Search

Aim: To assess the usefulness and efficacy of pulse oximetry (disappearance/reappearance of plethsmographic waves) as a method of non-invasive blood pressure monitoring in neonates. Objective: To investigate the reliability of the plethysmographic wave form of the pulse oximeter to measure the systolic blood pressure. Study Setting: A prospective observational study was done to assess usefulness and efficacy of pulse oximetry (disappearance/reappearance of plethysmographic waves) as a method of non-invasive blood pressure monitoring in neonates. Material and Methods: The study was conducted among 500 neonates to investigate the reliability of the plethysmographic waveform of the pulse oximeter to measure the systolic blood pressure as it is a easy way to perform and non invasive. Statistical Analysis Used: The results will compare and analyse statistically by Pearson correlation co-efficient. Regression modeling will carried out to explain the relationship of non-invasive blood pressure with mean DP and RP and attempted to predict the non-invasive blood pressure from mean DP/mean RP. Results: The study results revealed that NIBP systolic and diastolic both correlated with DP and RP of pulse oximetry plethysmograph. Conclusion: Study concluded that pulse oximetry is a reliable tool in measuring blood pressure in neonates (appearance and disappearance of plethysmogram). [ABSTRACT FROM AUTHOR]

Background:The use of automated (oscillometric) blood pressure (BP) devices is not validated in atrial fibrillation (AF) patients. Objectives:To assess the reliability of three oscillometric BP devices, and the agreement with invasive arterial blood pressure(IBP) in AF patients. Methods:48 AF patients with randomized sequences of 10 consecutive BP measurements with two pairs of devices: (1) OmronR7™(wrist) and OmronHEM907™(arm); (2) OmronR7™ and Microlife WatchBPhome(arm). Reliability and agreement of each device were assessed by the intra-class correlation coefficient (ICC) for the continuous BP measurements and Bland & Altman methodology, respectively. In 10 additional AF patients, 10 consecutive measurements with IBP and OmronHEM907™, and IBP and Microlife WatchBPhome were performed. Results:The OmronR7™ was not able to obtain any BP Readings. Arm devices presented better ICC for systolicBP(SBP) than for diastolicBP(DBP) (Omron HEM907™:0.94 [0.90; 0.97] vs. 0.77 [0.67; 0.89]; Microlife WatchBPhome:0.92 [0.88; 0.96] vs.0.79 [0.69; 0.89]).The correlation coefficient between Microlife WatchBPhome and IBP computed using the average of repeated measurements from two to ten measurements improved up to the third and remained stable afterwards. The agreement between IBP and SBP, and IBP and DBP, was moderate as illustrated by a wide limit of agreement [−24; 26](SBP) and [−15;17](DBP) for Microlife WatchBPHome, respectively and [−30; 13](SBP) and [−7; 15](DBP) for OmronHEM907. Conclusions:BP measurement using the two arm oscillometric devices achieved a high reliability for SBP. The agreement between IBP and arm devices was low but using the average of three consecutive measurements improved the results substantially. [ABSTRACT FROM PUBLISHER]

Background: Arterial blood pressure (BP) is one of the four vital signs that reflect cardiovascular status in neonates. The present study aimed to obtain BP percentiles among healthy, singleton, liveborn neonates between 34 and 43 weeks of gestation who were less than 1 h old. Methods: BP measurements were taken after birth in supine-positioned neonates in the delivery room using an oscillometric device. A total of 982 well-nourished neonates who did not require resuscitation, were not fetally malnourished, were not admitted to the neonatal intensive care unit and were without obvious congenital abnormalities were included in the study. Results: Sex- and type-of-delivery-specific 5th and 95th percentiles BP measurements were obtained for gestation. Mean BP values for systolic, diastolic and mean of term neonates were 63.98 ± 12.29 mmHg, 38.34 ± 11.06 mmHg and 49.32 ± 11.33 mmHg, and late preterm neonates were 61.80 ± 12.46 mmHg, 33.17 ± 9.97 mmHg and 46.52 ± 10.8 mmHg, respectively. There were weak but significant correlations between birthweight, birth length and head circumference and systolic, diastolic and mean arterial BP values (r = 0.20, r = 0.15 and r = 0.20, respectively, P < 0.001). Neonates who were delivered vaginally had higher mean BP values for systolic, diastolic and mean than neonates delivered by cesarean section ( P < 0.05). Female neonates had higher systolic BP values than male neonates ( P < 0.05). Conclusion: Data presented in this study include sex- and delivery-mode-specific BP percentile curves using an oscillometric method and serve as a valuable reference for physicians in dealing with the management of singleton, liveborn late preterm and term newborns in the delivery room intensive care. [ABSTRACT FROM AUTHOR]

The neonatal period is a time of extensive hemodynamic changes. It is expected that these changes are most prominent in premature infants during the first week of life. The aim of this study was to examine arterial blood pressure (BP) measured by an oscillometric device in the first month of life in a stable premature population admitted to our neonatal intensive care unit (NICU), and to evaluate the influence of gestational age, postnatal age, birth weight, gender, and sleep state on BP. This prospective study was conducted over 27 months. The study population consisted of 373 hemodynamically stable infants (292 preterm and 81 full-term infants). Overall 12,552 BP measurements were carried out using a non-invasive oscillometric blood pressure monitor. Both systolic and diastolic blood pressure progressively increased during the first month of life. BP increased more rapidly in preterm infants than in full-term infants, and was higher in groups with higher birth weight. Multiple regression analysis showed that mean BP during the first week and on the 30th day increased with gestational age, and also that it was higher in the awake than in the sleep state. [ABSTRACT FROM AUTHOR]

We previously reported blood pressure (BP) readings obtained by the Dinamap (DIN) (Model 8100) were 10 mmHg higher than those obtained by auscultatory methods and thus were not interchangeable. DIN BP data on 7208 schoolchildren ages 5 to 17 were analyzed to generate normative DIN BP standards and to examine the rational for presenting BP standards according to age and height percentiles. Three BP measurements were taken in the sitting position using a BP cuff width 40% to 50% of the circumference of the arm. Boys’ systolic pressures (SP) were significantly ( p < 0.05) greater (up to 11 mmHg) than those of the girls in subjects age 13 to 17 years. SP levels were most closely correlated with weight ( r = 0.595), followed by height ( r = 0.560) and age ( r = 0.518). When BP levels were adjusted for age and weight, the correlation coefficient of DIN SP with height was negligible ( r = 0.026 for boys; r = 0.085 for girls), whereas when adjusted for age and height, the correlation of SP with weight remained high ( r = 0.303 for boys; r = 0.216 for girls), indicating that height is not an important independent predictor of BP levels. In conclusion, Dinamap-specific BP standards presented in this report are the only standards that have been generated according to the current BP guidelines recommended by national committees. We found no rational for presenting BP standards according to age and height percentiles. [ABSTRACT FROM AUTHOR]

We conducted a study on blood pressure (BP) measurements in 40 healthy children (aged 11·0 ± 0·4 years), in 20 healthy students (18·8 ± 0·9 years), and in 19 children with a history of coarctation (9·3 ± 4·0 years). Both a standard sphygmomanometer and an oscillometric device (Dinamap, Critikon Inc, Tampa, FL, USA) were used. BP measurements in the arms, thighs and ankles were performed according to a fixed protocol. Although the site of measuring was switched each time successive measurements in the same limb resulted in lower systolic values than the first measurement. In patients with coarctation all gradient estimates correlated well with each other and with the gradient estimates obtained by Doppler-echocardiography. In healthy children, the systolic BP measured by Dinamap was 2 mmHg lower in the right arm than in the thighs, and 12 mmHg lower than in the ankles. In young adults, the differences were 12 and 16 mmHg, respectively. The BP difference between the right arm and the thighs by sphygmomanometer was +4 mmHg in children and -4 mmHg in adults. The cut point value to warrant further examinations was similar with both methods: 5–10 mmHg higher readings in the arm than in the leg. The first BP measurement should be ignored. After that, repetitive measurements in the arm with the higher systolic BP and the legs should be performed. [ABSTRACT FROM AUTHOR]