Correlation between invasive and noninvasive blood pressure measurements in severely burned children

Burns. 2018 Nov;44(7):1787-1791. doi: 10.1016/j.burns.2018.03.001. Epub 2018 Aug 25.

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±5years 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.

Keywords: Arterial line; Critical care; Cuff pressure; Intensive care unit; Monitoring.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Arterial Pressure*
  • Blood Pressure Determination / methods*
  • Burns*
  • Catheterization, Peripheral*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Hypertension / diagnosis*
  • Hypotension / diagnosis*
  • Male
  • Trauma Severity Indices