Correlation between Invasive and Noninvasive Blood Pressure Measurements in Extremely Low Gestational Age Newborns

Area of Science:

• Neonatal Medicine
• Pediatric Cardiology
• Clinical Monitoring

Background:

• Accurate blood pressure monitoring is critical for extremely low gestational age newborns (ELGANs).
• Invasive blood pressure (IBP) provides precise measurements but carries risks.
• Non-invasive blood pressure (NIBP) devices offer a safer alternative, but their accuracy in ELGANs requires validation.

Purpose of the Study:

• To investigate the correlation and agreement between IBP and NIBP measurements.
• To assess the accuracy of NIBP compared to IBP in ELGANs within the first 72 hours of life.
• To determine if NIBP overestimates or underestimates IBP, particularly in hypotensive neonates.

Main Methods:

• Retrospective cohort study of ELGANs within the first 72 hours of life.
• Simultaneous IBP and NIBP measurements were recorded.
• Calculation of the percentage difference in mean arterial blood pressure (% Diff-BP) and assessment of agreement using Bland-Altman analysis.

Main Results:

• A significant correlation (Spearman Rho = 0.887, p < 0.001) was observed between IBP and NIBP.
• However, the agreement between the two methods was poor (mean difference: 0.20; 95% limits of agreement: -5.48 to 5.89).
• In hypotensive infants, NIBP demonstrated a tendency to overestimate IBP measurements.

Conclusions:

• While NIBP correlates with IBP in ELGANs, its poor agreement necessitates caution.
• NIBP may overestimate blood pressure in hypotensive ELGANs, potentially leading to misdiagnosis or inappropriate treatment.
• Further research is needed to refine NIBP use and interpretation in this vulnerable population.