China
Africa
Explore chapters and articles related to this topic
Measuring and monitoring vital signs
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
The Korotkoff sounds are heard through the stethoscope when you manually record a BP value (Table 4.1). These sounds are not audible using electronic/digital devices. The sounds are named after Nikolai Korotkoff, who first identified the audible sounds of BP in 1905 (Korotkoff 1905, cited in O’Brien et al. 2003). There may be a period between phases 2 and 3 where no sounds are audible, but they become audible again at a lower pressure. This phenomenon is known as an auscultatory gap (Campbell et al. 2020). This phenomenon is seen in approximately 20% of elderly people with hypertension (McGee 2018). This is the reason that the correct procedure involves palpation to find the systolic BP before using the sphygmomanometer. This technique is explained later.
Chronic hypertension and acute hypertensive crisis
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
William F. Rayburn, Lauren Plante
Two readings should be taken, separated by 2 minutes. Systolic blood pressure should be noted with the appearance of Korotkoff sounds (phase I) and diastolic blood pressure with the disappearance of sounds (phase V). In certain patients, the Korotkoff sounds do not disappear but are present to 0 mmHg. In this case, the initial muffling of Korotkoff sounds (phase IV) should be taken as the diastolic blood pressure. In order to reduce inaccurate readings, an appropriately sized cuff should be used (length 1.5 times upper arm circumference or a cuff with a bladder that encircles 80% or more of the arm). The appropriate position in which to measure blood pressure is sitting, with the arm at the level of the heart. Measuring BP in the “up” arm with the patient side lying gives an artifactually lower reading, which does not represent a true decrease in BP.
Hypertension and pre-eclampsia
Published in Catherine Nelson-Piercy, Handbook of Obstetric Medicine, 2020
Phase V (disappearance) rather than phase IV (muffling) of Korotkoff sounds should be taken as the diastolic reading. Phase V is more reproducible, correlates better with intra-arterial measurements of diastolic blood pressure and is more closely related to outcome.
Accuracy of blood pressure measurement across BMI categories using the OptiBP™ mobile application
Published in Blood Pressure, 2022
Mary Caillat, Jean Degott, Arlene Wuerzner, Martin Proençain, Guillaume Bonnier, Jean-François Knebel, Chloé Stoll, Urvan Christen, Virginie Durgnat, Gregory Hofmann, Michel Burnier, Grégoire Wuerzner, Patrick Schoettker
Two blinded, independent, experienced observers listened to patients’ Korotkoff sounds through a dual-head (Y-tube) stethoscope, while they used a validated sphygmomanometer to take simultaneous reference auscultatory BP measurements (A&D UM-101, A&D Company, Ltd., Toshima Ku, Tokyo, Japan). These reference BPs were measured on one side, while simultaneously on the opposite arm, BPs were recorded with the OptiBP application, in accordance with the 81060-2:2018 ISO norm, as described previously and corresponding to an immediate post-qualibration test [16]. The size of the reference cuff was adapted to the circumference of the subject’s mid-arm using two sizes of inflatable bladders: 14 × 25 cm and 16 × 32 cm. Bladder size was determined so that the length corresponded to 75–100% of the subject’s mid-arm circumference and the width corresponded to 37–50%, according to the AAMI/ESH/ISO universal standard (ISO 81060-2:2018). Our study protocol used this standard with minor adjustments due to the cuffless approach.
Hypertension among obese children and youth age 8-12:Project EDDY-Kids 2019
Published in Child and Adolescent Obesity, 2021
G. Wolske, M. Joseph, H. Rosenauer, K. Widhalm
In the course of the pursued Viennese EDDY-Kids Project 2019 (Widhalm et al. 2018) we took one measurement at the beginning of the study in January (t0, baseline) and followed up in 2-month intervals (t1, t2), finishing in June. To receive more reliable blood pressure values and to oversee progress in those values, there were taken three measurements over the period of the project (Negroni-Balasquide et al. 2016). The sample included a control group in third grade (age ~9, 58 children, 33 boys and 25 girls) and an intervention group in fourth grade (age ~10, 65 children, 37 boys and 28 girls). Blood pressure was measured using auscultation according to international guidelines (Flynn et al. 2017), using a stethoscope with a blood pressure monitor (sphygmomanometer). A cuff of appropriate size was attached to the upper arm and inflated up to the expected arterial blood pressure. During the subsequent slow deflation, the manifestation and disappearance of Korotkoff sounds can be detected via the stethoscope at the brachial artery. The systolic pressure corresponds to the value indicated at the first appearance of Korotkoff sounds: at that moment, systolic pressure exceeds cuff pressure. Conversely, the Korotkoff sounds disappear when cuff pressure falls below arterial pressure, indicating a diastolic value.
Serum elabela and apelin levels during different stages of chronic kidney disease
Published in Renal Failure, 2020
Xuehong Lu, Shengmao Liu, Rumei Luan, Wenpeng Cui, Yu Chen, Yixian Zhang, Yue Lu, Hong Zhang, Lin Shi, Lining Miao, Feng Xu
Demographic, clinical, and biochemical data of the subjects were obtained from medical records and queries (e.g., gender, age, and history of hypertension), physical examination (e.g., height, weight, and blood pressure), and laboratory tests (e.g., hemoglobin (Hb), serum albumin, blood urea nitrogen (BUN), serum creatinine (Cre), ELA and apelin levels). Body mass index (BMI) was defined as weight/height2 (kg/m2). Blood pressure was measured in the right arm, with the subjects in a sitting position after a 10-min rest period; a mercury sphygmomanometer and a stethoscope were used for the measurement, following the recommendations of the American Heart Association [23]. Systolic and diastolic blood pressures were defined at the first and fifth phases of Korotkoff sounds, respectively. Blood samples were collected before taking any antihypertensive medications. The serum levels of Hb, BUN, and Cre were analyzed using UniCel DxH 800 (Beckman Coulter, Miami, FL) and Hitachi 008AS Autoanalyzer (Hitachi, Tokyo, Japan). Enzyme-linked immunosorbent assay was used to evaluate serum ELA and apelin levels. Venous blood samples were collected in EDTA/acetic acid-containing tubes and centrifuged at 3000 rpm for 10 min at 4C. ELA and apelin assays were performed using the ELABELA (human)-EIA kit (Peninsula Laboratories International Inc., San Carlos, CA, USA) and Apelin (human) C-Terminus EIA kit (RayBiotech Inc., Norcross, GA, USA) according to the manufacturers’ instructions.