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Comparison of non-invasive vs invasive blood pressure measurement in neonates undergoing therapeutic hypothermia for hypoxic ischemic encephalopathy

Journal of Perinatology volume 36, pages 381–385 (2016)Cite this article

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Abstract

Objective:

To evaluate the accuracy of blood pressure (BP) measured non-invasively (NIBP) compared with invasive arterial BP (IABP) measured by umbilical arterial catheter in neonates undergoing therapeutic hypothermia (TH) for hypoxic ischemic encephalopathy (HIE).

Study Design:

We conducted a retrospective study of neonates with gestational age (GA)⩾35 weeks with HIE who received TH. Paired NIBP and IABP measurements were obtained during TH and during normothermia.

Result:

We collected 897 paired measurements from 40 infants, which included 623 pairs during TH and 274 pairs during normothermia. The mean±s.d. differences in BP measured by NIBP compared with IABP in mmHg were −0.2±8.8 (P=0.505) for systolic BP (SBP), −4.5±8.3 (P<0.001) for diastolic BP (DBP) and −5.1±7.5 (P<0.001) for mean BP (MBP) during TH; and −1.3±9.2 (P=0.016) for SBP, −7.5±7.8 (P<0.001) for DBP and −7.3±6.8 (P<0.001) for MBP during normothermia. Overall 466/623 (74.8%), 324/623 (52.0%) and 363/623 (58.3%) of NIBP measurements of SBP, DBP and MBP, respectively, were clinically acceptable (defined as difference ⩽15% of IABP reading) during TH; and 202/274 (73.7%), 118/274 (43.1%) and 148/274 (54.0%), were clinically acceptable during normothermia.

Conclusion:

In term or near-term neonates with HIE, NIBP measurements are a robust method to determine SBP; however, DBP and MBP are underestimated. Determination of hypotension using the MBP measured non-invasively should be interpreted with caution.

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Acknowledgements

JZ wrote the first draft of the manuscript and no payment was given to anyone to produce the manuscript.

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Authors and Affiliations

  1. Division of Neonatology, Hospital for Sick Children, Toronto, ON, Canada

    J Zhou, O Elkhateeb & K-S Lee

  2. Division of Neonatology, Children's Hospital of Fudan University, Shanghai, China

    J Zhou

  3. Department of Paediatrics, University of Toronto, Toronto, ON, Canada

    K-S Lee

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  1. J Zhou
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  2. O Elkhateeb
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Correspondence to K-S Lee.

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Zhou, J., Elkhateeb, O. & Lee, KS. Comparison of non-invasive vs invasive blood pressure measurement in neonates undergoing therapeutic hypothermia for hypoxic ischemic encephalopathy. J Perinatol 36, 381–385 (2016). https://doi.org/10.1038/jp.2015.198

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