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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).

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.

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]

PurposeTo validate the Dinamap ProCare 200 blood pressure (BP) monitor against a mercury sphygmomanometer in children 7 to 18 years old in accordance with the 2010 International Protocol of European Society of Hypertension (ESH-IP2) and the British Hypertension Society (BHS) protocol.MethodsForty-five children were recruited for the study. A validation procedure was performed following the protocol based on the ESH-IP2 and BHS protocols for children and adolescents. Each subject underwent 7 sequential BP measurements alternatively with a mercury sphygmomanometer and the test device by trained nurses. The results were analyzed according to the validation criteria of ESH-IP2.ResultsThe mean (±SD) difference in the absolute BP values between test device and mercury sphygmomanometer readings was 1.85±1.65 mmHg for systolic BP (SBP) and 4.41±3.53 mmHg for diastolic BP (DBP). These results fulfilled the Association for the Advancement of Medical Instrumentation criterion of a mean±SD below 5±8 mmHg for both SBP and DBP. The percentages of test device-observer mercury sphygmomanometer BP differences within 5, 10, and 15 mmHg were 96%, 100%, and 100% for SBP, and 69%, 92%, and 100% for DBP, respectively, in the part 1 analysis; both SBP and DBP passed the part 1 criteria. In the part 2 analysis, SBP passed the criteria but DBP failed.ConclusionAlthough the Dinamap ProCare 200 BP monitor failed an adapted ESH-IP2, SBP passed. When comparing BP readings measured by oscillometers and mercury sphygmomanometers, one has to consider the differences between them, particularly in DBP, because DBP can be underestimated.

BACKGROUND Casual blood pressure (CBP) is considered a reliable proxy for cardiovascular health. Although the auscultatory technique is the reference standard method for measuring CBP, oscillometric devices are increasingly being used in children. We sought to establish oscillometric CBP normative standards for Swedish children. METHODS Cross-sectional oscillometric CBP readings were obtained by the Welch Allyn Spot Vital Signs 420 monitor and measured according to the International Guidelines' recommendations. Participants with elevated oscillometric CBP levels underwent verification by the auscultatory method. Ambulatory blood pressure monitoring (ABPM) was used to exclude casual hypertension. Data on 1,470 (772 males) apparently healthy Swedish schoolchildren aged 6-16 years were analyzed and sex-specific reference charts normalized to age or height were constructed. RESULTS Systolic and diastolic CBP values were significantly higher with age, height, height standard deviation score (SDS), body mass index (BMI), and BMI SDS. Gender differences for systolic CBP were present starting from age of 15 years and revealed significantly higher values in boys than in girls, whereas for diastolic CBP, the differences were apparent at the age of 12 years, with higher values in girls. Increased BMI and BMI SDS were positively associated with CBP levels. Positive parental history of hypertension turned out to be a risk factor for higher systolic and diastolic CBP across all ages. CONCLUSIONS Our normative standard for CBP can be used for blood pressure screening and control programs in Swedish children. The use of ABPM should be considered to confirm the diagnosis of casual hypertension. [ABSTRACT FROM AUTHOR]

Hypertension has become a serious global public health burden because of its high incidence and concomitant risk of cardiovascular disease. Many studies have verified that risk factors, such as hypertension and obesity which are responsible for cardiovascular disease, start in early childhood. In Asian countries, the prevalence of hypertension in the pediatric age group has become more prevalent than ever before with the increasing obesity epidemic. To tackle the epidemic of cardiovascular disease, a leading cause of death and disability of non-communicable diseases in Asian countries, population-based measures aiming at reducing harmful environmental factors to blood pressure and body weight must be applied to individuals in their early childhood, as early as the fetal stage. This review focused on the prevalence of pediatric hypertension in Asian countries and outlined several considerations for accurate blood pressure (BP) measurement and evaluation, along with an overview of pathophysiology of fetal programming and obesity related with childhood hypertension. [ABSTRACT FROM AUTHOR]

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]

Abstract: Objectives: The main objective of this study was to determine the within- and between-day variability of blood pressure measurement in dogs using an oscillometric device, pet-MAP®. Animals, materials and methods: Five healthy conscious adult Beagle dogs were used. The dogs were presented in a random order for examinations and the investigators were blinded to the dogs. Blood pressure was measured using a standardized procedure. Three investigators with the same level of experience, trained for 1 h with pet-MAP® the day before starting the study, performed 480 blood pressure measurements in 5 healthy conscious dogs on two different days. Results: The within- and between-day CVs for systolic blood pressure were 9.0–10.1% and 12.8–16.4%, respectively. The corresponding SD values were 14.7–16.6 mm Hg and 21.0–27.1 mm Hg respectively. For diastolic blood pressure, the within- and between-day CVs were 10.3–14.4% and 14.2–24.9% respectively. The corresponding SD values were 9.7–13.9 mm Hg and 13.0–24.0 mm Hg. Conclusions: The within- and between-day CVs for systolic blood pressure, measured with pet-MAP® by investigators with a minimal period of training, seem to be acceptable in Beagle dogs without hypertension or hypotension. This study suggests that, using this device, one investigator can be replaced by another under the described circumstances. [Copyright &y& Elsevier]

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]

Abstract Background Availability of a range of techniques and devices allow measurement of many variables related to the stiffness of large or medium sized arteries. There is good evidence that, pulse wave velocity is a relatively simple measurement and is a good indicator of changes in arterial properties. The pulse wave velocity calculated from pulse wave recording by other methods like doppler or tonometry is tedious, time-consuming and above all their reproducibility depends on the operator skills. It requires intensive resource involvement. For epidemiological studies these methods are not suitable. The aim of our study was to clinically evaluate the validity and reproducibility of a new automatic device for measurement of pulse wave velocity that can be used in such studies. Methods In 44 subjects including normal healthy control and patients with coronary artery disease, heart brachial, heart ankle, brachial ankle and carotid femoral pulse wave velocities were recorded by using a new oscillometric device. Lead I and II electrocardiogram and pressure curves were simultaneously recorded. Two observers recorded the pulse wave velocity for validation and one observer recorded the velocity on two occasions for reproducibility. Results and Discussion Pulse wave velocity and arterial stiffness index were recorded in 24 control and 20 coronary artery disease patients. All the velocities were significantly high in coronary artery disease patients. There was highly significant correlation between the values noted by the two observers with low standard deviation. The Pearson's correlation coefficient for various velocities ranged from (r = 0.88–0.90) with (p < 0.0001). The reproducibility was also very good as shown by Bland-Altman plot; most of the values were lying within 2 SD. The interperiod measurements of pulse wave velocity were also significantly correlated (r = 0.71 – 0.98) (P < 0.0001). Carotid-femoral pulse wave velocity was found to correlate significantly with heart brachial, heart ankle, brachial ankle pulse wave velocity and arterial stiffness index values. Reproducibility of our method was good with very low variability in both interobserver and interperiod analysis. Conclusion The new device "PeriScope" based on oscillometric technique has been found to be a simple, non-invasive and reproducible device for the assessment of pulse wave velocity and can be used to determine arterial stiffness in large population based studies.

The study was done to validate the use of automated devices (Datascope Duo) as a screening tool for measuring blood pressure. A cross sectional study was conducted in school children from urban slums of Bangalore. Blood pressure was recorded according to standard guidelines using a mercury sphygmomanometer and an automated device (Datascope Duo). The readings obtained using the two instruments were compared. One thousand four hundred eighty nine school children, both males and females, aged 5-16 y were included in the study. Readings with the Datascope Duo varied significantly when compared to the gold standard. The blood pressure measurements using Datascope Duo cannot be recommended as an accurate substitute for manual readings. [ABSTRACT FROM AUTHOR]

Objectives: To determine the recommended blood pressure (BP) measurement methods in neonates after systematically analyzing the literature regarding proper BP cuff size and measurement location and method.Study Design: A literature search was conducted in MEDLINE, PubMed, Embase, Cochrane Library, and CINAHL from 1946 to 2017 on BP in neonates <3 months of age (PROSPERO ID CRD42018092886). Study data were extracted and analyzed with separate analysis of Bland-Altman studies comparing measurement methods.Results: Of 3587 nonduplicate publications identified, 34 were appropriate for inclusion in the analysis. Four studies evaluating BP cuff size support a recommendation for a cuff width to arm circumference ratio of approximately 0.5. Studies investigating measurement location identified the upper arm as the most accurate and least variable location for oscillometric BP measurement. Analysis of studies using Bland-Altman methods for comparison of intra-arterial to oscillometric BP measurement show that the 2 methods correlate best for mean arterial pressure, whereas systolic BP by the oscillometric method tends to overestimate intra-arterial systolic BP. Compared with intra-arterial methods, systolic BP, diastolic BP, and mean arterial pressure by oscillometric methods are less accurate and precise, especially in neonates with a mean arterial pressure <30 mm Hg.Conclusions: Proper BP measurement is critical in neonates with naturally lower BP and attention to BP cuff size, location, and method of measurement are essential. With decreasing use of intra-arterial catheters for long-term BP monitoring in neonates, further studies are urgently needed to validate and develop oscillometric methodology with enhanced accuracy. [ABSTRACT FROM AUTHOR]

Background and Objectives: The Bland and Altman's limits of agreement (LoA) method is the most commonly used statistical method to assess the bias and precision of a new measuring device (it has been cited over 40,000 times as of March 2019). What is less known is that the LoA method can be dramatically misleading., Methods: A new statistical methodology, which circumvents these deficiencies, has recently been published and made available in the R and Stata statistical packages. We aimed at introducing and illustrating with a small data set on blood pressure (BP) measurements, taken by two different oscillometric devices, the use of this new methodology to a clinical audience., Results: For diastolic BP, the LoA method was particularly misleading, as it identified differential and proportional biases of opposite signs compared with the new methodology. Regarding systolic BP, the LoA method strongly overestimated both the differential and proportional biases, for both devices., Conclusion: The LoA method may be dramatically misleading and does not allow one to estimate the precision of each measurement method. We recommend the use of the newly developed statistical methodology instead., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Introduction: High blood pressure (HBP) is a modifiable cardiovascular risk factor and its detection at early ages may allow strategies to be designed to reduce cardiovascular risk in adulthood., Objectives: To provide blood pressure (BP) values in a sample of adolescents using an electronic oscillometric device., Material and Methods: BP was measured according the European Society of Hypertension guidelines using an oscillometric device. Height and weight were also measured. Four height groups were used in order to associate the 90, 95, and 99 percentiles with systolic BP (pSBP) and diastolic BP percentiles (pDBP) for sex and age: H150 (≤ 150cm), H160(151-160cm), H170(161-170cm), and H180(≥171cm)., Results: Data from 2,758 students aged 12-17 years were included in the analysis. BP increases with age, with differences of up to 11mmHg in boys vs. 3mmHg in girls for SBP and 3mmHg vs. 1mmHg for DBP. In high SBP, for the younger adolescents, the difference related to height was 15mmHg in boys vs. 8mmHg in girls, with no significant increase in the older ones in either gender. The high BDP varied depending on the height, 10mmHg in younger boys and 3mmHg in older ones, while in girls the variation was 3mmHg for all ages., Conclusions: SBP/DBP in adolescents increases with age and also with height, giving similar figures in the taller ones, regardless of age., (Copyright © 2017 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.)

Purpose: To validate the Dinamap ProCare 200 blood pressure (BP) monitor against a mercury sphygmomanometer in children 7 to 18 years old in accordance with the 2010 International Protocol of European Society of Hypertension (ESH-IP2) and the British Hypertension Society (BHS) protocol., Methods: Forty-five children were recruited for the study. A validation procedure was performed following the protocol based on the ESH-IP2 and BHS protocols for children and adolescents. Each subject underwent 7 sequential BP measurements alternatively with a mercury sphygmomanometer and the test device by trained nurses. The results were analyzed according to the validation criteria of ESH-IP2., Results: The mean (±SD) difference in the absolute BP values between test device and mercury sphygmomanometer readings was 1.85±1.65 mmHg for systolic BP (SBP) and 4.41±3.53 mmHg for diastolic BP (DBP). These results fulfilled the Association for the Advancement of Medical Instrumentation criterion of a mean±SD below 5±8 mmHg for both SBP and DBP. The percentages of test device-observer mercury sphygmomanometer BP differences within 5, 10, and 15 mmHg were 96%, 100%, and 100% for SBP, and 69%, 92%, and 100% for DBP, respectively, in the part 1 analysis; both SBP and DBP passed the part 1 criteria. In the part 2 analysis, SBP passed the criteria but DBP failed., Conclusion: Although the Dinamap ProCare 200 BP monitor failed an adapted ESH-IP2, SBP passed. When comparing BP readings measured by oscillometers and mercury sphygmomanometers, one has to consider the differences between them, particularly in DBP, because DBP can be underestimated.