Blood pressure in the neonate: three non-invasive oscillometric pressure monitors compared with invasively measured blood pressure.
OBJECTIVE
To compare blood pressure in neonates obtained from three different oscillometer blood pressure monitors (Dinamap, Criticare, Hewlett-Packard) with arterial blood pressure (Hewlett-Packard' invasive unit).


METHODS
A total of 32 randomized, non-invasive blood pressure series, each consisting of three measurements from each monitor, were obtained from 20 neonates (birthweight 531-4660 g). Each measurement was compared with the invasive pressure.


RESULTS
Two factors appear to have a systematic effect on the difference between oscillometric and invasive pressure (the measurement deviance): the size of the infant, e.g., the arm circumference, and the monitor system. For small infants, the non-invasively measured value tends to be too high. The deviance is partly reversed for larger infants (dependency on size significant for mean and diastolic pressure, p < 0.001). The difference between monitor systems is clearly significant (p < 0.001). Hewlett-Packard gives the lowest pressure values for all pressures. Thus, Criticare and Dinamap tended to show values too high in the smallest infants, while Hewlett-Packard tended to give values too low in larger infants. Birthweight, present weight and arm circumference affected measurement deviance approximately equally strongly, while factors such as the infant's sex, need of breath support and umbilical or radial arterial line were non-significant.


CONCLUSIONS
Blood pressure should preferably be measured invasively in severely ill neonates and preterm infants, being aware of pitfalls with measurements using different oscillometer monitors and the size/arm circumference of the infant.
Neonatal Intensive Care Unit, Department of Paediatrics, Ullevål University Hospital, Oslo, Norway.
Ingrid
I
Dannevig
Helen Caroline
HC
Dale
Knut
K
Liestøl
Rolf
R
Lindemann
D001794:Blood Pressure; D015924:Blood Pressure Monitors; D002406:Catheterization, Peripheral; D002408:Catheters, Indwelling; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D016014:Linear Models; D009991:Oscillometry