A practical and reliable method of measuring blood pressure in the neonate by pulse oximetry☆,☆☆,★
Section snippets
METHODS
Fifty-one infants admitted to the neonatal intensive care unit at the Johns Hopkins Bayview Medical Center were enrolled in the study. All infants had indwelling arterial catheters placed for their ongoing care. Size 3.5F (birth weight <1500 gm) or 5F gauge umbilical artery catheters were used. Peripheral arteries were cannulated with size 24F catheters.
An appropriately sized blood pressure cuff was placed on the extremity where the pulse oximeter (BIOX 3700; Ohmeda, Madison, Wis.) was
RESULTS
The median gestational age was 30.5 weeks (range, 24 to 40 weeks) and the mean birth weight was 1697 gm (range, 500 to 3856 gm); 48% of the infants weighed less than 1500 gm at birth. One infant was receiving a vasoactive medication (dopamine). Twenty-six infants received mechanical ventilation, four by high-frequency ventilators, and 24 received supplemental oxygen by hood or nasal continuous positive airway pressure. Intraarterial systolic blood pressure ranged from 33 to 82 mm Hg, with a
DISCUSSION
We have described a reliable, easily obtainable, and noninvasive method of measuring systolic blood pressure in neonates by the use of pulse oximetry. This method appears more accurate than the oscillometric measurements commonly used in neonatal intensive care units. Ninety-five percent of the measurements obtained by pulse oximetry will be between 6 mm Hg less than and 4 mm Hg greater than the intraarterial "gold standard." On the other hand, oscillometric measurements could differ by amounts
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Cited by (23)
Method of Blood Pressure Measurement in Neonates and Infants: A Systematic Review and Analysis
2020, Journal of PediatricsCitation Excerpt :Given the level of evidence in the literature, we recommend measurements be taken in the right upper arm when using an oscillometric device and cannot endorse the routine use of calf BP measurements (Table II). We identified 18 articles in which the authors had applied Bland-Altman methods to quantify the bias and agreement between different methods of measuring BP, comparing direct (intra-arterial) with indirect (oscillometric) methods.15,20,22-37 Results extracted from those articles are presented in forest plots (Figure 3, A-C) showing the bias and limits of agreement for all of the comparisons reported in the articles.
Neonatal hypotension: Dopamine or dobutamine?
2014, Seminars in Fetal and Neonatal MedicineCitation Excerpt :Although oscillometric methods of measuring blood pressure are widely used, neonatal readings are of limited accuracy, and the technique becomes least reliable when it needs to be most reliable – in babies with clinically significant hypotension. Fortunately, there is good agreement between intravascular and indirect Doppler measurements of systolic pressure, and between intravascular and pulse oximetry technique measurements throughout the blood pressure range [7,8]. What should be measured: systolic or mean pressures?
Definition of Normal Blood Pressure Range: The Elusive Target
2012, Hemodynamics and Cardiology: Neonatology Questions and Controversies Expert Consult - Online and PrintDefinition of normal blood pressure range: The elusive target
2012, Hemodynamics and CardiologyPulse oximetry in pediatrics
1996, Archives de PediatriePrehospital monitoring of trauma patients: Experience of a helicopter emergency medical service
1996, British Journal of Anaesthesia
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From the Department of Neonatology, Johns Hopkins Bayview Medical Center, Johns Hopkins School of Medicine, Baltimore, Maryland
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Reprint requests: Michael Langbaum, MD, Johns Hopkins Bayview Medical Center, Neonatal Intensive Care Unit, Second Floor, 4940 Eastern Ave., Baltimore, MD 21224.
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0022-3476/94/$3.00 + 0 9/23/58772