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Comparing oscillometric noninvasive and invasive intra‐arterial blood pressure monitoring in term neonates under general anesthesia: A retrospective study

Fujii, Tasuku Nishiwaki, Kimitoshi 名古屋大学

2020.12

概要

Background: Oscillometric noninvasive blood pressure and/or invasive intra‐arterial blood pressure are commonly used to measure the systolic, diastolic, and mean components of blood pressure. Agreement between the two methods has been reported in adults, children, and infants, but rarely in neonates, especially under general anesthesia. Aims: This retrospective study compared the agreement of each measured blood pressure value (oscillometric noninvasive or invasive intra‐arterial blood pressure monitoring) in term neonates under general anesthesia. Methods: Data were collected from neonates born at ≥36 weeks of gestation whose body weight was ≥2500 g and who underwent abdominal or noncardiac thoracic surgery with both oscillometric noninvasive and invasive intra‐arterial blood pressure measurements from January 2015 to March 2020. The primary outcome was the agreement of systolic, diastolic, and mean blood pressure values between the two methods using Bland‐Altman analysis. Results: Paired blood pressure measurements (n = 1193) from 67 cases were compared. In Bland‐Altman analysis, bias (standard deviation), 95% limits of agreement, and percentage error were −9.3 (8.4), −26.1‐7.6, and 26.9% for systolic; 1.6 (6.5), −11.3‐14.6, and 38.7% for diastolic; and −1.3 (5.8), −13.0‐10.3, and 26.9% for mean blood pressure, respectively. During low blood pressure (intra‐arterial mean blood pressure ≤30 mm Hg), the biases (standard deviation) of systolic, diastolic, and mean blood pressure were −11.4 (5.7), −0.7 (3.7), and −5.1 (4.2), whereas during high blood pressure (intra‐arterial mean blood pressure ≥60 mm Hg), the values were 0.1 (9.7), 5.6 (9.4), and 6.4 (7.4), respectively. Conclusions: Based on the bias and percentage error, the mean blood pressure exhibited the most acceptable agreement between oscillometric noninvasive and invasive intra‐arterial blood pressure monitoring in term neonates under general anesthesia. However, during hypertension or hypotension, there was a large discrepancy between the two methods.

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参考文献

1. Pickering TG, Hall JE, Appel LJ, et al. Recommendations for blood pressure

measurement in humans and experimental animals: part 1: blood pressure

measurement in humans: a statement for professionals from the Subcommittee of

Professional and Public Education of the American Heart Association Council on High

Blood Pressure Research. Circulation. 2005;111:697-716.

2. Rhodes A, Evans LE, Alhazzani W, et al. Surviving Sepsis Campaign: International

Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Med.

2017;43:304-377.

3. Wax DB, Lin HM, Leibowitz AB. Invasive and concomitant noninvasive intraoperative

blood pressure monitoring: observed differences in measurements and associated

therapeutic interventions. Anesthesiology. 2011;115:973-978.

4. Lehman LW, Saeed M, Talmor D, Mark R, Malhotra A. Methods of blood pressure

measurement in the ICU. Crit Care Med. 2013;41:34-40.

5. Meidert AS, Tholl M, Hüttl TK, Bernasconi P, Peraud A, Briegel J. Accuracy of

oscillometric noninvasive blood pressure compared with intra-arterial blood pressure in

infants and small children during neurosurgical procedures: An observational study. Eur

J Anaesthesiol. 2019;36:400-405.

6. Dionne JM, Bremner SA, Baygani SK, et al. Method of Blood Pressure Measurement in

Neonates and Infants: A Systematic Review and Analysis. J Pediatr. 2020;221:23-31.

7. Miall-Allen VM, de Vries LS, Whitelaw AG. Mean arterial blood pressure and neonatal

cerebral lesions. Arch Dis Child. 1987;62:1068-1069.

8. Bland JM, Altman DG. Statistical methods for assessing agreement between two

14

methods of clinical measurement. Lancet. 1986;1:307-310.

9. Bland JM, Altman DG. Measuring agreement in method comparison studies. Stat

Methods Med Res. 1999;8:135-160.

10. Critchley LA, Critchley JA. A meta-analysis of studies using bias and precision statistics

to compare cardiac output measurement techniques. J Clin Monit Comput. 1999;15:8591.

11. Saugel B, Grothe O, Wagner JY. Tracking changes in cardiac output: Statistical

considerations on the 4-quadrant plot and the polar plot methodology. Anesth Analg.

2015;121:514-524.

12. Rogge DE, Nicklas JY, Schön G, et al. Continuous noninvasive arterial pressure

monitoring in obese patients during bariatric surgery: An evaluation of the vascular

unloading technique (Clearsight system). Anesth Analg. 2019;128:477-483.

13. McEvoy MD, Gupta R, Koepke EJ, et al. Preoperative blood pressure group;

Intraoperative blood pressure group; Postoperative blood pressure group. Perioperative

Quality Initiative consensus statement on postoperative blood pressure, risk and

outcomes for elective surgery. Br J Anaesth. 2019;122:575-586.

14. McCann ME, Schouten ANJ, Dobija N, et al. Infantile postoperative encephalopathy:

perioperative factors as a cause for concern. Pediatrics. 2014;133:e751-e757.

15. Nafiu OO, Voepel-Lewis T, Morris M, et al. How do pediatric anesthesiologists define

intraoperative hypotension? Paediatr Anaesth. 2009;19:1048-1053.

16. Cunningham S, Symon AG, McIntosh N. Changes in mean blood pressure caused by

damping of the arterial pressure waveform. Early Hum Dev. 1994;36:27-30.

17. Pejovic B, Peco-Antic A, Marinkovic-Eric J. Blood pressure in non-critically ill preterm

15

and full-term neonates. Pediatr Nephrol. 2007;22:249-257.

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Tables

Table 1

Patient characteristics and neonatal blood pressure data

Characteristic

Value

Age; days

2 (1-13 [0-27])

Sex; female

22 (33%)

Height; cm

49.0 (2.3)

Weight; kg

2.96 (0.4)

Surgical procedures

Abdominal surgery

48 (72%)

Thoracic surgery

19 (28%)

Operation time; min

129 (97.5-180 [20-424])

Non-invasive SBP; mmHg

62.6 (11.4)

Non-invasive DBP; mmHg

33.6 (9.5)

Non-invasive mean BP; mmHg

44.2 (9.1)

Invasive intra-arterial SBP; mmHg

53.4 (11.4)

Invasive intra-arterial DBP; mmHg

35.2 (8.7)

Invasive intra-arterial mean BP; mmHg

42.8 (9.8)

Values are presented as the mean (standard deviation), median (interquartile range

[range]), or number (proportion, %) of patients. BP, blood pressure; DBP diastolic blood

pressure; SBP, systolic blood pressure.

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Table 2

Agreement of blood pressure values between oscillometric non-invasive and invasive

intra-arterial blood pressures

All data (n=1193)

Bias

SD

Percentage error

Correlation coefficient

Systolic

-9.3

8.4

26.9%

0.73

Diastolic

1.6

6.5

38.7%

0.75

Mean

-1.3

5.8

26.4%

0.81

Lower intra-arterial BP (intra-arterial mean BP ≤30 mmHg) (n=94)

Systolic

-11.1

5.6

24.2%

0.36

Diastolic

-0.7

3.7

31.6%

0.53

Mean

-5.1

4.2

25.4%

0.43

Higher intra-arterial BP (intra-arterial mean BP ≥60 mmHg) (n=62)

Systolic

0.1

9.7

23.3%

0.69

Diastolic

5.6

9.4

36.3%

0.71

Mean

6.4

7.4

23.5%

0.80

BP, blood pressure; SD, standard deviation.

18

Figure 1

Bland-Altman analysis assessing the reliability of both the oscillometric non-invasive and

invasive intra-arterial blood pressure measurement methods.

Bland-Altman analysis shows the mean bias (bold line) and 95% limits of agreement

(dashed line). (A) Systolic, (B) diastolic, and (C) mean blood pressure. BP, blood pressure;

SD, standard deviation.

19

Figure 2

Four-quadrant plot analysis for the tracking ability of two blood pressure monitoring

methods.

Black points show the change of each paired blood pressure within two minutes (Δ intraarterial BP: tracks the change of intra-arterial blood pressure; Δ non-invasive BP: tracks

the change of non-invasive blood pressure). The exclusion zone is ≤5 mmHg. (A) Systolic,

(B) diastolic, and (C) mean blood pressure. BP, blood pressure.

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