Streamlining pediatric vital sign assessment: innovations and insights

Accurate assessment of pediatric vital signs is critical for detecting abnormalities and guiding medical interventions, but interpretation is challenging due to age-dependent physiological variations. Therefore, this study aimed to develop age-specific centile curves for blood pressure, heart rate, and respiratory rate in pediatric patients and create a user-friendly web-based application for easy access to these data. We conducted a retrospective cross-sectional observational study analyzing 3,779,482 records from the National Emergency Department Information System of Korea, focusing on patients under 15 years old admitted between January 2016 and December 2017. After applying exclusion criteria to minimize the impact of patients' symptoms on vital signs, 1,369,608 records were used for final analysis. The box-cox power exponential distribution and Lambda-Mu-Sigma (LMS) method were used to generate blood pressure centile charts, while heart rate and respiratory rate values were drawn from previously collected LMS values. We developed comprehensive age-specific centile curves for systolic, diastolic, and mean blood pressure, heart rate, and respiratory rate. These were integrated into a web-based application ( http://centile.research.or.kr ), allowing users to input patient data and promptly obtain centile and z-score information for vital signs. Our study provides an accessible system for pediatric vital sign evaluation, addressing previous limitations and offering a practical solution for clinical assessment. Future research should validate these centile curves in diverse populations.