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Validation of the APLS age-based vital signs reference ranges in a Chinese population

S S W Chan1, G N Cattermole, P Y M Leung

  • 1Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Hong Kong. stewart chan@hotmail.com

Resuscitation
|April 22, 2011
PubMed

Insights

Vital signs reference ranges differ by ethnicity. This study found APLS ranges are often inappropriate for Chinese children, necessitating locally derived data for accurate pediatric care.

Area of Science:

  • Pediatrics
  • Clinical Physiology
  • Public Health

Background:

  • Vital signs reference ranges can vary significantly across different ethnic groups.
  • Existing pediatric vital signs reference ranges may not be universally applicable.

Purpose of the Study:

  • To validate the Advanced Paediatric Life Support (APLS) age-based vital signs reference ranges in Chinese children in Hong Kong.
  • To derive age-based centile curves for systolic blood pressure, heart rate, and respiratory rate specific to Chinese children.
  • To create a summarized table of reference ranges for APLS application in ethnic Chinese patients.

Main Methods:

  • A cross-sectional study of 1353 healthy Chinese children (12 months to 143 months) in Hong Kong.
  • Measurements of heart rate, systolic blood pressure, and respiratory rate were taken by trained operators.
  • Statistical analysis included Z-tests and one-sample t-tests, with LMS Chartmaker Pro used for centile curve derivation.

Main Results:

  • A significant proportion of measurements fell outside APLS ranges: 34.1% for heart rate, 55.9% for systolic blood pressure, and 55.7% for respiratory rate.
  • Chinese children in pre-school and school age groups showed significantly higher mean blood pressure and lower mean heart and respiratory rates compared to APLS values.
  • The study highlights ethnic-specific variations in pediatric vital signs.

Conclusions:

  • The Advanced Paediatric Life Support (APLS) age-based vital signs reference ranges require validation for diverse ethnic populations.
  • Independently derived vital signs reference ranges are more appropriate for applying APLS to Chinese patients in Hong Kong.
  • This research supports the need for localized vital signs data in pediatric emergency care.
Abstract

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