Feasibility of noninvasive continuous finger arterial blood pressure measurements in very young children, aged 0-4 years.
Our goal was to study the feasibility of continuous noninvasive finger blood pressure (BP) monitoring in very young children, aged 0-4 y. To achieve this, we designed a set of small-sized finger cuffs based on the assessment of finger circumference. Finger arterial BP measured by a volume clamp device (Finapres technology) was compared with simultaneously measured intra-arterial BP in 15 very young children (median age, 5 mo; range, 0-48), admitted to the intensive care unit for vital monitoring. The finger cuff-derived BP waveforms showed good resemblance with the invasive arterial waveforms (mean root-mean-square error, 3 mm Hg). The correlation coefficient between both methods was 0.79 +/- 0.19 systolic and 0.74 +/- 0.24 diastolic. The correlation coefficient of beat-to-beat changes between both methods was 0.82 +/- 0.18 and 0.75 +/- 0.21, respectively. Three measurements were related to measurement errors (loose cuff application; wrong set-point). Excluding these erroneous measurements resulted in clinically acceptable measurement bias (-3.8 mm Hg) and 95% limits of agreement (-10.4 to + 2.8 mm Hg) of mean BP values. We conclude that continuous finger BP measurement is feasible in very young children. However, cuff application is critical, and the current set-point algorithm needs to be revised in very young children.
Neonatal Intensive Care Unit, Máxima Medical Center, 5500 MB Veldhoven, The Netherlands. p.andriessen@mmc.nl
Peter
P
Andriessen
Olaf
O
Schraa
Wendy
W
van Den Bosch-Ruis
Derk
D
Jan Ten Harkel
Jos J
JJ
Settels
Sidarto Bambang
SB
Oetomo
Carlos E
CE
Blanco
D000465:Algorithms; D001158:Arteries / Q000503:physiopathology; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000295:instrumentation / Q000379:methods*; D015924:Blood Pressure Monitors; D002675:Child, Preschool; D003422:Critical Care; D004867:Equipment Design; D005240:Feasibility Studies; D005385:Fingers / Q000098:blood supply*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008904:Miniaturization; D009426:Netherlands; D015203:Reproducibility of Results