Management of invasive arterial blood pressure in critically ill patients
Abstract:
Background: Invasive arterial blood pressure monitoring is crucial in critical care, yet it has risks. Complications such as CRBSI and inaccurate readings are common. There is a lack of standardised nursing guidelines, and weak awareness of evidence-based protocols among nurses affects care quality.
Aim: To summarise the evidence for monitoring and management of invasive arterial blood pressure in critically ill patients and optimise critical care outcomes.
Study design: This study was conducted using the Joanna Briggs Institute (JBI) methodology. The PIPOST model guided the formulation of the review question, and a systematic bilingual search was performed across Chinese and international databases following the 6S evidence hierarchy. Eligible studies were screened, critically appraised using appropriate tools, and the extracted evidence was thematically categorised and graded to support standardised nursing practices in invasive arterial blood pressure monitoring.
Results: A total of 36 pieces of evidence were synthesised and categorised into six sections: catheterisation, catheter maintenance, blood pressure monitoring accuracy, complication management, patient safety and comfort and education and training.
Conclusions: These 36 synthesised recommendations form a comprehensive and actionable framework for the standardised management of invasive arterial blood pressure monitoring in critical care. Notably, the synthesis emphasises the integration of technical precision with nursing practice, addressing both clinical safety and operational feasibility. Their implementation holds the potential to reduce complications, enhance monitoring accuracy and promote evidence-based nursing excellence.
Relevance to clinical practice: Implementing these evidence-based guidelines can streamline monitoring, reduce complications and improve data reliability for better patient care.
Reference:
Zhang W, Zhang X, Han J, Wang L, Sun Y, Chen C, Zhou F. Best Evidence Summary for Monitoring and Management of Invasive Arterial Blood Pressure in Critically Ill Patients: An Evidence-Based Review. Nurs Crit Care. 2025 Nov;30(6):e70215. doi: 10.1111/nicc.70215. PMID: 41137525.