Continuous non-invasive finger blood pressure monitoring in children

Tanaka, Hidetaka; Thulesius, Olav; Yamaguchi, Hitoshi; Mino, Makoto; Konishi, Kazutaka

doi:10.1111/j.1651-2227.1994.tb13100.x

Cited by 45 publications

(26 citation statements)

References 25 publications

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“…However, the Finapres technology is validated only in adults and children Ͼ6 y (4,12). This is the first study that suggests that continuous finger BP waveforms can be obtained by a noninvasive technique using appropriate small finger cuffs in very young children, aged 0 -4 y.…”

Section: Discussionmentioning

confidence: 99%

“…The device is based on a photoplethysmographic system applied to the finger and provides beat-to-beat arterial finger BP with the use of the volume clamp technique of Peñáz (3). The Finapres method is evaluated in children aged 6 -16 y, showing similar accuracy as that in adults (4,5). Because no appropriate finger cuff exists for the children below 6 y of age, the applicability of the method is limited in this age group.…”

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confidence: 99%

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Feasibility of Noninvasive Continuous Finger Arterial Blood Pressure Measurements in Very Young Children, Aged 0–4 Years

et al. 2008

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ABSTRACT:Our goal was to study the feasibility of continuous noninvasive finger blood pressure (BP) monitoring in very young children, aged 0 -4 y. To achieve this, we designed a set of smallsized finger cuffs based on the assessment of finger circumference. Finger arterial BP measured by a volume clamp device (Finapres technology) was compared with simultaneously measured intra-arterial BP in 15 very young children (median age, 5 mo; range, 0 -48), admitted to the intensive care unit for vital monitoring. The finger cuff-derived BP waveforms showed good resemblance with the invasive arterial waveforms (mean root-mean-square error, 3 mm Hg). The correlation coefficient between both methods was 0.79 Ϯ 0.19 systolic and 0.74 Ϯ 0.24 diastolic. The correlation coefficient of beat-to-beat changes between both methods was 0.82 Ϯ 0.18 and 0.75 Ϯ 0.21, respectively. Three measurements were related to measurement errors (loose cuff application; wrong set-point). Excluding these erroneous measurements resulted in clinically acceptable measurement bias (Ϫ3.8 mm Hg) and 95% limits of agreement (Ϫ10.4 to ϩ 2.8 mm Hg) of mean BP values. We conclude that continuous finger BP measurement is feasible in very young children. However, cuff application is critical, and the current set-point algorithm needs to be revised in very young children. I n human adults, continuous noninvasive finger blood pressure (BP) measurement has been available using the Finapres (FINger Arterial PRESsure) device (1). It has been widely used in the investigation of autonomic function in adults and has proven to be a reliable substitute for intraarterial measurements (2). The device is based on a photoplethysmographic system applied to the finger and provides beat-to-beat arterial finger BP with the use of the volume clamp technique of Peñáz (3). The Finapres method is evaluated in children aged 6 -16 y, showing similar accuracy as that in adults (4,5). Because no appropriate finger cuff exists for the children below 6 y of age, the applicability of the method is limited in this age group. Still, in the evaluation of pediatric patients with cardiovascular abnormalities (e.g. sepsis) or autonomic dysfunction (e.g. syncope), it is desirable to have continuous BP measurements.Recently, there are several publications in which investigators performed BP measurements with the Finapres method in newborns by simply applying the (commercially available) finger cuff around the wrist (6 -9). However, Finapres was not designed for BP measurements on the wrist. First, the method of volume clamping is only validated with an appropriate cuff applied to the midphalanx of the finger. Second, the difference between fingers of adults and children may not only be the size but also the physiologic properties of the arteries and thus need an adaptation of the autocalibration (algorithm). Third, applying the cuff around the wrist will result in venous congestion of the whole hand and not just the fingertip, and will ultimately limit its clinical applicability. Measurements on...

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Feasibility of Noninvasive Continuous Finger Arterial Blood Pressure Measurements in Very Young Children, Aged 0–4 Years

et al. 2008

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“…A finger cuff measured online beat-to-beat BP on the second and third fingers of the right hand, using the vascular unloading technique (Task Force Monitor; CNS Systems, Graz, Austria). This technique has been validated by Tanaka et al [16]. The quality of the pulse signal obtained was controlled visually by one experienced reader.…”

Section: Methodsmentioning

confidence: 99%

Impaired short-term blood pressure regulation and autonomic dysbalance in children with type 1 diabetes mellitus

et al. 2007

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Aims Because reduction in baroreceptor sensitivity (BRS) has been associated with hypertension in the normal population and with increased cardiovascular morbidity and mortality in patients with diabetes mellitus, we measured BRS in a patient cohort of children with type 1 diabetes mellitus. Methods Two hundred and eight children (150 patients with type 1 diabetes mellitus, mean age 13.9±2.8 years, 70 boys, mean HbA 1c 7.8±1.4%; and 58 healthy controls, mean age 14.1±3.1 years, 32 boys) were studied. BRS and heart rate variability (HRV) were analysed from a shorttime ECG and BP recording using the sequence method (BRS) and the frequency domain method (HRV). Results There were 111 of 150 patients (74%) and 5 of 58 controls (8.6%) that showed impaired BRS. Mean BRS differed significantly between patients and controls (18.4± 7.2 vs 25.8 ± 8.2 ms/mm, p < 0.001). BRS correlated inversely with systolic BP (r=−0.23, p=0.009) and was related to diabetes duration (r=−0.194, p=0.027). Analysis of HRV showed greater sympathetic and less parasympathetic influence in patients than in controls (low frequency/ high frequency ratio 1.3±0.8 vs 0.9±0.6, p<0.05); the low frequency/high frequency ratio was inversely correlated with BRS (r=−0.28, p=0.001). Conclusions/interpretation Diabetic children show reduced BRS. In our patient group, the single risk factor for this finding was found to be the disease duration. The degree of BRS impairment was related to the degree of autonomic dysbalance.

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“…Finometer is a reliable device for tracking BP in adults and children Ͼ6 years of age. 24,25 Adolescents were defined as hypertensive if their sitting SBP or DBP was Ն95th age-, sex-, and height-specific percentile reported in the Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. 26 …”

Section: Bp At Rest and In Response To Physical And Mental Challengesmentioning

confidence: 99%

Sex Differences in the Contributions of Visceral and Total Body Fat to Blood Pressure in Adolescence

et al. 2012

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Abstract-Excess body fat deposited viscerally rather than elsewhere in the body is associated with higher risk for hypertension; this relationship is stronger in men than in women. Here we investigated whether similar sex dimorphism exists already in adolescence. A population-based sample of adolescent boys (nϭ237) and girls (nϭ262), age 12 to 18 years, was studied. Total body fat (TBF) was assessed with multifrequency bioelectrical impedance, and visceral fat (VF) was quantified with MRI. Blood pressure (BP) was measured beat by beat during an hour-long protocol, including supine, standing, sitting, mental stress, and poststress sections. Multivariate mixed-model analysis was used to assess the relative contributions of TBF and VF to BP during these sections. In boys, BP was strongly positively associated with VF (PϽ0.0001), whereas it was less strongly and negatively associated with TBF (Pϭ0.004); these relationships did not substantially vary during the protocol. In contrast, in girls, BP was strongly positively associated with TBF (Pϭ0.0006), whereas it was not associated with VF (Pϭ0.08); the relationship with TBF varied during the protocol and was most apparent during mental stress (TBF*section interaction: Pϭ0.002). Furthermore, when waist circumference was included in multivariate models instead of VF, it was not associated with BP in either sex; this indicates that waist circumference may not be an appropriate surrogate for VF. Thus, in adolescence, adiposity-related BP elevation is driven mainly by visceral fat in males and by fat deposited elsewhere in females. This dimorphism suggests sex-specific mechanisms of obesity-induced hypertension and the need for sex-specific criteria of its prevention. (Hypertension. 2012;59:572-579.) • Online Data SupplementKey Words: abdominal obesity Ⅲ blood pressure Ⅲ adolescence Ⅲ sex differences and mental stress O verweight and obesity have become a major health problem not only in adults but also in children and adolescents. In Canada and the United States, Ϸ60% of adults and 30% of adolescents are currently overweight or obese. [1][2][3][4] In both countries, the proportion of obese adolescents has tripled over the last 30 years. 4,5 This is alarming, because obesity is a leading risk factor for hypertension, 6,7 which, in turn, is a major risk factor for cardiovascular disease, 8 -10 still the main cause of death in industrialized countries. It is estimated that, at a population level, 65% to 78% of adult hypertension can be attributed to obesity. 11 The prevalence of hypertension is almost double in overweight and obese adults (35% to 50%) compared with normal weight individuals (23%). 2 A strong association between excess body fat and high blood pressure (BP) exists already among children and adolescents, with clinical hypertension occurring in 34% of those who are obese (Ն95th percentile). 12 The association of obesity and hypertension is related not only to excess body fat but also to its distribution. For any given quantity of total body fat (TBF), adults wh...

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Continuous non-invasive finger blood pressure monitoring in children

Cited by 45 publications

References 25 publications

Feasibility of Noninvasive Continuous Finger Arterial Blood Pressure Measurements in Very Young Children, Aged 0–4 Years

Feasibility of Noninvasive Continuous Finger Arterial Blood Pressure Measurements in Very Young Children, Aged 0–4 Years

Impaired short-term blood pressure regulation and autonomic dysbalance in children with type 1 diabetes mellitus

Sex Differences in the Contributions of Visceral and Total Body Fat to Blood Pressure in Adolescence

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