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Continuous non-invasive finger blood pressure monitoring in children
H Tanaka1, O Thulesius, H Yamaguchi
1Department of Clinical Physiology, Faculty of Health Sciences, University Hospital, Linköping, Sweden.
Insights
Continuous non-invasive finger arterial pressure measurement using the volume-clamp technique (Finapres) shows good agreement with traditional brachial blood pressure in children and adults. This method is valuable for assessing cardiovascular reflexes in pediatric populations.
Area of Science:
- Cardiovascular Physiology
- Pediatric Medicine
- Biomedical Engineering
Background:
- Accurate blood pressure monitoring is crucial in children, but non-invasive methods can be challenging.
- The volume-clamp technique (Finapres) offers continuous, non-invasive finger arterial pressure measurement.
Purpose of the Study:
- To evaluate the performance and accuracy of Finapres for continuous non-invasive finger arterial pressure measurement in children and adults.
- To compare Finapres readings with traditional brachial blood pressure measurements obtained via the auscultatory method.
Main Methods:
- A study involving 217 children (4-16 years) and 38 adults (18-45 years).
- Consecutive finger arterial pressure (Finapres) and brachial artery pressure (auscultatory method) readings were taken on the same side in a supine position.
- Waveform analysis was performed, with specific attention to variability and reproducibility.
Main Results:
- Good agreement was found between finger arterial pressure and brachial blood pressure, with slight underestimation for systolic (-1.9 mmHg) and diastolic (-5.1 mmHg) pressures.
- The observed differences are likely attributable to the limitations of the auscultatory method.
- Finapres demonstrated small within-subject variability (3.8 mmHg systolic, 4.1 mmHg diastolic) and good reproducibility, comparable to the auscultatory method.
Conclusions:
- Continuous non-invasive finger arterial pressure measurement using Finapres is accurate and reliable in children older than 6 years, similar to adults.
- The Finapres method is clinically useful for pediatric applications, particularly for evaluating autonomic control and cardiovascular reflexes.
- This technique facilitates non-invasive assessment of rapid blood pressure changes in children.
Abstract:
We evaluated the performance of continuous non-invasive finger arterial pressure measurement using the volume-clamp technique (Finapres). This study was designed to compare finger arterial pressure with brachial blood pressure estimated by the auscultatory method in 217 children (90 boys and 127 girls) aged 4-16 years and in 38 adults (aged 18-45 years). Finger and brachial artery pressure readings were obtained consecutively from the ipsilateral side in the supine position. Finger arterial pressure waveforms were recorded in all children except 4 with small and thin fingers. There was good agreement for systolic pressure with only a slight underestimation of 1.9 mmHg and 5.1 mmHg lower for diastolic pressure. This difference most probably reflects inaccuracy of the auscultatory cuff method rather than an error in the Finapres. There was large inter-individual variability in Finapres recordings which might be due to differences in vasomotor tone, as demonstrated by systolic amplification in 5 patients with anorexia. However, Finapres showed a small within-subject variability (3.8 mmHg for systolic and 4.1 mmHg for diastolic pressure) determined in 5 patients during phenylephrine infusion, and as good reproducibility as the auscultatory method. These results suggest that finger arterial pressure measurement in children older than 6 years of age has similar accuracy as that in adults, and that this method is useful for clinical applications in children, especially for the non-invasive evaluation of autonomic control and cardiovascular reflexes involving transient and rapid blood pressure changes.