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[Variability of blood pressure measured using an oscillometric method in children 4 to 48 months of age]
Insights
Measuring blood pressure in young children is challenging due to movement artifacts. The lowest recorded value, not the average, is recommended for tracking blood pressure trends in children under four.
Area of Science:
- Pediatric Medicine
- Cardiovascular Physiology
- Biomedical Engineering
Context:
- Standard arterial blood pressure measurement is difficult in uncooperative children under 4 years old.
- The oscillometric method (Dinamap) is an alternative for blood pressure monitoring in this age group.
- Movement artifacts significantly impact measurement reproducibility in young children.
Purpose:
- To investigate blood pressure variations using the oscillometric method in children aged 4 to 48 months.
- To establish recommendations for accurate blood pressure measurement and interpretation in young children.
- To address discrepancies in published blood pressure studies due to varying methodologies.
Summary:
- Serial oscillometric blood pressure recordings in 100 children (4-48 months) revealed significant variability due to unavoidable movements.
- The average of repeated measurements was found to be unreliable.
- The lowest recorded blood pressure value (minima) is proposed as the most reliable parameter for tracking age-related increases.
Impact:
- Provides a practical recommendation for improving blood pressure monitoring in pediatric populations.
- Highlights the limitations of current oscillometric devices in young children.
- Offers a potential solution to reconcile conflicting findings in pediatric hypertension research.
Abstract:
The usual method of measuring arterial blood pressure cannot be used in children less than 4 years of age because of lack of cooperation. We investigated variations of blood pressure measured during 20 minutes by an oscillometric method (Dinamap) in 100 children aged 4 to 48 months and tried to come up with some recommendations for measuring and interpreting blood pressure. Serial blood pressure recordings showed poor reproducibility due to movements which are impossible to avoid and which account for wide variations. Because of this variability, a single measurement is inadequate and must be repeated. The average of repeated recordings does not seem to be a reliable parameter. We suggest that the lower measured value (minima) as the only parameter allowing us to track the progressive increase in blood pressure with age. The data probably explain the large discrepancies between published studies taking into account the use of different methods.