Reference Values for Noninvasive Blood Pressure in Children during Anesthesia: A Multicentered Retrospective Observational Cohort Study.
Although noninvasive blood pressure (NIBP) monitoring during anesthesia is a standard of care, reference ranges for blood pressure in anesthetized children are not available. We developed sex- and age-specific reference ranges for NIBP in children during anesthesia and surgery.



In this retrospective observational cohort study, we included NIBP data of children with no or mild comorbidity younger than 18 yr old from the Multicenter Perioperative Outcomes Group data set. Sex-specific percentiles of the NIBP values for age were developed and extrapolated into diagrams and reference tables representing the 50th percentile (0 SD), +1 SD, -1 SD, and the upper (+2 SD) and lower reference ranges (-2 SD).



In total, 116,362 cases from 10 centers were available for the construction of NIBP age- and sex-specific reference curves. The 0 SD of the mean NIBP during anesthesia varied from 33 mmHg at birth to 67 mmHg at 18 yr. The low cutoff NIBP (2 SD below the 50th percentile) varied from 17 mmHg at birth to 47 mmHg at 18 yr old.



This is the first study to present reference ranges for blood pressure in children during anesthesia. These reference ranges based on the variation of values obtained in daily care in children during anesthesia could be used for rapid screening of changes in blood pressure during anesthesia and may provide a consistent reference for future blood pressure-related pediatric anesthesia research.
From the Department of Anesthesiology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands (J.C.d.G., W.P., J.J.D., W.A.v.K.); Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands (J.C.d.G.); Department of Anesthesia, Sophia Children's Hospital, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands (J.C.d.G.); Netherlands Organization for Applied Scientific Research TNO, Leiden, The Netherlands (S.v.B.); Department of Methodology and Statistics, FSS, University of Utrecht, Utrecht, The Netherlands (S.v.B.); and Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan (O.O.N., S.K.).
Jurgen C
JC
de Graaff
Wietze
W
Pasma
Stef
S
van Buuren
Jesse J
JJ
Duijghuisen
Olubukola O
OO
Nafiu
Sachin
S
Kheterpal
Wilton A
WA
van Klei
D000293:Adolescent; D000367:Age Factors; D000758:Anesthesia; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D012016:Reference Values; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012737:Sex Factors