Influence of Behavioural State on Blood Pressure in Preterm Infants during the First 5 Days of Life

Abstract

The influence of behavioural state on neonatal blood pressure was studied in 19 healthy preterm infants. During the first five days of life every three hours a series of oscillometric blood pressure measurements was made. During the measurements the behavioural state was scored. The predominant states were quiet and active sleep. We confirmed the age-dependency of blood pressure with a steep increase during the first day of life. After the first day blood pressure and heart rate were slightly higher when the infant was awake than when asleep. Paired comparison (t-test) before and after spontaneous state transitions showed significant differences in median heart rate and ranges of heart rate and blood pressure, but not in median blood pressure. We conclude that especially movements influence oscillometric determination of blood pressure and heart rate.

Method of Blood Pressure Measurement in Neonates and Infants: A Systematic Review and Analysis

“…43 Infant BP is higher when awake and crying, when feeding or sucking, and when being held head up. 50,51 The standardized protocol for BP measurement studied by Nwankwo et al is in line with the findings of our systematic review. 43 For oscillometric BP measurements, an appropriate sized cuff should be applied to the right upper arm, the neonate allowed to settle and when the infant is asleep or quietly awake, up to 3 BP measurements should be taken.…”

Effects of prone and supine positions on sleep state and stress responses in mechanically ventilated preterm infants during the first postnatal week

“…Positioning did not affect the drowsy and awake states which collectively occurred only 1·4% of the time during prone placement and 4% during supine. Van Ravenswaaij‐Arts et al . (1989) found that quiet and active sleep were the prominent states and the awake state occurred less than 22% of the time in healthy preterm infants younger than 36 weeks of gestation.…”

“…1991). Quiet and active sleep were also distinguished among preterm infants of 26–28 weeks gestation (Karch et al . 1982, Van Ravenswaaij‐Arts et al .…”

“…Behavioural state is associated with the infant's physiological parameters such as heart rate (HR) and oxygen consumption, which are higher in the awake state than in the sleep state. Significant increases in HR and oxygen consumption were observed when preterm infants switched from a quiet sleep to an active sleep or awake state (Dinwiddie et al . 1979, Schulze et al .…”