title: Radial mean arterial pressure reliably reflects femoral mean arterial pressure in uncomplicated pediatric cardiac surgery.
abstract: OBJECTIVE
  To see if radial mean arterial pressure reliably reflects femoral mean arterial pressure in uncomplicated pediatric cardiac surgery.
  
  
  METHODS
  An ethics committee-approved prospective interventional study.
  
  
  METHODS
  Operating room of a tertiary care hospital.
  
  
  METHODS
  Forty-five children aged 3 months to 4 years who underwent pediatric cardiac surgery with hypothermic cardiopulmonary bypass.
  
  
  RESULTS
  Simultaneous femoral and radial arterial pressures were recorded at 10-minute intervals intraoperatively. A pressure gradient>5mmHg was considered to be clinically significant. The patients' mean age was 14±11 months and and mean weight was 8.0±3.0kg. A total of 1,816 simultaneous measurements of arterial pressure from the radial and femoral arteries were recorded during the pre-cardiopulmonary bypass, cardiopulmonary bypass, and post-cardiopulmonary bypass periods, including 520 (29%) systolic arterial pressures, 520 (29%) diastolic arterial pressures, and 776 (43%) mean arterial pressures. The paired mean arterial pressure measurements across the 3 periods were significantly and strongly correlated, and this was true for systolic arterial pressures and diastolic arterial pressures as well (r>0.93 and p<0.001 for all). Bland-Altman plots demonstrated good agreement between femoral and radial mean arterial pressures during the pre-cardiopulmonary bypass, cardiopulmonary bypass, and post-cardiopulmonary bypass periods. A significant radial-to-femoral pressure gradient was observed in 150 (8%) of the total 1,816 measurements. These gradients occurred most frequently between pairs of systolic arterial pressure measurements (n = 113, 22% of all systolic arterial pressures), followed by mean arterial pressure measurements (n = 28, 4% of all mean arterial pressures) and diastolic arterial pressures measurements (n = 9, 2% of all diastolic arterial pressures). These significant gradients were not sustained (ie, were not recorded at 2 or more successive time points).
  
  
  CONCLUSIONS
  The results suggested that radial mean arterial pressure provided an accurate estimate of central mean arterial pressure in uncomplicated pediatric cardiac surgery. There was a significant gradient between radial and femoral mean arterial pressure measurements in only 4% of the mean arterial pressure measurements, and these significant gradients were not sustained.
authors.affiliation: Department of Anesthesiology, Baskent University Faculty of Medicine, Ankara, Turkey.
authors.forename: Secil
authors.initials: S
authors.lastname: Cetin
authors.affiliation: Department of Anesthesiology, Baskent University Faculty of Medicine, Ankara, Turkey.
authors.forename: Arash
authors.initials: A
authors.lastname: Pirat
authors.affiliation: Department of Anesthesiology, Baskent University Faculty of Medicine, Ankara, Turkey.
authors.forename: Aycan
authors.initials: A
authors.lastname: Kundakci
authors.affiliation: Department of Anesthesiology, Baskent University Faculty of Medicine, Ankara, Turkey. Electronic address: arastirma@baskent.edu.tr.
authors.forename: Aynur
authors.initials: A
authors.lastname: Camkiran
authors.affiliation: Department of Anesthesiology, Baskent University Faculty of Medicine, Ankara, Turkey.
authors.forename: Pinar
authors.initials: P
authors.lastname: Zeyneloglu
authors.affiliation: Department of Cardiovascular Surgery, Baskent University Faculty of Medicine, Ankara, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Ozkan
authors.affiliation: Department of Anesthesiology, Baskent University Faculty of Medicine, Ankara, Turkey.
authors.forename: Gulnaz
authors.initials: G
authors.lastname: Arslan
mesh_terms: D062186:Arterial Pressure; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D002675:Child, Preschool; D005263:Femoral Artery / Q000502:physiology*; D006801:Humans; D007223:Infant; D017534:Radial Artery / Q000502:physiology*
keywords: blood pressure; cardiac surgical procedure; cardiopulmonary bypass; congenital heart defects; femoral artery; radial artery