B40/B20 Patient Monitor14-12The operating cycle is composed of four parts: inflation time, deflation time, evaluation time,and wait time. Wait time, which varies from mode to mode, is affected by the cycle time (automode) or operator intervention (manual mode). The figure shows the basic operating cycle foran NIBP determination.Figure 14-5 NIBP - Auto ModeSystolic SearchIf systolic pressure is not found, the NIBP parameter can search at cuff pressures higher thanthe initial target pressure. The parameter will inflate the cuff above the initial target pressure toget better data in the systolic region. The maximum pressure allowed in systolic search islimited by the normal range for cuff pressures.In any operating mode, if a patient's systolic pressure exceeds the inflation pressure, theparameter will begin normal deflation sequence, detect the absence of a systolic value, stopdeflation, reinflate to a higher (than initial) inflation pressure (290 mmHg maximum in adultmode; 145 mmHg in neonatal mode), and resume the normal deflation sequence.If it has been 16 minutes or less since the last determination and the current blood pressure issimilar to the previous reading, the monitor will try to make an accelerated determination ofblood pressure. During irregular rhythms, only pulses from the current determination are usedin calculating the blood pressure values. In order to ensure adequate artifact rejectioncapability and optimal SuperSTAT NIBP performance, several criteria used to match and qualifythe oscillometric pulses at each pressure step are relaxed while supplementing the criteria withadditional information from ECG.NOTE: (Adult/Pediatric only) When ECG is monitored, SuperSTAT NIBP is able todetermine blood pressure in the presence of irregular heart rhythms. At the beginningof a SuperSTAT NIBP determination, the coefficient of variation from the previous 120ECG R-R intervals is used to determine if an irregular rhythm is present.Accuracy of the NIBP parameter was validated against the intra-arterial method. Do not usethe auscultatory method to verify the accuracy of the NIBP parameter. Auscultatory method(using cuff and stethoscope) calculates the mean pressure value from audible sounds atsystolic and diastolic, but the NIBP parameter method detects all three values.
