Blood Pressure Measurement in Shock: Mechanism of Inaccuracy in Auscultatory and Palpatory Methods

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Arterial pressure was considerably higher than the cuff pressure obtained by auscultation or palpation of the brachial artery in 18 patients with shock and high total peripheral vascular resistance. Pulse pressure was also greatly underestimated by indirect measurement. This discrepancy was not observed in 21 hypotensive patients with low or normal resistance. Infusion of vasoconstrictor drugs into the arm circulation of normal subjects reproduced the clinical situation of normal arterial pressure with absent Korotkoff sounds and diminished radial pulses. High vascular resistance in the upper extremity prevents the hemodynamic events which normally produce the Korotkoff sounds. Disappearance of peripheral pulses is probably the result of reduced stroke volume and increased arterial wall stiffness.

Original languageEnglish (US)
Pages (from-to)972-976
Number of pages5
JournalJAMA: The Journal of the American Medical Association
Volume199
Issue number13
DOIs
StatePublished - Mar 27 1967

Fingerprint

Vascular Resistance
Shock
Blood Pressure
Arterial Pressure
Auscultation
Vascular Stiffness
Brachial Artery
Palpation
Vasoconstrictor Agents
Upper Extremity
Stroke Volume
Arm
Hemodynamics
Pressure

Cite this

@article{b3c886ef489446e69c79221f746c41ea,
title = "Blood Pressure Measurement in Shock: Mechanism of Inaccuracy in Auscultatory and Palpatory Methods",
abstract = "Arterial pressure was considerably higher than the cuff pressure obtained by auscultation or palpation of the brachial artery in 18 patients with shock and high total peripheral vascular resistance. Pulse pressure was also greatly underestimated by indirect measurement. This discrepancy was not observed in 21 hypotensive patients with low or normal resistance. Infusion of vasoconstrictor drugs into the arm circulation of normal subjects reproduced the clinical situation of normal arterial pressure with absent Korotkoff sounds and diminished radial pulses. High vascular resistance in the upper extremity prevents the hemodynamic events which normally produce the Korotkoff sounds. Disappearance of peripheral pulses is probably the result of reduced stroke volume and increased arterial wall stiffness.",
author = "Cohn, {Jay N.}",
year = "1967",
month = "3",
day = "27",
doi = "10.1001/jama.1967.03120130058009",
language = "English (US)",
volume = "199",
pages = "972--976",
journal = "JAMA - Journal of the American Medical Association",
issn = "0098-7484",
publisher = "American Medical Association",
number = "13",

}

TY - JOUR

T1 - Blood Pressure Measurement in Shock

T2 - Mechanism of Inaccuracy in Auscultatory and Palpatory Methods

AU - Cohn, Jay N.

PY - 1967/3/27

Y1 - 1967/3/27

N2 - Arterial pressure was considerably higher than the cuff pressure obtained by auscultation or palpation of the brachial artery in 18 patients with shock and high total peripheral vascular resistance. Pulse pressure was also greatly underestimated by indirect measurement. This discrepancy was not observed in 21 hypotensive patients with low or normal resistance. Infusion of vasoconstrictor drugs into the arm circulation of normal subjects reproduced the clinical situation of normal arterial pressure with absent Korotkoff sounds and diminished radial pulses. High vascular resistance in the upper extremity prevents the hemodynamic events which normally produce the Korotkoff sounds. Disappearance of peripheral pulses is probably the result of reduced stroke volume and increased arterial wall stiffness.

AB - Arterial pressure was considerably higher than the cuff pressure obtained by auscultation or palpation of the brachial artery in 18 patients with shock and high total peripheral vascular resistance. Pulse pressure was also greatly underestimated by indirect measurement. This discrepancy was not observed in 21 hypotensive patients with low or normal resistance. Infusion of vasoconstrictor drugs into the arm circulation of normal subjects reproduced the clinical situation of normal arterial pressure with absent Korotkoff sounds and diminished radial pulses. High vascular resistance in the upper extremity prevents the hemodynamic events which normally produce the Korotkoff sounds. Disappearance of peripheral pulses is probably the result of reduced stroke volume and increased arterial wall stiffness.

UR - http://www.scopus.com/inward/record.url?scp=0041640651&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0041640651&partnerID=8YFLogxK

U2 - 10.1001/jama.1967.03120130058009

DO - 10.1001/jama.1967.03120130058009

M3 - Article

AN - SCOPUS:0041640651

VL - 199

SP - 972

EP - 976

JO - JAMA - Journal of the American Medical Association

JF - JAMA - Journal of the American Medical Association

SN - 0098-7484

IS - 13

ER -