Blood Pressure in Critically Ill Children: Exploratory Analyses of Concurrent Invasive and Noninvasive Measurements

Goodwin, Andrew; Mazwi, Mjaye; Somer, Jonathan; McEwan, Alistair; Eytan, Danny

doi:10.1097/cce.0000000000000586

Cited by 4 publications

(2 citation statements)

References 23 publications

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“… 14 A retrospective analysis of big data provided similar findings. 15 Intra-arterial blood pressure readings are reportedly similar to auscultatory NIBP readings among critically ill children (age, 29.4 + 3.9 months). 13 In our study, overestimation of SBP, DBP, and MAP by MPMs, irrespective of age, gender, and critical care characteristics are in agreement.…”

Section: Discussionmentioning

confidence: 70%

“… 1 , 3 Recently, an attempt was made to develop and to quantify mathematical relationship between NIBP values (obtained from MPMs) and IABP values from big data analysis to improve clinicians’ confidence in the MPMs. 15 However, it may not be the best alternative, especially in the busy PERs of LMICs. There is a felt need to encourage industry to develop and to evaluate MPMs for accuracy and reliability across pediatric age groups and in different clinical situations.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Blood Pressure Measurements by Currently Available Multiparameter Monitors and Mercury Column Sphygmomanometer in Patients Admitted in Pediatric Intensive Care Unit

Sahoo¹,

Jayashree²,

Baranwal³

et al. 2023

Indian Journal of Critical Care Medicine

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A bstract Background The multiparameter monitor (MPM) is replacing mercury column sphygmomanometers (MCS) in acute care settings. However, data on the former's accuracy in critically ill children are scarce and mostly extrapolated from adults. We compared non-invasive blood pressure (NIBP) measurements by MPMs with MCS in pediatric intensive care unit (PICU). Patients Adequately sedated and hemodynamically stabilized children (age, 1–144 months) were prospectively enrolled. Materials and methods Three NIBP measurements were obtained from MCS (Diamond®, India) and MPM (Intellivue MX800® or Ultraview SL®) in rapid succession in the upper limb resting in supine position. Respective three measurements were averaged to obtain a paired set of NIBP readings, one each from MCS and MPM. Such readings were obtained thrice a day. NIBP readings were then compared, and agreement was assessed. Results From 39 children [median age (IQR), 30 (10–72) months], 1,690 sets of NIBP readings were obtained. A-third of readings were from infants and children >96 months, while 383 (22.6%) readings were from patients on inotropes. Multiparameter monitors gave significantly higher NIBP readings compared to MCS [median systolic blood pressure (SBP), 6.5 (6.4–6.7 mm Hg); diastolic blood pressure (DBP), 4.5 (4.3–4.6 mm Hg); mean arterial pressure (MAP), 5.3 (5.1–5.4 mm Hg); p < 0.05]. It was consistent across age, gender, and critical care characteristics. Multiparameter monitors overestimated SBP in 80% of readings beyond the maximal clinically acceptable difference (MCAD). Conclusions Non-invasive blood pressure readings from MCS and MPMs are not interchangeable; SBP was 6–7 mm Hg higher with the latter. Overestimation beyond MCAD was overwhelming. Caution is required while classifying systolic hypotension with MPMs. Confirmation with auscultatory methods is advisable. More studies are required to evaluate currently available MPMs in different pediatric age groups. How to cite this article Khan AA, Gupta PK, Baranwal AK, Jayashree M, Sahoo T. Comparison of Blood Pressure Measurements by Currently Available Multiparameter Monitors and Mercury Column Sphygmomanometer in Patients Admitted in Pediatric Intensive Care Unit. Indian J Crit Care Med 2023;27(3):212–221.

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Section: Discussionmentioning

confidence: 70%