Influencing factors on indirect measurement of blood pressure in children.
In order to investigate the influence of cuff size and anthropometric values for the measurement of indirect blood pressure (IP) by sphygmomanometer, IP was measured simultaneously with the recording of direct aortic pressure (DP) by catheter tip micromanometer. Observations were made in 56 patients, aged 3 to 16 years. The majority had a history of Kawasaki disease and some type of congenital heart disease, but all were normotensive and none had aortic insufficiency and stenosis. As IP values, Korotokoff 1 sound, and Korotokoff 4 and 5 sounds were regarded as systolic and diastolic pressure values, respectively. IP measurement was performed in each subject using at least 6 types of cuffs with different widths and lengths. The results were as follows: (1) IP was noted to have a linear correlation to DP (p less than 0.01), but systolic IP tended to show higher values than those of DP. The same tendency was noted for the diastolic IP. (2) There was a negative correlation between IP/DP and cuff width/arm length (p less than 0.01). (3) According to cuff width/arm length, values of IP/DP were divided into 2 groups: a group less than 0.4 and another group more than 0.4. In the former group, values of IP/DP were significantly higher than those of the other group. The most important influencing factor on IP measurement was the cuff width in relation to the arm length. Use of a short width cuff may cause overestimation of the indirect blood pressure.
Department of Pediatrics, National Cardiovascular Center, Osaka, Japan.
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Okahata
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Kamiya
D000293:Adolescent; D001132:Arm / Q000033:anatomy & histology; D001795:Blood Pressure Determination / Q000295:instrumentation / Q000379:methods*; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D003971:Diastole; D006801:Humans; D007223:Infant; D012044:Regression Analysis; D013599:Systole