Blood Pressure in Infancy and in Childhood

Abstract

The first systematic study of blood pressure in children was made by von Basch in 1894. Using a tonometer of his own design, he took the blood pressure of sixty-eight children, in Monti's Clinic in Vienna.Friedman, in 1893 in Heubner's Clinic, repeated von Basch's work. He took the reading of a number of children, but drew no definite conclusions. The first important work on blood pressure in children in America was done by Cook in 1903, while working at the Thomas Wilson Sanitarium for sick children at Johns Hopkins. In the hope of obtaining a more accurate criterion for the stimulation of sick infants and young children, he employed blood pressure examinations.Although numerous methods have been used and recommended for the determination of blood pressure in children, Korotkoff's auscultatory method, with a modification of the Riva-Rocci mercury manometer, using a 9 cm. cuff, is undoubtedly the most practical and accurate for clinical purposes. Von Recklinghausen, in his observations on blood pressure, showed that errors are frequently due to a narrow armlet and that one less than 10 cm. in width should never be used. Mae Michaels, in the examination of children, found that the readings averaged only 5 cm. lower with the wider than with the narrower cuff. The narrower cuff is more easily adjusted to the small arms of children.A study of the literature on blood pressure in infants and children reveals great differences in the results obtained by the numerous inves¬ tigators, dependent not only on the great variations in the sphygmomanometer and in the methods used, but also on the personal equation, both as to the examiner and as to the patient. The literature offers no abso-From the