Mean BP: Difference between revisions

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The '''mean''' Blood Pressure [[BP]] as collected for the APACHE II score is calculated as follows:
{{Data element
Mean BP = round(((2x Diastolic) + Systolic)) ÷ 3)
|field_name=MBP
|CCMDB_label=<not in CCMDB>
|CCMDB_tab=Apache
|in_table=Created_Variables_CC_2021 table
|data_type=number
|datafield_length=single
|program_collecting=CC
|created_raw=Created
|data_element_sort_index=13
|element_description=Mean Blood Pressure defined by round(((2x Diastolic) + Systolic)) ÷ 3)
}}
The '''mean''' Blood Pressure as collected for the [[APACHE]] score.


Rounding may not be part of the original definition of Mean BP, but it is how we do it in order to get integers that work with the [[APACHE_Scoring_table#Physiological_Variables|Apache Ranges]].  
Rounding may not be part of the original definition of Mean BP, but it is how we do it in order to get integers that work with the [[APACHE_Scoring_table#Physiological_Variables| scoring ranges]].  


== Collection Instructions for mean arterial [[BP]] ==
== Collection Instructions for mean arterial [[BP]] ==
*The data collector is responsible to collect from the chart, the '''worst''' BP (be it high or low) during the '''first 24 hours in ICU'''.
Collect the blood pressure chosen as per [[Selection and timing of APACHE components]].
** there is a [[BP Helper button]] to help pick the Sys/Dia combination for the worst mean BP
*The APACHE II score is based on the worst calculated '''mean BP'''. 
*The mean BP is automatically calculated when the CSV data is uploaded to [[TMSX]].
*when selecting the worst BP, you must also take into account the diagnosis. For example, if a patient is in septic shock, you want to select the lowest BP as opposed to the highest BP which is artificially enhanced by inotropes.
{{discussion}}
*If BP is not available from the chart because of short stay or death, what specific normal value should be used so we can have an idea how often this is not available? [[User:Ttenbergen|Ttenbergen]] 15:06, 2 November 2010 (CDT)Ttenbergen 15:28, 2014 January 2 (CST)Ttenbergen 11:23, 2014 January 10 (CST)
**See: [http://ccmdb.kuality.ca/index.php/Apache_II_General_Collection_Guidelines#Missing_Values_Rules_for_APACHE_II_for_patients_who_DIED_shortly_after_arriving_in_unit Missing value rule]


The APACHE II score is based on the worst calculated '''mean BP'''. There is a '''[[BP Helper button]]''' to help pick the Sys/Dia combination for the worst mean BP.


Look carefully when selecting this value. APACHE II score is based on the '''worst''' calculated mean BP (either high or low) which ever gives you the highest points as per scoring table, but you must also take in account the diagnosis.  For example if a patient is in septic shock, you would want the lowest BP as opposed to the highest BP that is artificially enhanced by inotropes.
=== artificially changed BPs ===
See [[General Collection Guidelines for Apache II#When to collect]] for which value to use.
We don't want values that are changed by interventions already, for example if a patient is in septic shock, you would want the lowest BP as opposed to the highest BP that is '''artificially enhanced by inotropes'''.
 
=== Blood Pressure when on IAPB (intra aortic balloon pump) ===
We want the worst value in the 1st 24 hrs in ICU, so if possible get the '''pre IABP BP'''. If only post IABP BPs are available, use peripheral arterial BP, '''not''' aortic pressure.
 
{{APACHE physiological variable
|AP phys name=mean blood pressure
|AP phys unit=mmHG
|AP H4= >=160
|AP H3= >=130 and <160
|AP H2= >=110 and <130
|AP 0= >=70 and <110
|AP L2= >=50 and <70
|AP L4= <49
}}
 
== In CFE ==
The mean BP is calculated automatically in [[CFE]] by [[Created_Variables_CC_maker_2021 query]] and stored there in [[Created_Variables_CC_2021 table]].
 
== Related articles ==
{{Related Articles}}




[[Category:APACHE II Physiological Variables]]
[[Category:APACHE II Physiological Variables]]
[[Category:Blood Pressure-APACHE]]
[[Category:Blood Pressure-APACHE]]
[[Category:Created Variables]]

Latest revision as of 14:12, 2023 April 19

Data Element (edit)
Field Name: MBP
CCMDB Label: <not in CCMDB>
CCMDB tab: Apache
Table: Created_Variables_CC_2021 table
Data type: number
Length: single
Program: CC
Created/Raw: Created
Start Date: 1988-07-11
End Date: 2300-01-01
Sort Index: 13

Mean Blood Pressure defined by round(((2x Diastolic) + Systolic)) ÷ 3)

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Legacy implementation right in the table

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The mean Blood Pressure as collected for the APACHE score.

Rounding may not be part of the original definition of Mean BP, but it is how we do it in order to get integers that work with the scoring ranges.

Collection Instructions for mean arterial BP

Collect the blood pressure chosen as per Selection and timing of APACHE components.

The APACHE II score is based on the worst calculated mean BP. There is a BP Helper button to help pick the Sys/Dia combination for the worst mean BP.

artificially changed BPs

See General Collection Guidelines for Apache II#When to collect for which value to use. We don't want values that are changed by interventions already, for example if a patient is in septic shock, you would want the lowest BP as opposed to the highest BP that is artificially enhanced by inotropes.

Blood Pressure when on IAPB (intra aortic balloon pump)

We want the worst value in the 1st 24 hrs in ICU, so if possible get the pre IABP BP. If only post IABP BPs are available, use peripheral arterial BP, not aortic pressure.


Apache Physiological Variable
variable name mean blood pressure
unit mmHG
absolute max allowed
warning max
high score 4 >=160
high score 3 >=130 and <160
high score 2 >=110 and <130
high score 1
score 0 >=70 and <110
low score 1
low score 2 >=50 and <70
low score 3
low score 4 <49
AP phys warnMin
AP phys absMin

APACHE Score

This value is used to generate the APACHE Score.

Collecting Apache physiological variables

There are some specific rules to follow in choosing which one of several lab results to collect.

See APACHE physiological variable collection for details.

Cross Chcks

Rules described in APACHE_physiological_variable_collection#Exceptionally_high_or_low_values are implemented by Check APACHE physiological variable high low.

In CFE

The mean BP is calculated automatically in CFE by Created_Variables_CC_maker_2021 query and stored there in Created_Variables_CC_2021 table.

Related articles

Related articles:
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