The impact of blood pressure cuff location on the accuracy of noninvasive blood pressure measurements in obese patients: an observational study Impact de l'emplacement du brassard pneumatique sur la precision des mesures non invasives de la tension arterielle chez les patients obeses: une etude observationnelle

Purpose Obesity presents many challenges to the anesthesiologist, including poorly fitting blood pressure (BP) cuffs due to the conical shape of the upper arm. The aim of this study was to determine the accuracy of noninvasive BP readings, obtained from a noninvasive BP cuff using various cuff locations and wrapping techniques, compared with invasive intra-arterial BP readings. Methods Thirty American Society of Anesthesiologists physical status I-III obese (body mass index[30 kgm -2 ) individuals undergoing non-cardiac surgery were enrolled in this observational study. Serial oscillometric noninvasive BP (NIBP) measurements were taken in the patients’ forearm and upper arm with two different wrapping formations (one following the contour of the upper arm, the other keeping cuff edges parallel). These NIBP measurements were compared with invasive arterial blood pressure (ABP) measurements taken from the ipsilateral radial artery. The precision and bias of the NIBP and ABP measurements were determined using Bland-Altman analysis. Analysis of variance and Welch’s t test were used to determine between-group differences in