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Use of pulse oximetry for blood pressure measurement after cardiac surgery
A J Movius1, S L Bratton, G K Sorensen
1Department of Anesthesiology, University of Washington, School of Medicine, Seattle 98105, USA.
Insights
Pulse oximeter waveform analysis offers accurate, non-invasive blood pressure monitoring in children post-cardiac surgery. This method proves superior to oscillometric devices, especially for smaller patients, ensuring reliable measurements.
Area of Science:
- Pediatric Cardiology
- Biomedical Engineering
- Critical Care Medicine
Background:
- Accurate blood pressure monitoring is crucial for pediatric patients after cardiac surgery.
- Traditional methods like intra-arterial measurement are invasive.
- Non-invasive alternatives are needed, particularly for vulnerable pediatric populations.
Purpose of the Study:
- To evaluate the accuracy and reliability of pulse oximeter waveform changes for non-invasive blood pressure (NIBP) measurement in children.
- To compare the pulse oximeter NIBP method with oscillometric NIBP and intra-arterial blood pressure (IAPB) measurements.
- To determine the efficacy of the pulse oximeter method in different weight groups of pediatric patients.
Main Methods:
- A prospective study involving 46 pediatric patients undergoing cardiac surgery.
- Simultaneous blood pressure measurements using intra-arterial catheter, oscillometric device, and pulse oximeter.
- Pulse oximeter measurements were taken with a blood pressure cuff placed proximal to the oximeter probe.
Main Results:
- Pulse oximeter NIBP measurements showed better correlation with IAPB (0.77-0.96) compared to oscillometric NIBP (0.42-0.83).
- Absolute differences between pulse oximeter and IAPB were significantly smaller than between oscillometric and IAPB in children < 15.0 kg.
- The pulse oximeter method demonstrated higher accuracy and reliability, especially in smaller children.
Conclusions:
- Non-invasive blood pressure measurement using pulse oximeter waveform changes is accurate and reliable in pediatric patients post-cardiac surgery.
- The pulse oximeter method is superior to the oscillometric method for NIBP monitoring in smaller pediatric patients.
- This technique offers a valuable non-invasive alternative for blood pressure management in pediatric critical care settings.
Abstract:
Blood pressure measurement using pulse oximeter waveform change was compared with an oscillometric measurement and the gold standard, intra-arterial measurement, in children after cardiac surgery. Forty six patients were enrolled and divided into groups according to weight. Simultaneous blood pressure measurements were obtained from the arterial catheter, the oscillometric device, and the pulse oximeter. Pulse oximeter measurements were obtained with a blood pressure cuff proximal to the oximeter probe. The blood pressure measurements from the pulse oximeter method correlated better with intra-arterial measurements than those from the oscillometric device (0.77-0.96 v 0.42-0.83). The absolute differences between the pulse oximeter and intra-arterial measurements were significantly smaller than between the oscillometric and intra-arterial measurements in children less than 15.0 kg. The pulse oximeter waveform change is an accurate and reliable way to measure blood pressure in children non-invasively, and is superior to the oscillometric method for small patients.