动脉内血压(IABP)测量,虽然被认为是危重病儿童的黄金标准,与某些风险相关,缺乏广泛的可用性。进行这项研究是为了确定儿童的示波无创血压(NIBP)和有创IABP测量之间的差异和协议。纳入标准包括进入教学医院儿科重症监护病房(PICU)的儿童(1个月至18岁),他们需要插入动脉导管进行血压(BP)监测。IABP和NIBP的比较采用配对t检验,Bland-Altman分析,和皮尔逊相关系数。总的来说,从65名儿童中收集了4,447对同时记录的每小时NIBP和IABP测量值。IABP和NIBP之间的平均收缩压差异为-3.6±12.85,-4.7±9.3和-3.12±9.30mmHg,舒张压,和平均动脉血压,分别(p<0.001),有广泛的协议限制。在所有三种BP状态下,NIBP均显着高估了BP(p<0.001)(低血压,血压正常,和高血压),除了高血压期间的收缩压(SBP)外,IABP显着升高。在低血压期间,SBP的差异最为明显。SBP在<10岁儿童中差异显著(p<0.001),最大的差异是婴儿。在青少年(p=0.28)和体重不足的儿童(p=0.55)中微不足道。除高血压状态下的SBP外,NIBP在所有BP状态下记录的BP均显着较高。在青少年和体重不足的儿童中,通过NIBP测量的SBP往往是最可靠的。NIBP在婴儿中最不可靠,肥胖儿童,在低血压期间。
Intra-arterial blood pressure (IABP) measurement, although considered the gold standard in critically ill children, is associated with certain risks and lacks widespread availability. This study was conducted to determine the differences and agreements between oscillometric non-invasive blood pressure (NIBP) and invasive IABP measurements in children. Inclusion criteria consisted of children (from 1 month to 18 years) admitted to the pediatric intensive care unit (PICU) of a teaching hospital who required arterial catheter insertion for blood pressure (BP) monitoring. The comparison between IABP and NIBP was studied using paired t -test, Bland-Altman analysis, and Pearson\'s correlation coefficient. In total, 4,447 pairs of simultaneously recorded hourly NIBP and IABP measurements were collected from 65 children. Mean differences between IABP and NIBP were -3.6 ± 12.85, -4.7 ± 9.3, and -3.12 ± 9.30 mm Hg for systolic, diastolic, and mean arterial BP, respectively ( p < 0.001), with wide limits of agreement. NIBP significantly overestimated BP ( p < 0.001) in all three BP states (hypotensive, normotensive, and hypertensive), except systolic blood pressure (SBP) during hypertension where IABP was significantly higher. The difference in SBP was most pronounced during hypotension. The difference in SBP was significant in children <10 years ( p < 0.001), with the maximum difference being in infants. It was insignificant in adolescents ( p = 0.28) and underweight children ( p = 0.55). NIBP recorded significantly higher BP in all states of BP except SBP in the hypertensive state. SBP measured by NIBP tended to be the most reliable in adolescents and underweight children. NIBP was the most unreliable in infants, obese children, and during hypotension.