血压测量的比较。

带袖带放气的传统血压计用于校准所有无创血压 (NIBP) 仪器，国际标准没有提及专门针对 NIBP 仪器的校准方法，该方法在袖带充气而不是袖带放气期间估计收缩压和舒张压。然而，由于测量时间更短、最大充气压力降低以及患者舒适度和结果得到改善，人们对基于充气的 NIBP (iNIBP) 仪器越来越感兴趣。然而，我们之前已经证明，基于袖带放气期间出现的第一个 K1 柯氏音的 SBP 估计可能会平均低估动脉内 SBP (IA-SBP) 14 ± 10 mmHg。在这项研究中，我们比较了同一个体在袖带充气和袖带放气期间动脉血压（IABP）测量的动态与柯氏音的连续测量。在 40 名年龄 64.1 ± 9.6 岁（范围 36-86 岁）的个体中，袖带以下的总体动态响应相似，但充气期间的低估误差明显大于通货紧缩期间的误差，从 14 ± 10 增加到 19 ± 12 mmHg（P < 0.0001)。没有发现统计模型可以像袖带放气那样补偿这一误差。本研究中报告的充气和通气协议之间的统计显着血压差异表明，动脉打开和关闭之间动脉和静脉脉管系统的行为不同，值得进一步研究，特别是对于报告袖带充气期间估计值的 iNIBP 设备。此外，由于泵电机噪音增加，在袖带充气期间测量柯氏音存在重大技术困难。