title: Comparison of calf and brachial blood pressures in infants: is there a difference between calf and brachial blood pressures?
abstract: The standard of care is to obtain a noninvasive blood pressure (NIBP) measurement from the right upper arm. However, in the pediatric population it is common practice to take blood pressure (BP) measurements from the calf/upper ankle. Nurses commonly take calf NIBPs for many reasons, but there is little evidence to support calf BPs as a reliable site for BP measurement. Furthermore, there is conflicting evidence. Some studies suggest no difference between the calf and the upper arm BPs, whereas others conclude great variability between the two. The purpose of this study was to demonstrate the reliability of calf BPs, by showing no difference between brachial and calf BP measurements in neonates and infants ≤ 1 year old. From July 2008 to December 2008, a convenience sample of 52 subjects admitted to the Neonatal and Infant Critical Care Unit were enrolled into the study. Limb selection was not randomized. Three BPs were taken from the arm and 3 BPs were taken from the calf. Data were analyzed using a mixed analysis of variance (P = 0.05). The difference was not significant for systolic (P = 0.6159) or mean BP (P = 0.1298), but it was significant for diastolic (P = 0.0263). The authors concluded that these results support the current practice of bedside nurses and contribute to the limited knowledge on this topic. Because there was a difference in the diastolic BPs, further investigation is needed.
authors.affiliation: Children's Hospital Los Angeles, Los Angeles, California. Electronic address: ntran@chla.usc.edu.
authors.forename: Nhu
authors.initials: N
authors.lastname: Tran
authors.affiliation: Children's Hospital Los Angeles, Los Angeles, California.
authors.forename: Heather
authors.initials: H
authors.lastname: Hackett
authors.affiliation: Children's Hospital Los Angeles, Los Angeles, California.
authors.forename: Carol
authors.initials: C
authors.lastname: Cadaver
authors.affiliation: Children's Hospital Los Angeles, Los Angeles, California.
authors.forename: Sharon
authors.initials: S
authors.lastname: Fichera
authors.affiliation: Children's Hospital Los Angeles, Los Angeles, California.
authors.forename: Colleen
authors.initials: C
authors.lastname: Azen
mesh_terms: D055109:Ankle Brachial Index / Q000379:methods; D001132:Arm / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007866:Leg / Q000502:physiology; D008297:Male; D011446:Prospective Studies; D015203:Reproducibility of Results; D014481:United States