Intraoperative blood pressure considerations in pediatric anesthesia

Figures

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  Fig. 1.. Photograph demonstrating the discrepancy in the measurements recorded by a functioning invasive arterial line (ART, in red) compared to a simultaneous measurement by a automatic NBP cuff (NBP, in white) in an infant. Personal photo by author (SJG). HR: heart rate, NBP: noninvasive blood pressure, ART: direct arterial invasive blood pressure (ART-line).

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  Fig. 2.. Bland– Altman plot showing difference in mean blood pressure for all patients. Hypotensive readings in blue. BP: blood pressure. Adapted from the article of Beringer et al. (Paediatr Anaesth 2023; 33: 816-22) [9] with original copyright holder's permission.

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  Fig. 3.. Methodology used to determine the LLA [18]. The LLA was determined by drawing the Vmca/MAP plateau line and the Vmca/MAP above and below the inflection point (tangential line). Where these two lines intersect determined the LLA. (A) Idealized cerebral autoregulation curve, (B) actual patient data points, (C) horizontal regression line from the autoregulatory plateau, (D) tangential regression line from one point above and one point below the inflection point, (E) LLA. The LLA in this patient is 53 mmHg. LLA: lower limit of cerebral autoregulation, MAP: mean blood pressure, Vmca: mean middle cerebral artery flow velocity. Adapted from the article of Vavilala et al. (J Neurosurg Anesthesiol 2003; 15: 307-12) [18] with original copyright holder's permission.