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Comparison of Blood Pressure Measurements by Currently Available Multiparameter Monitors and Mercury Column Sphygmomanometer in Patients Admitted in Pediatric Intensive Care Unit
BACKGROUND: The multiparameter monitor (MPM) is replacing mercury column sphygmomanometers (MCS) in acute care settings. However, data on the former's accuracy in critically ill children are scarce and mostly extrapolated from adults. We compared non-invasive blood pressure (NIBP) measurements...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Jaypee Brothers Medical Publishers
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10028710/ https://www.ncbi.nlm.nih.gov/pubmed/36960118 http://dx.doi.org/10.5005/jp-journals-10071-24424 |
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author | Khan, Adil Ahmed Gupta, Pramod Kumar Baranwal, Arun Kumar Jayashree, Muralidharan Sahoo, Tanushree |
author_facet | Khan, Adil Ahmed Gupta, Pramod Kumar Baranwal, Arun Kumar Jayashree, Muralidharan Sahoo, Tanushree |
author_sort | Khan, Adil Ahmed |
collection | PubMed |
description | BACKGROUND: The multiparameter monitor (MPM) is replacing mercury column sphygmomanometers (MCS) in acute care settings. However, data on the former's accuracy in critically ill children are scarce and mostly extrapolated from adults. We compared non-invasive blood pressure (NIBP) measurements by MPMs with MCS in pediatric intensive care unit (PICU). PATIENTS: Adequately sedated and hemodynamically stabilized children (age, 1–144 months) were prospectively enrolled. MATERIALS AND METHODS: Three NIBP measurements were obtained from MCS (Diamond®, India) and MPM (Intellivue MX800® or Ultraview SL®) in rapid succession in the upper limb resting in supine position. Respective three measurements were averaged to obtain a paired set of NIBP readings, one each from MCS and MPM. Such readings were obtained thrice a day. NIBP readings were then compared, and agreement was assessed. RESULTS: From 39 children [median age (IQR), 30 (10–72) months], 1,690 sets of NIBP readings were obtained. A-third of readings were from infants and children >96 months, while 383 (22.6%) readings were from patients on inotropes. Multiparameter monitors gave significantly higher NIBP readings compared to MCS [median systolic blood pressure (SBP), 6.5 (6.4–6.7 mm Hg); diastolic blood pressure (DBP), 4.5 (4.3–4.6 mm Hg); mean arterial pressure (MAP), 5.3 (5.1–5.4 mm Hg); p < 0.05]. It was consistent across age, gender, and critical care characteristics. Multiparameter monitors overestimated SBP in 80% of readings beyond the maximal clinically acceptable difference (MCAD). CONCLUSIONS: Non-invasive blood pressure readings from MCS and MPMs are not interchangeable; SBP was 6–7 mm Hg higher with the latter. Overestimation beyond MCAD was overwhelming. Caution is required while classifying systolic hypotension with MPMs. Confirmation with auscultatory methods is advisable. More studies are required to evaluate currently available MPMs in different pediatric age groups. HOW TO CITE THIS ARTICLE: Khan AA, Gupta PK, Baranwal AK, Jayashree M, Sahoo T. Comparison of Blood Pressure Measurements by Currently Available Multiparameter Monitors and Mercury Column Sphygmomanometer in Patients Admitted in Pediatric Intensive Care Unit. Indian J Crit Care Med 2023;27(3):212–221. |
format | Online Article Text |
id | pubmed-10028710 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Jaypee Brothers Medical Publishers |
record_format | MEDLINE/PubMed |
spelling | pubmed-100287102023-03-22 Comparison of Blood Pressure Measurements by Currently Available Multiparameter Monitors and Mercury Column Sphygmomanometer in Patients Admitted in Pediatric Intensive Care Unit Khan, Adil Ahmed Gupta, Pramod Kumar Baranwal, Arun Kumar Jayashree, Muralidharan Sahoo, Tanushree Indian J Crit Care Med Pediatric Critical Care BACKGROUND: The multiparameter monitor (MPM) is replacing mercury column sphygmomanometers (MCS) in acute care settings. However, data on the former's accuracy in critically ill children are scarce and mostly extrapolated from adults. We compared non-invasive blood pressure (NIBP) measurements by MPMs with MCS in pediatric intensive care unit (PICU). PATIENTS: Adequately sedated and hemodynamically stabilized children (age, 1–144 months) were prospectively enrolled. MATERIALS AND METHODS: Three NIBP measurements were obtained from MCS (Diamond®, India) and MPM (Intellivue MX800® or Ultraview SL®) in rapid succession in the upper limb resting in supine position. Respective three measurements were averaged to obtain a paired set of NIBP readings, one each from MCS and MPM. Such readings were obtained thrice a day. NIBP readings were then compared, and agreement was assessed. RESULTS: From 39 children [median age (IQR), 30 (10–72) months], 1,690 sets of NIBP readings were obtained. A-third of readings were from infants and children >96 months, while 383 (22.6%) readings were from patients on inotropes. Multiparameter monitors gave significantly higher NIBP readings compared to MCS [median systolic blood pressure (SBP), 6.5 (6.4–6.7 mm Hg); diastolic blood pressure (DBP), 4.5 (4.3–4.6 mm Hg); mean arterial pressure (MAP), 5.3 (5.1–5.4 mm Hg); p < 0.05]. It was consistent across age, gender, and critical care characteristics. Multiparameter monitors overestimated SBP in 80% of readings beyond the maximal clinically acceptable difference (MCAD). CONCLUSIONS: Non-invasive blood pressure readings from MCS and MPMs are not interchangeable; SBP was 6–7 mm Hg higher with the latter. Overestimation beyond MCAD was overwhelming. Caution is required while classifying systolic hypotension with MPMs. Confirmation with auscultatory methods is advisable. More studies are required to evaluate currently available MPMs in different pediatric age groups. HOW TO CITE THIS ARTICLE: Khan AA, Gupta PK, Baranwal AK, Jayashree M, Sahoo T. Comparison of Blood Pressure Measurements by Currently Available Multiparameter Monitors and Mercury Column Sphygmomanometer in Patients Admitted in Pediatric Intensive Care Unit. Indian J Crit Care Med 2023;27(3):212–221. Jaypee Brothers Medical Publishers 2023-03 /pmc/articles/PMC10028710/ /pubmed/36960118 http://dx.doi.org/10.5005/jp-journals-10071-24424 Text en Copyright © 2023; The Author(s). https://creativecommons.org/licenses/by-nc/4.0/© The Author(s). 2023 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Pediatric Critical Care Khan, Adil Ahmed Gupta, Pramod Kumar Baranwal, Arun Kumar Jayashree, Muralidharan Sahoo, Tanushree Comparison of Blood Pressure Measurements by Currently Available Multiparameter Monitors and Mercury Column Sphygmomanometer in Patients Admitted in Pediatric Intensive Care Unit |
title | Comparison of Blood Pressure Measurements by Currently Available Multiparameter Monitors and Mercury Column Sphygmomanometer in Patients Admitted in Pediatric Intensive Care Unit |
title_full | Comparison of Blood Pressure Measurements by Currently Available Multiparameter Monitors and Mercury Column Sphygmomanometer in Patients Admitted in Pediatric Intensive Care Unit |
title_fullStr | Comparison of Blood Pressure Measurements by Currently Available Multiparameter Monitors and Mercury Column Sphygmomanometer in Patients Admitted in Pediatric Intensive Care Unit |
title_full_unstemmed | Comparison of Blood Pressure Measurements by Currently Available Multiparameter Monitors and Mercury Column Sphygmomanometer in Patients Admitted in Pediatric Intensive Care Unit |
title_short | Comparison of Blood Pressure Measurements by Currently Available Multiparameter Monitors and Mercury Column Sphygmomanometer in Patients Admitted in Pediatric Intensive Care Unit |
title_sort | comparison of blood pressure measurements by currently available multiparameter monitors and mercury column sphygmomanometer in patients admitted in pediatric intensive care unit |
topic | Pediatric Critical Care |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10028710/ https://www.ncbi.nlm.nih.gov/pubmed/36960118 http://dx.doi.org/10.5005/jp-journals-10071-24424 |
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