Non-invasive blood pressure measurement in the neonate

Kollée, L.A.A.; Schöls, Willem A.; Peer, Petronella G. M.

doi:10.1016/b978-0-407-00451-1.50013-8

Cited by 4 publications

(4 citation statements)

References 16 publications

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“…This treatment was continued during the study but midazolam and morphine were always infused by a separate venous access. Blood pressure was within the normal range [12] before the start of midazolam or morphine in all patients.…”

Section: Study Populationmentioning

confidence: 99%

“…In 2 patients severe hypotension ( 1 2 SD below mean blood pressure for BW [12] ) occurred for which clinical intervention was necessary (inotropic support in 1 patient and plasma expanders in 1 patient). Although we only studied a small sample size, infants who were treated with dopamine before midazolam infusion seemed to be less vulnerable for hypotension.…”

Section: Midazolammentioning

confidence: 99%

“…Mean arterial blood pressure (MABP) was continuously recorded if an arterial catheter was available, otherwise non-invasive blood pressure was measured using the oscillometric method before and 15, 30, 60 and 120 min after sedation. We defined hypotension as a blood pressure below the normal range for BW [12] . All continuously measured parameters were registered at a sample rate of 1 Hz.…”

Section: Other Physiological Measurementsmentioning

confidence: 99%

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Effects of Midazolam and Morphine on Cerebral Oxygenation and Hemodynamics in Ventilated Premature Infants

Velden¹,

Hopman²,

Klaessens³

et al. 2006

Neonatology

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Background: Midazolam sedation and morphine analgesia are commonly used in ventilated premature infants. Objectives: To evaluate the effects of midazolam versus morphine infusion on cerebral oxygenation and hemodynamics in ventilated premature infants. Methods: 11 patients (GA 26.6–33.0 weeks, BW 780–2,335 g) were sedated with midazolam (loading dose 0.2 mg/kg, maintenance 0.2 mg/kg/h) and 10 patients (GA 26.4–33.3 weeks, BW 842–1,955 g) were sedated with morphine (loading dose 0.05 mg/kg, maintenance 0.01 mg/kg/h). Changes in oxyhemoglobin (ΔcO₂Hb) and deoxyhemoglobin (ΔcHHb) were assessed using near infrared spectrophotometry. Changes in cHbD (= ΔcO₂Hb – ΔcHHb) reflect changes in cerebral blood oxygenation and changes in concentration of total hemoglobin (ΔctHb = ΔcO₂Hb + ΔcHHb) represent changes in cerebral blood volume (ΔCBV). Changes in cerebral blood flow velocity (ΔCBFV) were intermittently measured using Doppler ultrasound. Heart rate (HR), mean arterial blood pressure (MABP), arterial oxygen saturation (saO₂) and transcutaneous measured pO₂ (tcpO₂) and pCO₂ (tcpCO₂) were continuously registered. Statistical analyses were carried out using linear mixed models to account for the longitudinal character study design. Results: Within 15 min after the loading dose of midazolam, a decrease in saO_2,tcpO₂and cHbD was observed in 5/11 infants. In addition, a fall in MABP and CBFV was observed 15 min after midazolam administration. Immediately after morphine infusion a decrease in saO_2, tcpO₂and cHbD was observed in 6/10 infants. Furthermore, morphine infusion resulted in a persistent increase in CBV. Conclusions: Administration of midazolam and morphine in ventilated premature infants causes significant changes in cerebral oxygenation and hemodynamics, which might be harmful.

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Section: Study Populationmentioning

confidence: 99%

Section: Midazolammentioning

confidence: 99%

Section: Other Physiological Measurementsmentioning

confidence: 99%

See 1 more Smart Citation

Effects of Midazolam and Morphine on Cerebral Oxygenation and Hemodynamics in Ventilated Premature Infants

Velden¹,

Hopman²,

Klaessens³

et al. 2006

Neonatology

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show abstract

“…These variables were kept within the normal range by adjusting the ventilator settings if necessary. Continuously vasoactive medication, if needed, was adjusted to keep the mean arterial blood pressure within the normal range of the gestational age according to the guidelines used in our department (18).…”

Section: Clinical Variablesmentioning

confidence: 99%

Changes in cerebral, renal and mesenteric blood flow velocity during continuous and bolus infusion of indomethacin

et al. 2002

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Vasoconstriction induced by bolus injection of indomethacin reduces organ perfusion and has been related to the well‐known side effects of indomethacin given for closure of the patent ductus arteriosus (PDA). The aim of the study was to compare the changes in cerebral, renal and mesenteric blood flow velocities after continuous infusion versus bolus injection of indomethacin for closure of the PDA. Thirty‐two preterm infants (range 26–35 wk gestational age) with PDA were randomly assigned to receive the same amount of indomethacin either as three bolus injections (n= 14) or as a continuous infusion (n= 18) over 36 h. Blood flow velocities were measured in the internal carotid, right renal and superior mesenteric arteries at baseline and serially at 10, 30, 60 and 120 min and 12, 24, 36 and 48 h after the start of indomethacin treatment. There were no differences in blood flow velocities between both groups at baseline. During continuous infusion of indomethacin there was no significant change in the cerebral, renal and mesenteric blood flow velocities, whereas the flow velocities in the infants receiving bolus injections decreased significantly during the first 2 h after indomethacin administration in all arteries measured. There was a transient, but significant reduction in urine output after bolus injection of indomethacin. Conclusion: In contrast to bolus injections, decrease of organ blood flow and impairment of urine output do not accompany continuous infusion of indomethacin over 36 h.

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Changes in cerebral, renal and mesenteric blood flow velocity during continuous and bolus infusion of indomethacin

et al. 2002

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show abstract

Non-invasive blood pressure measurement in the neonate

Cited by 4 publications

References 16 publications

Effects of Midazolam and Morphine on Cerebral Oxygenation and Hemodynamics in Ventilated Premature Infants

Effects of Midazolam and Morphine on Cerebral Oxygenation and Hemodynamics in Ventilated Premature Infants

Changes in cerebral, renal and mesenteric blood flow velocity during continuous and bolus infusion of indomethacin

Changes in cerebral, renal and mesenteric blood flow velocity during continuous and bolus infusion of indomethacin

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