Assessment of techniques for measurement of blood pressure in infants and children.

Elseed, A M; Shinebourne, E A; Joseph, M C

doi:10.1136/adc.48.12.932

Cited by 95 publications

(39 citation statements)

References 14 publications

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“…54 Another variation of this method detects the onset of blood flow, which has been found to be of particular value for measuring systolic pressure in infants and children. 55 In patients with very faint Korotkoff sounds (for example those with muscular atrophy), placing a Doppler probe over the brachial artery may help to detect the systolic pressure, and the same technique can be used for measuring the ankle-arm index, in which the systolic pressures in the brachial artery and the posterior tibial artery are compared to obtain an index of peripheral arterial disease.…”

Section: Ultrasound Techniquesmentioning

confidence: 99%

Recommendations for Blood Pressure Measurement in Humans and Experimental Animals

Pickering¹,

Hall²,

Appel³

et al. 2005

Hypertension

2,053

963

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Abstract-Accurate measurement of blood pressure is essential to classify individuals, to ascertain blood pressure-related risk, and to guide management. The auscultatory technique with a trained observer and mercury sphygmomanometer continues to be the method of choice for measurement in the office, using the first and fifth phases of the Korotkoff sounds, including in pregnant women. The use of mercury is declining, and alternatives are needed. Aneroid devices are suitable, but they require frequent calibration. Hybrid devices that use electronic transducers instead of mercury have promise. The oscillometric method can be used for office measurement, but only devices independently validated according to standard protocols should be used, and individual calibration is recommended. They have the advantage of being able to take multiple measurements. Proper training of observers, positioning of the patient, and selection of cuff size are all essential. It is increasingly recognized that office measurements correlate poorly with blood pressure measured in other settings, and that they can be supplemented by self-measured readings taken with validated devices at home. There is increasing evidence that home readings predict cardiovascular events and are particularly useful for monitoring the effects of treatment. Twenty-four-hour ambulatory monitoring gives a better prediction of risk than office measurements and is useful for diagnosing white-coat hypertension. There is increasing evidence that a failure of blood pressure to fall during the night may be associated with increased risk. In obese patients and children, the use of an appropriate cuff size is of paramount importance.

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Section: Ultrasound Techniquesmentioning

confidence: 99%

Recommendations for Blood Pressure Measurement in Humans and Experimental Animals

Pickering¹,

Hall²,

Appel³

et al. 2005

Hypertension

2,053

963

View full text Add to dashboard Cite

show abstract

“…Another variation of this method detects the onset of blood flow at systolic pressure, which has been found to be of particular value for measuring pressure in infants and children. 18 In patients with very faint Korotkoff sounds (for example those with muscular atrophy) placing a Doppler probe over the brachial artery may help to detect the systolic pressure, and the same technique can be used for measuring the ankle-brachial index, in which the systolic pressures in the brachial artery and the posterior tibial artery are compared, to obtain an index of peripheral arterial disease. …”

mentioning

confidence: 99%

Principles and techniques of blood pressure measurement

Pickering

2002

Cardiology Clinics

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Although the mercury sphygmomanometer is widely regarded as the "gold standard" for office blood pressure measurement, the ban on use of mercury devices continues to diminish their role in office and hospital settings. To date, mercury devices have largely been phased out in US hospitals. This has led to the proliferation of non-mercury devices and has changed (probably for ever) the preferable modality of blood pressure measurement in clinic and hospital settings. In this article, the basic techniques of blood pressure measurement and the technical issues associated with measurements in clinical practice are discussed. The devices currently available for hospital and clinic measurements and their important sources of error are presented. Practical advice is given on how the different devices and measurement techniques should be used. Blood pressure measurements in different circumstances and in special populations such as infants, children, pregnant women, elderly persons, and obese subjects are discussed. Keywordsblood pressure measurement; self-monitoring; ambulatory blood pressure monitoring Basic techniques of blood pressure measurement Location of measurementThe standard location for blood pressure measurement is the brachial artery. Monitors that measure pressure at the wrist and fingers have become popular, but it is important to realize that systolic and diastolic pressures vary substantially in different parts of the arterial tree with systolic pressure increasing in more distal arteries, and diastolic pressure decreasing. The auscultatory methodAlthough the auscultatory method using mercury sphygmomanometer is regarded as the 'gold standard' for office blood pressure measurement, widespread implementation of the ban in use of mercury sphygmomanometers continues to diminish the role of this technique. 72 The situation is made worse by the fact that existing aneroid manometers, © 2010 Elsevier Inc. All rights reserved.Corresponding author for proof and prints: Gbenga Ogedegbe, MD, Center for Healthful Behavior Change, Division of General Internal Medicine, Department of Medicine, New York University School of Medicine, 423 East 23 rd Street, 15N-168, New York, NY 10010, olugbenga.ogedegbe@nyumc.org, Ph: 212-263-4183, Fax: 212-263-4201. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access The oscillometric techniqueThis was first demonstrated by Marey in 1876, 38 and it was subsequently shown that when the oscillations of pressure in a sphygmomanometer cuff are recorded during gradual deflation, the point of maximal oscillation corresponds t...

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“…Os registros diretos são obtidos no RN por meio de cateterização da aorta abdominal, através da artéria umbilical. Constitui a forma mais precisa de medida da PA, mas está associada a complicações como infecção, vasoespasmo e formação de trombos, além de dificultar a monitorização do paciente fora da UTI 1,2,3 . A oscilometria tem sido empregada como método de determinação da PA há muitos anos 4 .…”

Section: Introductionunclassified

Evolution of systemic arterial blood pressure during neonatal period in term newborns adequate for gestacional age

Matsuoka

Pinheiro²,

Pascuas³

et al. 1996

J Pediatr (Rio J)

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IntroduçãoA pressão arterial sistêmica (PA) pode ser determinada através de diferentes métodos. As técnicas mais largamente utilizadas incluem registro direto da pressão intraarterial, uso do esfigmomanômetro e palpação, ultra-somdoppler e oscilometria 1 . Os registros diretos são obtidos no RN por meio de cateterização da aorta abdominal, através da artéria umbilical. Constitui a forma mais precisa de medida da PA, mas está associada a complicações como infecção, vasoespasmo e formação de trombos, além de dificultar a monitorização do paciente fora da UTI 1,2,3 . A oscilometria tem sido empregada como método de determinação da PA há muitos anos 4 . No início deste século, Balard já citava que a oscilometria era o único método que possibilitava a determinação da PA em crianças pequenas 4 . Atualmente, está comprovada a correlação entre a variação da PA determinada pela técnica de oscilometria e aquela obtida por cateter intra-arterial 1,4-7 . Sendo assim, a oscilometria constitui um instrumento de grande utilidade para a monitorização não-invasiva de pacientes graves e para determinação da PA no exame detalhado do RN.Não existe consenso na literatura quanto à definição de hipertensão arterial sistêmica no RN. De forma geral, considera-se hipertensão arterial a presença de pressão sistólica dois desvios-padrão acima do esperado para idade e peso de nascimento 1 . Entretanto, ainda existem poucos estudos com rigidez metodológica relativos à distribuição dos níveis de PA em RN normais, particularmente em nosso meio. ResumoOs autores estudaram a evolução dos níveis médios de pressão arterial sistêmica (PAS) sistólica, média e diastólica em RNT-AIG durante o primeiro mês de vida, utilizando a técnica de oscilometria, com monitor não invasivo de pressão arterial. Foi realizado um estudo prospectivo, em que foram acompanhados apenas RN com Apgar de 1º minuto > 7, sem intercorrências clínicas e sem uso de drogas com possíveis efeitos sobre a PA. Foram medidos os valores de PA sistólica, média e diastólica na 12ª hora de vida e no 3º, 7º, 14º e 28º dias de vida. Demonstraram que existe uma elevação dos níveis de PA no RN estatisticamente significante do 1º ao 3º dia e entre este e o 7º dia de vida. A partir da primeira semana de vida, até o final do 1º mês, essas modificações não foram significativas.J. pediatr. (Rio J.). 1996; 72(3):155-158: pressão arterial, recém-nascidos, oscilometria. AbstractThe authors studied the levels and evolution of systolic, mean and diastolic arterial blood pressure in term newborns adequate for gestacional age during the first month of life. The applied technique was oscillometric, using a non-invasive monitor. The study was prospective, including newborns who had received first minute Apgar score above 6, with no clinical disturbances or use of any drug with possible arterial blood pressure side effects. The measurements of systolic, mean and diastolic arterial blood pressure were taken at 12 hours of life and 3rd, 7th, 14th and 28th days of life. The authors observed an increase in arter...

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Assessment of techniques for measurement of blood pressure in infants and children.

Cited by 95 publications

References 14 publications

Recommendations for Blood Pressure Measurement in Humans and Experimental Animals

Recommendations for Blood Pressure Measurement in Humans and Experimental Animals

Principles and techniques of blood pressure measurement

Evolution of systemic arterial blood pressure during neonatal period in term newborns adequate for gestacional age

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