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Changes in mean blood pressure caused by damping of the arterial pressure waveform
S Cunningham1, A G Symon, N McIntosh
1Department of Child, Life and Health, University of Edinburgh, UK.
Abstract:
'Damping' of an intra-arterial pressure waveform theoretically affects systolic and diastolic blood pressure whilst mean blood pressure (mbp) continues to be reliable. We assessed changes in mbp associated with 79 episodes of damping in 30 infants. The average mbp in the hour just before damping occurred was compared with that in the first hour of damping. The mean change in mbp was -0.845 mmHg. In 50% of cases this change was < 2 mmHg and in 24% of episodes > or = 4.1 mmHg. Damping may produce clinically significant changes in mbp which computer trend data may help to differentiate.
Insights
Intra-arterial pressure waveform damping can alter mean blood pressure (mbp) in infants. While often small, changes in mbp during damping episodes may be clinically significant and detectable with computer trend data.
Area of Science:
- Pediatric Cardiology
- Biomedical Engineering
- Neonatal Intensive Care
Background:
- Intra-arterial pressure monitoring is crucial for critically ill infants.
- Waveform damping theoretically impacts systolic and diastolic pressures but not mean blood pressure (mbp).
- Clinical significance of mbp changes during damping episodes requires further investigation.
Purpose of the Study:
- To assess changes in mean blood pressure (mbp) during intra-arterial pressure waveform damping in infants.
- To determine the clinical significance of observed mbp variations.
- To evaluate the utility of computer trend data in differentiating damping effects.
Main Methods:
- Retrospective analysis of 79 damping episodes in 30 infants.
- Comparison of mbp in the hour preceding damping versus the first hour of damping.
- Statistical analysis of mean change and variability in mbp.
Main Results:
- The average change in mbp during damping was -0.845 mmHg.
- In 50% of cases, mbp change was less than 2 mmHg.
- In 24% of episodes, mbp change exceeded or equaled 4.1 mmHg, indicating potential clinical significance.
Conclusions:
- Waveform damping can lead to clinically significant changes in infant mean blood pressure (mbp).
- Computer trend data may assist in identifying and interpreting these mbp fluctuations.
- Relying solely on mbp during damping may require careful consideration of potential variations.