Medición indirecta de la presión arterial en miembros inferiores: revisión integradora
DOI:
https://doi.org/10.62827/eb.v23i2.4004Palabras clave:
Presión arterial; determinación de la presíon arterial; tobillo; extremidades inferiores; enfermería.Resumen
Introducción: La técnica de auscultación realizada en los miembros superiores, en posición sentada, es la más utilizada. Sin embargo, también es posible medir en las extremidades inferiores y en las posiciones de pie o tumbadoo. Objetivo: analizar la evidencia científica disponible en la literatura sobre la medición indirecta de la presión arterial en los miembros inferiores. Métodos: revisión integradora, con estrategia de búsqueda utilizando Academic Search Premier, CINAHL, Embase, LILACS, PubMed, Scopus y Web of Science, con los términos Ankle, Arterial Pressure, Blood Pressure, Blood Pressure Determination, Leg, Lower Extremity, Thigh y sus sinónimos. Se añadió uma búsqueda manual a las referencias de los estudios incluidos. Resultados: la muestra final consistió em 23 estudios primarios que se dividieron en tres categorías temáticas: comparación de valores de presión arterial; comparación de métodos de medición de la presión arterial; recomendaciones. Así comprobaron que los valores de presión arterial en los miembros inferiores presentan una diferencia entre11,2 y 36,5 milímetros de mercurio cuando se comparan com los de la parte superior del brazo. Además, la técnica realizada en los miembros inferiores provoca molestias y dolor. Conclusión: el tobillo y el muslo son alternativas viables cuando la medición indirecta de la presión arterial no pueda realizarse en el brazo, sin embargo, no debe utilizarse como sustituto debido a la valores encontrados y su importancia en la práctica clínica.
Referencias
Sasaki J, Kikuchi Y, Usuda T, Hori S. Validation of inflationary noninvasive blood pressure monitoring in the emergency room. Blood Press Monit. 2015;20(6):325-9.https://doi.org/10.1097/MBP.0000000000000145.
Daniel ACQG, Veiga EV, Machado JP, Mafra ACCN, Cloutier L. Effect of an educational program for the knowledge and quality of blood pressure recording. Rev. Latino-Am. Enfermagem. 2019;27:e3179. https://doi.org/10.1590/1518-8345.3011.3179.
Sapp OL, Arney GK, Mattingly TW. Determination of arterial blood pressure in the lower extremity; use of an eighteen centimeter sphygmomanometer thigh cuff. J Am Med Assoc. 1955;159(18):1727-30.https://doi.org/10.1001/jama.1955.02960350027008.
Keidan I, Sidi A, Ben-Menachem E, Tene Y, Berkenstadt H. Inconsistency between simultaneous blood pressure measurements in the arm, forearm, and leg in anesthetized children. J Clin Anesth. 2014;26(1):52-7.https://doi.org/10.1016/j.jclinane.2013.10.005
Leng IH, Lang D. Clinical comparison of non-invasive blood pressure measurement at different sites: a systematic review protocol. JBI Database System Rev Implement Rep. 2014;12(4) 86 - 101. https://doi.org/10.11124/jbisrir-2014-936
Muntner P, Shimbo D, Carey RM, Charleston JB, Gaillard T, Misra S, et al. Measurement of Blood Pressure in Humans: A Scientific Statement From the American Heart Association. Hypertension. 2019;73(5):e35-e66.https://doi.org/10.1161/HYP.0000000000000087
Barroso WKS, Rodrigues CIS, Bortolotto LA, Gomes MAM, Brandão AA, Feitosa ADdM, et al. Diretrizes Brasileiras de Hipertensão Arterial - 2020. Arq Bras Cardiol. 2021; 116(3):516-658.https://doi.org/10.36660/abc.20201238
Lakhal K, Mac QC, Ehrmann S, Boulain T, Capdevila X. Noninvasive monitoring of blood pressure in the critically ill: Reliability according to the cuff site (arm, thigh, or ankle). Crit Care Med. 2012;40(4):1207-13. https://doi.org/10.1097/CCM.0b013e31823dae42.
Goldstein LN, Wells M, Sliwa K. Blood pressure measurements in the ankle are not equivalent to blood pressure measurements in the arm. S Afr Med J. 2014;104(12):869-73.https://doi.org/10.7196/SAMJ.8102
Unger T, Borghi C, Charchar F, Khan NA, Poulter NR, Prabhakaran D, et al. 2020 International Society of Hypertension Global Hypertension Practice Guidelines. Hypertension. 2020;75(6):1334-57.https://doi.org/10.1161/HYPERTENSIONAHA.120.15026
Sheppard JP, Albasri A, Franssen M, Fletcher B, Pealing L, Roberts N, et al. Defining the relationship between arm and leg blood pressure readings: a systematic review and meta-analysis. J Hypertens. 2019;37(4):660-70.https://doi.org/10.1097/HJH.0000000000001958
Moore C, Dobson A, Kinagi M, Dillon B. Comparison of blood pressure measured at the arm, ankle and calf. Anaesthesia. 2008;63(12):1327-31.https://doi.org/10.1111/j.1365-2044.2008.05633.x.
Pickering TG, Hall JE, Appel LJ, Falkner BE, Graves J, Hill MN, et al. Recommendations for blood pressure measurement in humans and experimental animals: part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Circulation. 2005;111(5):697-716.https://doi.org/10.1161/01.CIR.0000154900.76284.F6.
Araujo TL, Arcuri EAM. Influência de fatores anátomo-fisiológicos na medida indireta da pressão arterial: identificação do conhecimento dos enfermeiros. Rev LatAmEnfermagem. 1998;6:21-9.https://doi.org/10.1590/S0104-11691998000400004
Lakhal K, Macq C, Ehrmann S, Boulain T, Capdevila X. Noninvasive monitoring of blood pressure in the critically ill: reliability according to the cuff site (arm, thigh, or ankle). Crit Care Med. 2012;40(4):1207-13.https://doi.org/10.1097/CCM.0b013e31823dae42.
O'Brien E, Stergiou G, Palatini P, Asmar R, Ioannidis JP, Kollias A, et al. Validation protocols for blood pressure measuring devices: the impact of the European Society of Hypertension International Protocol and the development of a Universal Standard. Blood Press Monit. 2019;24(4):163-6.https://doi.org/10.1097/MBP.0000000000000391.
Goldthorp SL, Cameron A, Asbury AJ. Dinamap arm and thigh arterial pressure measurement. Anaesthesia. 1986;41(10):1032-5. doi: 10.1111/j.1365-2044.1986.tb12749.x
Beyea S, Nicoll LH. Writing an integrative review. Aorn J. 1998;67(4):877-80.https://doi.org/10.1016/s0001-2092(06)62653-7.
Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al. Prisma Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. AnnIntern Med. 2018;169(7):467-73.https://doi.org/10.7326/M18-0850
Richards D. Handsearching still a valuable element of the systematic review. Evid Based Dent. 2008;9(3):85. https://doi.org/10.1038/sj.ebd.6400602.
Pompeo DA. Diagnóstico de enfermagem náusea em pacientes no período pós-operatório imediato: revisão integrativa da literatura [dissertação].Universidade de São Paulo; 2007.https://doi.org/10.11606/D.22.2007.tde-15102007-140328
Fineout-Overholt E, Melnyk BM, Stillwell SB, Williamson KM. Evidence-based practice step by step: Critical appraisal of the evidence: part I. Am J Nurs. 2010;110(7):47 52.https://doi.org/10.1097/01.naj.0000383935.22721.9c
Downes MJ, Brennan ML, Williams HC, Dean RS. Development of a critical appraisal tool to assess the quality of cross-sectional studies (AXIS). BMJ Open. 2016;6(12):e011458.https://doi.org/10.1136/bmjopen-2016-011458
Wendkos MH, Rossman PL. The normal blood pressure in the lower extremity. American Heart Journal. 1943;26(5):623-30. https://doi.org/10.1016/S0002-8703(43)90004-3.
Sanghera S, North A, Abernethy S, Wrench I. Arm and ankle blood pressure during caesarean section. Int J Obstet Anesth. 2006;15(1):24-7.https://doi.org/10.1016/j.ijoa.2005.04.016
Sareen P, Saxena K, Sareen B, Taneja B. Comparison of arm and calf blood pressure. Indian J Anaesth. 2012;56(1):83-5.https://doi.org/10.4103/0019-5049.93354
Maneval RE, Fowler KA, Fox L, Wilson C. Clinical Nurse Specialists Leading Research to Improve Practice in the Use of Ankle Blood Pressure Readings. Clin Nurse Spec. 2014;28(1):33-40.https://doi.org/10.1097/NUR.0000000000000015.
Henley N, Quatrara BD, Conaway M. A Pilot Study: Comparison of Arm Versus Ankle Noninvasive Blood Pressure Measurement at 2 Different Levels of Backrest Elevation. Dimens Crit Care Nurs. 2015;34(4):232-5.https://doi.org/10.1097/DCC.0000000000000126
Drake MJP, Hill JS. Observational study comparing non-invasive blood pressure measurement at the arm and ankle during caesarean section. Anaesthesia. 2013;68(5):461-6.https://doi.org/10.1111/anae.12194.
Hocken AG. Measurement of blood-pressure in the leg. Lancet. 1967;289(7488):466 8. https://doi.org/10.1016/S0140-6736(67)91091-4
Wertheim D, Trenary K, Melhuish J, Williams R, Harding K. Ankle systolic blood pressure measurement and cuff application. Lancet. 1996;347(9018):1845-6. https://doi.org/10.1016/S0140-6736(96)91671-2
Takahashi O, Shimbo T, Rahman M, Okamoto S, Tanaka Y, Fukui T. Evaluation of cuff-wrapping methods for the determination of ankle blood pressure. Blood Press Monit. 2006;11(1):21-6.https://doi.org/10.1097/01.mbp.0000189787.67617.0c.
Gambill EE, Hines EA. Blood pressure in the arm and thigh of man: I. A study of averages, variations, and differences between thigh and arm. American Heart Journal. 1944;28(6):763-72. https://doi.org/10.1016/S0002-8703(44)91043-4
Mundt KA, Chambless LE, Burnham CB, Heiss G. Measuring ankle systolic blood pressure: validation of the Dinamap 1846 SX. Angiology. 1992;43(7):555-66.https://doi.org/10.1177/000331979204300703.
Bramwell C, Campbell M, Cotton T F, Evans W, Gilchrist A R, Hay J et al. Standardization of methods of measuring the arterial blood pressure: A joint report of the comittees appointed by the Cardiac Society of Great Britain and Ireland and the American Heart Association. Br Heart J. 1939;1(3):261-7. https://doi.org/10.1136/hrt.1.3.261
Bordley J, Connor CA, Hamilton WF, Kerr WJ, Wiggers CJ. Recommendations for human blood pressure determinations by sphygmomanometers. Circulation. 1951;4(4):503-9. https://doi.org/10.1161/01.cir.4.4.503.
Kirkendall WM, Feinleib M, Freis ED, Mark AL. Recommendations for human blood pressure determination by sphygmomanometers. Subcommittee of the AHA Postgraduate Education Committee. Stroke. 1981;12(4):555a-64a.https://doi.org/10.1161/01.CIR.36.6.980
Perloff D, Grim C, Flack J, Frohlich ED, Hill M, McDonald M, et al. Human blood pressure determination by sphygmomanometry. Circulation. 1993;88(5 Pt 1):2460-70.https://doi.org/10.1161/01.CIR.88.5.2460
Sapp OL, Arney GK, Mattingly TW. Determination of arterial blood pressure in the lower extremity: Use of an eighteen centimeter sphygmomanometer thigh cuff. J Am MedAssoc. 1955;159(18):1727-30.https://doi.org/10.1001/jama.1955.02960350027008
Zahn J, Bernstein H, Hossain S, Bodian C, Beilin Y. Comparison of non-invasive blood pressure measurements on the arm and calf during cesarean delivery. J Clin Monit Comput. 2000;16(8):557-62. https://doi.org/10.1023/a:1012267312308
Block FE, Schulte GT. Ankle blood pressure measurement, an acceptable alternative to arm measurements. Int J Clin Monit Comput. 1996;13(3):167-71.https://doi.org/10.1023/a:1016997232542
Flack JM, Adekola B. Blood pressure and the new ACC/AHA hypertension guidelines. Trends Cardiovasc Med. 2020;30(3):160-4.https://doi.org/10.1016/j.tcm.2019.05.003
Kreuning EB, Graube SL, Meneghete MC, Fontana RT, Rodrigues FCP, Bittencourt VLL. Protocol for blood pressure measurement in lower limbs.Rev Baiana Enferm. 2018;32.https://doi.org/10.18471/rbe.v32.27394
Yang Y, Liu L, Sun H, Nie F, Hu X. Relation between high Ankle-Brachial Index and cardiovascular outcomes in the general population and cardiovascular disease: a meta-analysis. Int Angiol. 2020;39(2):131-8.https://doi.org/10.23736/S0392-9590.19.04276-7.
Refaat S, Mostafa M, Hasanin A, Rujubali N, Fouad R, Hassabelnaby Y. Accuracy of noninvasive blood pressure measured at the ankle during cesarean delivery under spinal anesthesia. J Clin Monit Comput. 2020.https://doi.org/10.1007/s10877-020-00583-y
Wax DB, Lin HM, Leibowitz AB. Invasive and concomitant noninvasive intraoperative blood pressure monitoring: observed differences in measurements and associated therapeutic interventions. Anesthesiology. 2011;115(5):973-8.https://doi.org/10.1097/ALN.0b013e3182330286.
Jaouhari SDE, Meziane M, Kessouati J, Razine R, Jaafari A, Bensghir M. Can we use the ankle non-invasive blood pressure during otolaryngologic surgery: an observational study.Pan Afr Med J. 2020;36:31-.https://doi.org/10.11604/pamj.2020.36.31.21019
Sheppard JP, Lacy P, Lewis PS, Martin U. Measurement of blood pressure in the leg-a statement on behalf of the British and Irish Hypertension Society. J Hum Hypertens. 2020;34(6):418-9.https://doi.org/10.1038/s41371-020-0325-5
Li Y, Li F, Li Y, Cui X, Li J, Zhi H, et al. Effect of cuff positioning on the accuracy of blood pressure measurement with automated electronic blood pressure monitors.J Clin Hypertens. 2020;22(7):1163-72.https://doi.org/10.1111/jch.13902
Daniel ACQG, Veiga EV, Machado JP, Mafra ACCN, Cloutier L. Effect of an educational program for the knowledge and quality of blood pressure recording. Revista Latino-Americana de Enfermagem. 2019;27.https://doi.org/10.1590/1518-8345.3011.3179
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Derechos de autor 2024 Isabella Wilson Paiva Gonçalves, Bárbara Caroliny Pereira da Costa, Isabela Gomes Musa dos Santos, Ana Carolina Queiroz Godoy Daniel, Renata Cristina Campos Pereira Silveira, Eugenia Velludo Veiga (Autor)
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