Blood pressure in the neonate

Three non-invasive oscillometric pressure monitors compared with invasively measured blood pressure

DANNEVIG, Ingrid
DALE, Helen Caroline
LIESTØL, Knut
LINDEMANN, Rolf

¹Neonatal Intensive Care Unit, Department of Paediatrics, Ullevål University Hospital, Oslo, Norway
²Department of Informatics, University of Oslo, Oslo, Norway

Correspondence: R. Lindemann, Neonatal Intensive Care Unit, Department of Paediatrics, Ullevål University Hospital, NO-0407, Oslo, Norway. Tel: +47 2211 8765. Fax: +47 2211 8663. E-mail: [email protected]

(Received 3 September 2003; revised 10 February 2004 and 13 May 2004 accepted 22 June 2004)

Acta Paediatrica 94(2):p 191-196, February 2005.

Aim

To compare blood pressure in neonates obtained from three different oscillometer blood pressure monitors (Dinamap™, Criticare™, Hewlett-Packard™) with arterial blood pressure (Hewlett-Packard™ invasive unit).

Study design

A total of 32 randomized, non-invasive blood pressure series, each consisting of three measurements from each monitor, were obtained from 20 neonates (birthweight 531–4660 g). Each measurement was compared with the invasive pressure.

Results

Two factors appear to have a systematic effect on the difference between oscillometric and invasive pressure (the measurement deviance): the size of the infant, e.g., the arm circumference, and the monitor system. For small infants, the non-invasively measured value tends to be too high. The deviance is partly reversed for larger infants (dependency on size significant for mean and diastolic pressure, p < 0.001). The difference between monitor systems is clearly significant (p < 0.001). Hewlett-Packard™ gives the lowest pressure values for all pressures. Thus, Criticare™ and Dinamap™ tended to show values too high in the smallest infants, while Hewlett-Packard™ tended to give values too low in larger infants. Birthweight, present weight and arm circumference affected measurement deviance approximately equally strongly, while factors such as the infant's sex, need of breath support and umbilical or radial arterial line were non-significant.

Conclusions

Blood pressure should preferably be measured invasively in severely ill neonates and preterm infants, being aware of pitfalls with measurements using different oscillometer monitors and the size/arm circumference of the infant.