Age-dependent changes in arterial blood pressure in neonates during the first week of life: reference values and development of a model

Zadelhoff, Arjan C van; Poppe, Jarinda A.; Willemsen, Sten P.; Mauff, Katya; Weteringen, Willem van; Goos, Tom G.; Reiss, Irwin K M; Vermeulen, Marijn J.; Graaff, Jurgen C. de

doi:10.1016/j.bja.2023.01.024

Cited by 6 publications

(4 citation statements)

References 26 publications

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“…In view of this, future presentation of summary statistics that use universally accepted subgroups and standard postnatal timepoints for measurement would ensure that appropriate statistical analyses could be implemented more effectively. Finally, whilst this review has been undertaken as part of an international consortium, it is worth noting that there have been further studies evaluating neonatal blood pressure since this review which demonstrate agreement with our overall findings [ 43 , 44 ].…”

Section: Discussionsupporting

confidence: 81%

Neonatal blood pressure by birth weight, gestational age, and postnatal age: a systematic review

Dore,

Barnes,

Bremner

et al. 2024

matern health, neonatol and perinatol

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Background Blood pressure is a vital hemodynamic marker during the neonatal period. However, normative values are often derived from small observational studies. Understanding the normative range would help to identify ideal thresholds for intervention to treat hypotension or hypertension. Therefore, the aim of this study was to assess observed blood pressure values in neonates who have not received any blood-pressure modifying treatments from birth to three months postnatal age and whether these vary according to birth weight, gestational age and postnatal age. Methods This was a systematic review. A literature search was conducted in MEDLINE, PubMed, Embase, Cochrane Library, and CINAHL from 1946 to 2017 on blood pressure in neonates from birth to 3 months of age (PROSPERO ID CRD42018092886). Unpublished data were included where appropriate. Results Of 3,587 non-duplicate publications identified, 30 were included (one unpublished study). Twelve studies contained data grouped by birth weight, while 23 contained data grouped by gestational age. Study and clinical heterogeneity precluded meta-analyses thus results are presented by subgroup. A consistent blood pressure rise was associated with increasing birth weight, gestational age, and postnatal age. In addition, blood pressure seemed to rise more rapidly in the most preterm and low birth weight neonates. Conclusion Despite blood pressure increasing with birth weight, gestational age, and postnatal age, there was marked blood pressure variability observed throughout. To better define hypotension and hypertension, future studies should develop consistent approaches for factors related to blood pressure variability, including the method and timing of measurement as well as statistical control of relevant patient characteristics.

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Section: Discussionsupporting

confidence: 81%

Neonatal blood pressure by birth weight, gestational age, and postnatal age: a systematic review

Dore,

Barnes,

Bremner

et al. 2024

matern health, neonatol and perinatol

View full text Add to dashboard Cite

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“…It is worth noting that considering the significant impact of age on the odds of NAFLD and VAT content in both sexes, investigating the isolated and combined effects of age and METS-VF on the odds of NAFLD may hold crucial implications for clinical prevention and risk stratification management of NAFLD in the general population ( 33 , 34 ). The current study investigated the relationship between age and METS-VF with NAFLD based on established multivariate logistic regression models, and visually displayed the isolated and combined associations of both factors with the odds of NAFLD through 3D fitted surface plots ( 35 , 36 ). In terms of the isolated effects of the two indicators on NAFLD, METS-VF was linearly and positively associated with the odds of NAFLD in both sexes, and an increase in METS-VF in females was associated with greater odds of NAFLD, which were consistent with the results of the logistic regression analyses [OR (Q5): females 23.72 > males 12.88].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, we transformed METS-VF into a categorical variable using quintile function and included it in the above regression models, followed by a linear trend test. It is worth noting that considering the significant impact of age-related reproductive status and metabolic condition on visceral fat content and NAFLD risk ( 33 , 34 ), we employed the OpenGL technique to fit surface elevation plots of the association between METS-VF, age, and NAFLD, based on the adjustment strategy from logistic regression Model 3, and displayed this joint relationship through 3D fitted surface plots ( 35 , 36 ). Moreover, to further validate the utility of METS-VF in assessing fatty liver risk, we also investigated its correlation with other widely recognized hepatic steatosis assessment indices, HSI and FLI.…”

Section: Methodsmentioning

confidence: 99%

The newly proposed Metabolic Score for Visceral Fat is a reliable tool for identifying non-alcoholic fatty liver disease, requiring attention to age-specific effects in both sexes

Kuang,

Qiu,

et al. 2023

Front. Endocrinol.

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ObjectiveThe newly proposed Metabolic Visceral Fat Score (METS-VF) is considered a more effective measure for visceral adipose tissue (VAT) than other obesity indicators. This study aimed to reveal the association between METS-VF and non-alcoholic fatty liver disease (NAFLD), and its variations across age groups within both sexes.MethodsData from 14,251 medical examiners in the NAGALA project were employed in this study. 3D fitted surface plots were constructed based on multivariate logistic regression models to visualize the isolated and combined effects of aging and METS-VF on NAFLD. Receiver operating characteristic curve (ROC) analysis was conducted to compare the diagnostic performance of METS-VF with other VAT surrogate markers in predicting NAFLD.ResultsThe results of multivariate logistic regression analysis showed that each unit increase in METS-VF was independently associated with a 333% and 312% increase in the odds of NAFLD in males and females, respectively. Additionally, the 3D fitted surface plot showed that age significantly influenced the association between METS-VF and the odds of NAFLD in both sexes, as follows: (i) In males, when METS-VF was less than 6.2, the METS-VF-related odds of NAFLD increased gradually with age in the 20-45 age group, reached a plateau in the 45-65 age group, and then decreased in the group above 65 years old; however, when male METS-VF exceeded 6.2, aging and METS-VF combined to further increase the odds of NAFLD in all age groups, particularly in the 45-65 age group. (ii) In females, aging seemed to reduce METS-VF-related odds of NAFLD in the 18-40 age group, but significantly increased it in the 40-60 age group, particularly for those with higher METS-VF levels. Further ROC analysis revealed that compared to other VAT surrogate markers, METS-VF showed the highest diagnostic accuracy for NAFLD in females, especially in those under 45 years of age [area under the curve (AUC) = 0.9256].ConclusionsThis study firstly revealed a significant positive correlation between METS-VF and the odds of NAFLD, with METS-VF surpassing other VAT surrogate markers in NAFLD diagnosis. Moreover, age significantly influenced the METS-VF-related odds of NAFLD and METS-VF’s diagnostic efficacy for NAFLD in both sexes.

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“…For example, intraoperative volemia and antinociception (opioids, adjuvants, regional blockade) should be considered for further studies. Regarding neonatal anesthesia, based on current status of knowledge, we would nowadays also monitor cerebral NIRS as well as pre‐ and post‐ductal SpO 2 , and consider using van Zadelhoff's data on awake neonatal blood pressure as baseline values 21 …”

Section: Limitationsmentioning

confidence: 99%

Evaluation of quality of care in neonatal anesthesia using a bundle of intraoperative parameters

Salaün

Beaufils

Chagnot

et al. 2023

Pediatric Anesthesia

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BackgroundMaintenance of physiological homeostasis is key in the safe conduct of pediatric anesthesia. Achieving this goal is especially difficult in neonatal surgery.AimsThe first aim was to document the absolute number of seven intraoperative parameters monitored during anesthesia in neonates undergoing gastroschisis surgery. The second aims were to determine the frequency of monitoring of each of these intraoperative parameters as well as the proportion of cases in which each parameter was both monitored and maintained within a pre‐defined range.MethodsThis retrospective observational analysis includes data from 53 gastroschisis surgeries performed at Caen University Hospital (2009–2020). Seven intraoperative parameters were analyzed. First, we assessed if the intraoperative parameters were monitored or not. Second, when monitored, we assessed if these parameters were maintained within a pre‐defined range, based on the current literature and on local agreement.ResultsThe median [first–third Q], range (min–max) number of intraoperative parameters monitored during the 53 gastroschisis surgeries was 6 [5–6], range (4–7). There were no missing data for the automatically recorded ones such as arterial blood pressure, heart rate, end‐tidal CO2, and oxygen saturation. Temperature was monitored in 38% of the patients, glycemia in 66%, and natremia in 68% of the cases. Oxygen saturation and heart rate were maintained within the pre‐defined range in 96% and 81% of the cases respectively. The blood pressure (28%) and temperature (30%) were instead the least often maintained within the pre‐defined range.ConclusionAlthough a median of six out of the seven selected intraoperative parameters were monitored during gastroschisis repair, only two of them (oxygen saturation and heart rate) were maintained within the pre‐defined range more than 80% of the time. It might be of interest to extend physiologic age‐ and procedure‐based approach to the development of specific preoperative anesthetic planning.

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Age-dependent changes in arterial blood pressure in neonates during the first week of life: reference values and development of a model

Cited by 6 publications

References 26 publications

Neonatal blood pressure by birth weight, gestational age, and postnatal age: a systematic review

Neonatal blood pressure by birth weight, gestational age, and postnatal age: a systematic review

The newly proposed Metabolic Score for Visceral Fat is a reliable tool for identifying non-alcoholic fatty liver disease, requiring attention to age-specific effects in both sexes

Evaluation of quality of care in neonatal anesthesia using a bundle of intraoperative parameters

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