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Blood pressure is one of the most frequently measured variables in clinical practice and is one of the most important in influencing treatment. Measurements are normally made with an indirect method and since the first such techniques were described progressive development has been made towards their automation. Even in patients with normal blood pressures, however, these methods have been found to be inaccurate and they are most liable to error with extremes of pressure---when high in severe hypertension or low in shock---and when peripheral vasoconstriction is present. It is in precisely these situations when it is often of critical importance to know the blood pressure, and at such times the direct measurement of intra-arterial pressure is the only reliable method. This approach is now used in many intensive care units and is likely to be implemented progressively more as the techniques are further improved and the usefulness of the results is more widely appreciated. The volume of data is potentially very large and there is the possibility of many derived results. Digital computers have been previously applied to the analyses involved, the general approach being to compress the results of intermittent measurements made in real time on an arterial recording to a form essentially similar to standard nursing charts although considerably more comprehensive, and to leave interpretation to the attending physician. The present paper describes a method based on a cumulative sum technique for demonstrating trends in the mean level and variability of the recorded parameter and its derivatives and for assessing the significance of trends detected. It has been applied to subsequent analysis at high speed of recordings made on a multi-channel F.M. tape recorder, but the basic programme could also be used for on-line analysis and the general approach is suitable for the analysis of heart rate, centra venous or other pressures, some respiratory variables, and temperature.

Applications of digital computers to the long term measurement of blood pressure and the management of patients in intensive care situations