Reliability of flush blood pressure measurements in the sick newborn infant

Virnig, Norman L.; Reynolds, John W.

doi:10.1016/s0022-3476(74)80688-8

“…Por outro lado, a pressão obtida pelo método do flush mostrou uma boa correlação e valores muito próximos àqueles obtidos pelo Doppler, sugerindo que a pressão do flush represente a pressão arterial sistólica, como relatado em alguns estudos, e não a pressão arterial média, como relatado em outros 8,10,19,20 . Essas diferenças podem ocorrer devido a pequenas variações nas técnicas de mensuração da pressão arterial pelo método do flush.…”

Section: Discussionunclassified

“…Em nosso estudo, não detectamos as limitações desse método descritas por outros autores, provavelmente porque não incluímos recém-nascidos hipotérmicos ou com edema de extremidades 20 .…”

Section: Discussionunclassified

“…O último estudo sobre essa técnica foi publicado no Brasil há mais de 25 anos 19 . As limitações desse método seriam: presença de anemia importante, edema, hipotermia e valores de pressão menores do que 20 mmHg 20 .…”

Section: Introductionunclassified

“…Os poucos estudos em recém-nascidos utilizando essas técnicas mostraram boa correlação com a monitorização invasiva 5,[20][21][22] .…”

Section: Introductionunclassified

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Comparison of noninvasive techniques to measure blood pressure in newborns

Ribeiro¹,

Fiori²,

Luz³

et al. 2011

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Objective: To compare blood pressure measurements in newborn infants using the flush method, pulse oximetry and oscillometry according to Doppler findings. Methods:Noninvasive blood pressure measurements were made using three techniques (flush method, pulse oximetry and oscillometry) in three groups of newborns: 15 normal term infants, 16 stable preterm infants, and 14 critically ill infants. All measurements were video recorded, edited separately, coded and analyzed independently by three neonatologists.Results: Fifty-seven measurements were made using each method. The flush method and pulse oximetry had a better correlation with Doppler findings than oscillometry (correlation coefficients: 0.89, 0.85, 0.71; p < 0.01). The difference between measurement means, their standard deviations and the 95% confidence intervals when compared with Doppler findings were: -5.2±7.9 (-21.1:10.7) mmHg for the flush method; 0.4±8.9 (-17.5:18.2) mmHg for pulse oximetry; and 6.4±16.1 (-25.8:8.6) mmHg for oscillometry. The flush method had a better agreement with Doppler findings for the diagnosis of hypotension than oximetry and oscillometry. Conclusions:The flush method and pulse oximetry seem to be useful techniques to measure systolic blood pressure in newborn infants; oscillometry had the poorest agreement with Doppler findings to detect hypotension.J Pediatr (Rio J). 2011;87(1):57-62: Hypotension, systolic blood pressure, newborn infant. ResumoObjetivo: Comparar a pressão arterial pelos métodos do flush, da oximetria de pulso e da oscilometria utilizando o Doppler em neonatos.Métodos: Foram realizadas medidas de pressão arterial não invasiva utilizando três métodos distintos (flush, oximetria de pulso e oscilometria automática) em três grupos de recém-nascidos selecionados por sorteio: 15 a termo e normais, 16 prematuros estáveis e 14 doentes. Todas as medidas foram filmadas, editadas separadamente, codificadas e analisadas independentemente por três neonatologistas. Resultados:Realizaram-se 57 medidas por cada método. Os méto-dos do flush e da oximetria de pulso mostraram melhor correlação com o Doppler do que a oscilometria (coeficiente de correlação 0,89, 0,85 e 0,71, respectivamente, p < 0,01). A diferença entre as médias das medidas, seus respectivos desvios padrão e o intervalo de confiança de 95% quando comparados com Doppler foram: -5,2±7,9 (-21,1:10,7) mmHg com o método do flush; 0,4±8,9 (-17,5:18,2) mmHg com a oximetria de pulso; e 6,4±16,1 (-25,8:8,6) mmHg com a oscilometria. O método do flush mostrou melhor concordância com o Doppler para diagnóstico de hipotensão do que os métodos da oximetria e da oscilometria. Conclusões:Os métodos do flush e da oximetria de pulso mostraram-se úteis para medir a pressão arterial sistólica de recém-nascidos, sendo que o método oscilométrico mostrou-se o menos concordante com o Doppler para detectar hipotensão. J Pediatr (Rio J) IntroduçãoA monitorização da pressão arterial é um componente essencial no manejo de recém-nascidos, especialmente prematuros. Entretanto, vári...

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“…19 Measurements using this method may be limited by severe anemia, edema, hypothermia and blood pressure values below 20 mmHg. 20 Systolic blood pressure measured by pulse oximetry is characterized by the disappearance and reappearance of the waveform on the monitor screen during cuff inflation, deflation, or both. 21 The few studies with newborn infants using this technique found a good correlation with invasive monitoring.…”

Section: Comparison Of Noninvasive Techniques To Measure Blood Pressumentioning

confidence: 99%

Comparação de técnicas não invasivas para medir a pressão arterial em recém-nascidos

Ribeiro¹,

Fiori²,

Luz³

et al. 2011

J. Pediatr. (Rio J.)

7

0

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Objective: To compare blood pressure measurements in newborn infants using the flush method, pulse oximetry and oscillometry according to Doppler findings. Methods:Noninvasive blood pressure measurements were made using three techniques (flush method, pulse oximetry and oscillometry) in three groups of newborns: 15 normal term infants, 16 stable preterm infants, and 14 critically ill infants. All measurements were video recorded, edited separately, coded and analyzed independently by three neonatologists.Results: Fifty-seven measurements were made using each method. The flush method and pulse oximetry had a better correlation with Doppler findings than oscillometry (correlation coefficients: 0.89, 0.85, 0.71; p < 0.01). The difference between measurement means, their standard deviations and the 95% confidence intervals when compared with Doppler findings were: -5.2±7.9 (-21.1:10.7) mmHg for the flush method; 0.4±8.9 (-17.5:18.2) mmHg for pulse oximetry; and 6.4±16.1 (-25.8:8.6) mmHg for oscillometry. The flush method had a better agreement with Doppler findings for the diagnosis of hypotension than oximetry and oscillometry. Conclusions:The flush method and pulse oximetry seem to be useful techniques to measure systolic blood pressure in newborn infants; oscillometry had the poorest agreement with Doppler findings to detect hypotension.J Pediatr (Rio J). 2011;87(1):57-62: Hypotension, systolic blood pressure, newborn infant.

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Rapid measurement of blood pressure in the sick neonate

Ogata

¹

,

Herring

²

1980

Intensive Care Med

1

0

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We measured mean arterial blood pressure using a hydrostatic technique in 24 sick neonates who had umbilical artery catheters in place. Value for blood pressure obtained with this technique correlated significantly (r = 0.9844, P less than 0.01) with measurements obtained with standard strain gauge and electronic monitor. The method is simple, quick, and safe. It is particularly useful when the infant's size or clinical condition precludes the use of the sphygmomanometer or Doppler ultrasound device or in a setting, such as during transport, when standard electronic means of blood pressure measurement are unavailable.

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Reliability of flush blood pressure measurements in the sick newborn infant

Cited by 13 publications

References 24 publications

Comparison of noninvasive techniques to measure blood pressure in newborns

Comparison of noninvasive techniques to measure blood pressure in newborns

Comparação de técnicas não invasivas para medir a pressão arterial em recém-nascidos

Rapid measurement of blood pressure in the sick neonate

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