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DOI: 10.1055/s-0034-1390345
Factors Influencing the Accuracy of Noninvasive Blood Pressure Measurements in NICU Infants
Publikationsverlauf
03. März 2014
28. Juli 2014
Publikationsdatum:
26. Oktober 2014 (online)
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Abstract
Objective Compare invasive blood pressure (IBP) and noninvasive blood pressure (NIBP) measurement methods in the neonatal intensive care unit (NICU) across various gestational age and postmenstrual age (PMA), and determine the effect of gestational age and PMA on accuracy of NIBP measurements.
Study Design Retrospective chart review of paired mean IBP and NIBP measurements from infants admitted to a single NICU from January 2008 through December 2010. Infants with congenital anomalies or receiving therapeutic hypothermia were excluded. Difference between paired measurements was analyzed using Bland–Altman method. We examined the association between PMA, sex, race, mechanical ventilation, medications, and axillary temperature, and the difference in measurements using a mixed effects linear regression model.
Results Eighty-seven infants had 243 observations. The mean (range) gestational age at birth was 31.9 (23–41) weeks and PMA at time of measurement ranged from 26 to 52 weeks. We found poor agreement between IBP and NIBP measurements, with mean difference (95% limits of agreement) of −8.8 (11, −28.7) mm Hg. The mean blood pressure percent difference ( ± SD) was −28.3 ( ± 35.6%). A greater blood pressure percent difference between the two measurement techniques was associated with lower PMA and lower mean IBP.
Conclusion NIBP measurements overestimate IBP measurements particularly in smaller, sicker infants at lower IBP measurements.
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References
- 1 Nuntnarumit P, Yang W, Bada-Ellzey HS. Blood pressure measurements in the newborn. Clin Perinatol 1999; 26 (4) 981-996 , x
- 2 Meyer S, Sander J, Gräber S, Gottschling S, Gortner L. Agreement of invasive versus non-invasive blood pressure in preterm neonates is not dependent on birth weight or gestational age. J Paediatr Child Health 2010; 46 (5) 249-254
- 3 Takci S, Yigit S, Korkmaz A, Yurdakök M. Comparison between oscillometric and invasive blood pressure measurements in critically ill premature infants. Acta Paediatr 2012; 101 (2) 132-135
- 4 Vasquez P, Burd A, Mehta R, Hiatt M, Hegyi T. Resolution of peripheral artery catheter-induced ischemic injury following prolonged treatment with topical nitroglycerin ointment in a newborn: a case report. J Perinatol 2003; 23 (4) 348-350
- 5 Troy R, Doron M, Laughon M, Tolleson-Rinehart S, Price W. Comparison of noninvasive and central arterial blood pressure measurements in ELBW infants. J Perinatol 2009; 29 (11) 744-749
- 6 Emery EF, Greenough A. Non-invasive blood pressure monitoring in preterm infants receiving intensive care. Eur J Pediatr 1992; 151 (2) 136-139
- 7 Gevers M, van Genderingen HR, Lafeber HN, Hack WW. Accuracy of oscillometric blood pressure measurement in critically ill neonates with reference to the arterial pressure wave shape. Intensive Care Med 1996; 22 (3) 242-248
- 8 Chia F, Ang AT, Wong TW , et al. Reliability of the Dinamap non-invasive monitor in the measurement of blood pressure of ill Asian newborns. Clin Pediatr (Phila) 1990; 29 (5) 262-267
- 9 Dannevig I, Dale HC, Liestøl K, Lindemann R. Blood pressure in the neonate: three non-invasive oscillometric pressure monitors compared with invasively measured blood pressure. Acta Paediatr 2005; 94 (2) 191-196
- 10 Diprose GK, Evans DH, Archer LN, Levene MI. Dinamap fails to detect hypotension in very low birthweight infants. Arch Dis Child 1986; 61 (8) 771-773
- 11 O'Shea J, Dempsey EM. A comparison of blood pressure measurements in newborns. Am J Perinatol 2009; 26 (2) 113-116
- 12 Pichler G, Urlesberger B, Reiterer F, Gradnitzer E, Müller W. Non-invasive oscillometric blood pressure measurement in very-low-birthweight infants: a comparison of two different monitor systems. Acta Paediatr 1999; 88 (9) 1044-1045
- 13 König K, Casalaz DM, Burke EJ, Watkins A. Accuracy of non-invasive blood pressure monitoring in very preterm infants. Intensive Care Med 2012; 38 (4) 670-676
- 14 Mantha S, Roizen MF, Fleisher LA, Thisted R, Foss J. Comparing methods of clinical measurement: reporting standards for Bland and Altman analysis. Anesth Analg 2000; 90 (3) 593-602
- 15 Bland JM, Altman DG. Agreement between methods of measurement with multiple observations per individual. J Biopharm Stat 2007; 17 (4) 571-582
- 16 Arnau J, Balluerka N, Bono R, Gorostiaga A. General linear mixed model for analysing longitudinal data in developmental research. Percept Mot Skills 2010; 110 (2) 547-566
- 17 Sonesson SE, Broberger U. Arterial blood pressure in the very low birthweight neonate. Evaluation of an automatic oscillometric technique. Acta Paediatr Scand 1987; 76 (2) 338-341