Correlation between invasive and noninvasive blood pressure measurements in severely burned children. Issue 7 (November 2018)

• Record Type: Journal Article
• Authors: Cambiaso-Daniel, Janos; Rontoyanni, Victoria G.; Foncerrada, Guillermo; Nguyen, Anthony; Capek, Karel D.; Wurzer, Paul; Lee, Jong O.; Hundeshagen, Gabriel; Voigt, Charles D.; Branski, Ludwik K.; Finnerty, Celeste C.; Herndon, David N.
• Is Part Of: Burns. Volume 44:Issue 7(2018)
• Page Start: 1787
• Page End: 1791
• Publication Date: 2018-11
• Subjects: IAP intra-arterial pressure -- ICC intraclass correlations -- DBP diastolic blood pressure -- MAP mean arterial pressure -- NIBP noninvasive blood pressure -- SBP systolic blood pressure; Arterial line -- Cuff pressure -- Monitoring -- Critical care -- Intensive care unit; Burns and scalds -- Periodicals; 617.11
• DOI: 10.1016/j.burns.2018.03.001
• Languages: English
• ISSNs: 0305-4179

Abstract

Highlights: Arterial line and blood pressure cuff measurements have high variability between one other. Blood pressure cuff values overestimate hypotension and hypertension. Arterial lines have a very low complication rate (1%). Abstract: Introduction: Accurate blood pressure monitoring is essential for burn management, with the intra-arterial line method being the gold standard. Here we evaluated agreement between cuff and intra-arterial line methods. Methods: Data from burned children admitted from 1997 to 2016 were retrospectively reviewed. Simultaneously collected intra-arterial and cuff measurements were cross-matched and linear regression performed to assess agreement for systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP). Results: We identified 9969 matches for SBP, DBP, and MAP in 872 patients (579 male) aged 8 ± 5 years with burns covering 52 ± 20% of the total body surface area and a hospitalization lasting 33 ± 31 days. Intra-arterial lines had a complication rate of 1%. The mean bias (95% CI) between methods was 1.3 (0.5, 2.1) mm Hg for SBP, −6.4 (−7.0, −5.7) mmHg for DBP, and −5.8 (−6.4, −5.3) mmHg for MAP. The standard deviation of the bias (95% limit of agreement) was 12.1 (−22.5, 25.1) mmHg for SBP, 9.9 (−25.8, 13.0) mmHg for DBP, and 8.7 (−22.8, 11.1) mmHg for MAP. Conclusions: Cuff measurements vary widely from those of intra-arterial lines, which have a low complication rate. Intra-arterial lines are advisable when tight control of the hemodynamic response is essential.