Blood pressure in very low birth weight infants in the first 70 days of life

Tan, K. L.

doi:10.1016/s0022-3476(88)80068-4

Cited by 77 publications

(51 citation statements)

References 11 publications

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“…We then compared our results with those published by Tan,12 who used the Dianamap oscillometer to study BPs in low birth weight infants in the first 10 weeks of life. Tan studied infants with birth weights Ͻ1500 g, whereas we included babies with birth weights of Ͻ2500 g (range, 901 to 2423 g).…”

Section: Resultsmentioning

confidence: 99%

“…12 We believe that these clinically significant differences are the result of assuring a restful state in the subjects after cuff application. Although BPs were lower in the prone position than in supine, this difference was of low magnitude and, therefore, of little clinical relevance.…”

Section: Discussionmentioning

confidence: 96%

“…Unfortunately, normative data on BP in the convalescing preterm newborn are scant 12,13 and comparison of data from various studies is hampered by methodologic differences in design. In most BP studies in adults, the protocol designed for the multiple risk factor intervention trials 14 is the gold standard for BP recording.…”

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confidence: 99%

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A Standard Protocol for Blood Pressure Measurement in the Newborn

Nwankwo¹,

Lorenz²,

Gardiner³

1997

PEDIATRICS

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ABSTRACT. Objectives. Improvements in neonatal care have resulted in increasing survival of extremely premature infants whose hospital course often runs into weeks or months. Some interventions during the acute care of these neonates, such as umbilical catheterization and use of steroids, not infrequently result in elevation of blood pressure (BP). It is, therefore, essential that these infants be monitored accurately for possible hypertension during their convalescence. Unfortunately, normative data on BP in this population are scant and comparison of data from various studies is hampered by methodologic differences in design. Studies in adults address the necessity for a restful state, adopting a comfortable position, and attempts to reduce the startle response to initial cuff inflation. Studies in the newborn using the oscillometric technique have not addressed these concerns. A standard BP measurement protocol was studied to determine the effect of ensuring a restful state, startle response to cuff inflation, and infant position on BP in clinically stable low birth weight infants after the first week of life.Study Design. The Dianamap oscillometer was used to measure BP in infants with a birth weight <2500 g between 7 and 42 days postnatal age. Each infant was studied only once when they were clinically stable. BP was measured in two positions, prone and supine, in random order. Infants were studied at least 1 1 ⁄2 hours after their last feeding or medical intervention. An appropriate sized cuff was applied to the right upper arm and the infant was positioned according to randomization. The infant was then left undisturbed for at least 15 minutes or until the infant was sleeping or in a quiet awake state. Three successive BP recordings were taken at 2-minute intervals. The infant's position was then reversed and another 15 minutes of quiet time was allowed. Thereafter, a second set of three successive BP recordings were obtained. The most recent routine nursing BP measurement was also recorded. Data were analyzed using analysis of variance and are presented as means and standard errors of the mean.Results. Sixty-four infants were studied. Birth weights ranged from 901 to 2423 g and gestational ages from 26 to 37 weeks. Overall, mean BP was significantly lower in the prone than supine positions (45.7 ؎ 0.7 vs 47.8 ؎ 0.8 mm Hg, P < .002). In either position, the first measurement was significantly higher than the third (average difference was 3 mm Hg, P < .003). In general, the relationships among position and order of measurement were similar for systolic and diastolic BP. Mean BPs obtained by routine nurse measurements were significantly higher than those in either position using our standard protocol (54.4 vs 47.0 or 49.1 mm Hg, P < .003). Moreover, the routine nurse measurements varied more widely than did those obtained using the standard protocol. The standard deviation for the routine mean BP measurements by nurses was 11.4 compared with 6.8 and 8.2 for the first measurements in the prone and supine pos...

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 96%

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A Standard Protocol for Blood Pressure Measurement in the Newborn

Nwankwo¹,

Lorenz²,

Gardiner³

1997

PEDIATRICS

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“…33 Systemic arterial hypertension was defined as a systolic pressure equal to or higher than 2 standard deviations from that reference. 34 The diagnosis of persistence of ductus arteriosus was based on the presence of clinical manifestations such as systolic or continuous murmur in the second left intercostal space, pulsatile precordium or visible ictus, or wide pulses at the physical examination and confirmed by the echocardiogram. The diagnosis of necrotizing enterocolitis was made when the following clinical alterations were noted: abdominal distention, bloody stools, pain at abdominal palpation and/ or radiological alterations, distended intestinal loops, edema in the walls of intestinal loops, and the presence of pneumatosis intestinalis.…”

Section: Methodsmentioning

confidence: 99%

Effects of Corticosteroids in Very Low Birth Weight Newborns Dependent on Mechanical Ventilation

Mataloun

Leone

Gibelli

et al. 2005

Clinics

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RESULTS: The incidence of bronchopulmonary dysplasia was 6.5% (Group I) and 30% (Group II), P = .07. A decrease in growth was detected in Group I compared with Group II (change in weight: Group I -47 g/week, Group II -85.5 g/week, P = .06; change in head circumference: Group I -0.75 cm/week, Group II -1 cm/week, P = .05).CONCLUSION: Use of corticosteroids in very low birth weight infants dependent on mechanical ventilation during the first 10 to 14 days of life did not affect the respiratory evolution and occurrence of bronchopulmonary dysplasia, but the velocity of growth was reduced.KEYWORDS: Corticosteroids. Very low birth weight newborn. Bronchopulmonary dysplasia.

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“…We monitored blood pressure measurements and heelstick glucose estimation twice a day, and serum electrolytes weekly. Hypertension was defined as a mean arterial blood pressure greater than two standard deviations above the values reported by Tan 11 for similar infants, and requiring medical intervention. Hyperglycemia was defined as two consecutive heelstick glucose estimation greater than 180 mg/dl and requiring medical intervention (insulin or >25% reduction in glucose infusion rate).…”

Section: Patient Monitoringmentioning

confidence: 99%