{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T16:55:11Z","timestamp":1793206511234,"version":"4.5.0"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2014,11,30]],"date-time":"2014-11-30T00:00:00Z","timestamp":1417305600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2014,11,30]],"date-time":"2014-11-30T00:00:00Z","timestamp":1417305600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Crit Care"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Critically ill patients and patients undergoing high-risk and major surgery, are instrumented with intra-arterial catheters and invasive blood pressure is considered the \u201cgold standard\u201d for arterial pressure monitoring. Nonetheless, artifacts due to inappropriate dynamic response of the fluid-filled monitoring systems may lead to clinically relevant differences between actual and displayed pressure values. We sought to analyze the incidence and causes of resonance\/underdamping phenomena in patients undergoing major vascular and cardiac surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Arterial pressures were measured invasively and, according to the fast-flush Gardner\u2019s test, each patient was attributed to one of two groups depending on the presence (R-group) or absence (NR-group) of resonance\/underdamping. Invasive pressure values were then compared with the non-invasive ones.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 11,610 pulses and 1,200 non-invasive blood pressure measurements were analyzed in 300 patients. Ninety-two out of 300 (30.7%) underdamping\/resonance arterial signals were found. In these cases (R-group) systolic invasive blood pressure (IBP) average overestimation of non-invasive blood pressure (NIBP) was 28.5 (15.9) mmHg (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001) while in the NR-group the overestimation was 4.1(5.3) mmHg (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001). The mean IBP-NIBP difference in diastolic pressure in the R-group was \u22122.2 (10.6) mmHg and, in the NR-group \u22121.1 (5.8) mmHg. The mean arterial pressure difference was 7.4 (11.2) mmHg in the R-group and 2.3 (6.4) mmHg in the NR-group. A multivariate logistic regression identified five parameters independently associated with underdamping\/resonance: polydistrectual arteriopathy (\n                      <jats:italic>P<\/jats:italic>\n                      =0.0023; OR\u2009=\u20092.82), history of arterial hypertension (\n                      <jats:italic>P<\/jats:italic>\n                      =0.0214; OR = 2.09), chronic obstructive pulmonary disease (\n                      <jats:italic>P<\/jats:italic>\n                      =0.198; OR\u2009=\u20092.61), arterial catheter diameter (20 vs. 18 gauge) (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001; OR\u2009=\u20090.35) and sedation (\n                      <jats:italic>P<\/jats:italic>\n                      =0.0131; OR\u2009=\u20090.5). The ROC curve for the maximal pressure\u2013time ratio, showed an optimum selected cut-off point of 1.67 mmHg\/msec with a specificity of 97% (95% CI: 95.13 to 99.47%) and a sensitivity of 77% (95% CI: 67.25 to 85.28%) and an area under the ROC curve by extended trapezoidal rule of 0.88.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Physicians should be aware of the possibility that IBP can be inaccurate in a consistent number of patients due to underdamping\/resonance phenomena. NIBP measurement may help to confirm\/exclude the presence of this artifact avoiding inappropriate treatments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13054-014-0644-4","type":"journal-article","created":{"date-parts":[[2014,11,29]],"date-time":"2014-11-29T07:01:57Z","timestamp":1417244517000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":178,"title":["Accuracy of invasive arterial pressure monitoring in cardiovascular patients: an observational study"],"prefix":"10.1186","volume":"18","author":[{"given":"Stefano","family":"Romagnoli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaccaria","family":"Ricci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Quattrone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Tofani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Tujjar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Villa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore M","family":"Romano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A Raffaele","family":"De Gaudio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2014,11,30]]},"reference":[{"key":"644_CR1","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1007\/s00134-007-0531-4","volume":"33","author":"M Antonelli","year":"2007","unstructured":"Antonelli M, Levy M, Andrews PJ, Chastre J, Hudson LD, Manthous C, Meduri GU, Moreno RP, Putensen C, Stewart T, Torres A: Hemodynamic monitoring in shock and implications for management. 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