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June 10, 2011Pediatric Critical Care Medicine

Which pressure to believe? A comparison of direct arterial with indirect blood pressure measurement techniques in the pediatric intensive care unit

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Key result

Automated oscillometric blood pressure readings were higher during hypotension (p<0.001) and lower during hypertension compared with direct arterial and Doppler ultrasound methods.

Why the study?

Do direct arterial and automated oscillometric blood pressure measurements accurately reflect sphygmomanometer/Doppler ultrasound measurements in pediatric intensive care patients?

Population

40 children admitted to the pediatric intensive care unit with various clinical conditions requiring a…

Comparison

Direct arterial blood pressure and automated… vs Indirect blood pressure using sphygmomanometer…

Design

Cohort

Follow-up

24 hours

Authors

THTanya HoltSaskatoon City HospitalDWDavinia E. WithingtonMontreal Children's HospitalEMEllen Siobhan MitchellAmerican Cancer Society

Discussion

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Implication

Automated oscillometric readings may misclassify BP extremes in PICU; leaves open whether arterial monitoring improves outcomes.

Study Design

Type

Observational (n=40)

Multicenter

No

Structured PICO

Do direct arterial and automated oscillometric blood pressure measurements accurately reflect sphygmomanometer/Doppler ultrasound measurements in pediatric intensive care patients?

P
Population
40 children (birth to 17 years) in a pediatric intensive care unit requiring a radial arterial catheter, with blood pressure measured every 6 hours over 24 hours.
E
Exposure
Direct arterial blood pressure and automated oscillometric blood pressure measurements (using Phillips automated oscillometric device).
C
Comparator
Indirect blood pressure using sphygmomanometer and Doppler ultrasound (considered the gold standard).
O
Outcome
Accuracy of blood pressure measurements compared to the gold standard (sphygmomanometer/Doppler ultrasound).surrogate

Main Result

p-value: p=<0.001

In pediatric intensive care patients, direct arterial blood pressure measurements are more accurate than automated oscillometric readings during hypo- and hypertension when compared to Doppler ultrasound.

Cite This Study

Holt et al. (2011) conducted an observational in Pediatric intensive care patients requiring a radial arterial catheter (n=40). Direct arterial and automated oscillometric blood pressure measurements vs. Sphygmomanometer/Doppler ultrasound measurements was evaluated on Accuracy of blood pressure measurements across different methods (p=<0.001). Automated oscillometric blood pressure readings were higher during hypotension (p<0.001) and lower during hypertension compared with direct arterial and Doppler ultrasound methods.

synapsesocial.com/papers/6a97a4fb569c5cfd27fabfb5https://doi.org/10.1097/pcc.0b013e3182230f43
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1A Comparative Study of the Measurement of Mean Arterial Blood Pressure Using Automatic Oscillometers, Arterial Cannulation and Auscultation1986 · 61 citations
  2. 2Cuff bladder width and blood pressure measurement in children and adolescents1992 · 72 citations
  3. 3Is the blood pressure the same in both arms?1985 · 45 citations
  4. 4The sixth report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure1997 · 5,666 citations
  5. 5Early heart failure as a cause of growth and tissue disorders in children with congenital heart disease.1980 · 34 citations