Continuous Noninvasive Orthostatic Blood Pressure Measurements in Syncope and Elderly Patients at the Emergency Department.

Wijnen (2014) Continuous Noninvasive Orthostatic Blood Pressure Measurements in Syncope and Elderly Patients at the Emergency Department. thesis, Medicine.

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Abstract

Introduction Orthostatic hypotension is a frequent cause of syncope at the emergency department (ED) and is common in the elderly population. Correct orthostatic blood pressure measurement is important, but a standardized measurement method is not yet implemented. The non-invasive beat-to-beat blood pressure measurement (Nexfin) can identify different morphological initial blood pressure recovery patterns whereby abnormal recovery patterns correlate with symptoms of orthostatic intolerance. Hypothesis Can we diagnose orthostatic hypotension more often with the Nexfin. Is orthostatic hypotension more common with the patients ≥60 years with syncope than in the group of patients ≥60 years without syncope. Do symptoms of orthostatic intolerance correlate better with the Nexfin measurements. How many patients with an abnormal blood pressure recovery pattern meet the consensus definition of orthostatic hypotension. Methods During 14 weeks the orthostatic blood pressure was measured using the conventional method and with the Nexfin at the ED in 76 patients with a referral of (pre)syncope and in 96 patients ≥60 years with a different reason of referral. Results The Nexfin does not diagnose orthostatic hypotension more often. There is no difference in the correlation with symptoms of orthostatic intolerance between the different measurement methods. An abnormal blood pressure recovery pattern met the criteria of orthostatic hypotension in 27% and 45% in the syncope and the ≥ 60 year group respectively. Conclusion The Nexfin is a standardized measurement method, comparable with the conventional method but has the strong advantage that it can identify different morphological initial blood pressure recovery patterns which correlate with symptoms of orthostatic intolerance.

Item Type:	Thesis (Thesis)
Supervisor name:	Harms, Dr. M.P.M. and Maaten, Dr. J.C. ter
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:59
Last Modified:	25 Jun 2020 10:59
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1949

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