Related Experiment Video
Updated: Dec 17, 2025
Software for Analysis of Heart Rate and Blood Pressure Time-series Data from the Valsalva Maneuver
Published on: June 27, 2025
Blood pressure in Danish children during general anaesthesia: Hypotension in a paediatric population observational
Nicola G Clausen1, Maja Filipovic2, Gerrit H de Pater3
1Anaesthesiology and Intensive Care, Section Paediatric Anaesthesia, Odense University Hospital, Odense, Denmark.
Insights
Blood pressure in children during general anaesthesia varies significantly, especially in infants. Monitoring blood pressure in all pediatric patients is crucial, though safe limits require further definition.
Area of Science:
- Pediatric Anesthesiology
- Cardiovascular Physiology
Background:
- Thousands of Danish infants and children undergo general anesthesia annually.
- Hypotension during anesthesia may compromise cerebral blood flow and oxygenation.
- Defining safe blood pressure limits in pediatric populations is challenging.
Purpose of the Study:
- To assess blood pressure in Danish children during general anesthesia.
- To analyze blood pressure variability and interventions in pediatric patients.
- To contribute data for establishing safe anesthetic practices in children.
Main Methods:
- Prospective, observational, multicenter study design.
- Inclusion of children aged 0-12 years (excluding premature infants and those undergoing cardio-thoracic surgery).
- Measurement of mean arterial blood pressure via oscillometry or invasive methods.
Main Results:
- 726 pediatric patients were included in the study.
- Median arterial pressure ranged from 51 mm Hg in infants (<1 year) to 58 mm Hg in 12-year-olds.
- Blood pressure modulation interventions were required in 32 patients.
Conclusions:
- The study provides real-world data on pediatric blood pressure during general anesthesia.
- Significant blood pressure variability exists, particularly in younger infants.
- Continuous blood pressure monitoring is recommended for all pediatric patients, but safe ranges need further research.
Background:
In Denmark, thousands of infants and children require general anaesthesia annually. Hypotension during general anaesthesia might reduce cerebral blood flow and oxygen delivery to the brain. Safe lower limits of blood pressure are ill defined. The Hypotension in Paediatric Populations Observational study objective was to assess blood pressure in Danish children during general anaesthesia.
Methods:
This study is a prospective observational multicentre study. Primary outcomes were mean arterial blood pressures in children aged 0-12 years. Lowest mean arterial blood pressure, intervention thresholds to increase blood pressure and type of intervention were secondary outcomes. Premature infants and children scheduled for cardio-thoracic surgery were excluded. Blood pressures were measured by oscillometry or invasively.
Results:
In total, 726 patients were included. In children < 1 year, median arterial pressure was 51 mm Hg, (interquartile range; 43-58) and increased to 58 mm Hg (interquartile range; 52-65) for 12-year-old children. In 32 patients, 49 actions were taken to modulate blood pressure. Pre-induction blood pressures were recorded for 29%.
Conclusion:
This study presents pragmatic, multicentre, prospectively collected observations of blood pressure in children undergoing general anaesthesia in usual practice. In the youngest infants, variability in blood pressure appears to be large. Measurement of blood pressure is recommended during every general anaesthesia and in children of all ages. Safe ranges of blood pressure remain to be defined.
Related Concept Videos
01:30Alterations in Blood Pressure
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart...
01:28Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
01:17Measurement of Blood Pressure
01:24Blood Pressure
01:10Pre-Procedural Guidelines for Assessing Blood Pressure
01:21Sites for measruring blood pressure
The Brachial Artery: Primary Site for Blood Pressure Measurement