Aim: To compare blood pressure in neonates obtained from three different osci llometer blood pressure monitors (DinamapTM, CriticareTM, Hewlett- PackardTM) w ith arterial blood pressure (Hewlett- PackardTM invasive unit). Study design: A total of 32 randomized, non- invasive blood pressure series, each consisting o f three measurements from each monitor, were obtained from 20 neonates (birthwei ght 531- 4660 g). Each measurement was compared with the invasive pressure. Res ults: Two factors appear to have a systematic effect on the difference between o scillometric and invasive pressure (the measurement deviance): the size of the i nfant, e.g., the arm circumference, and the monitor system. For small infants, t he non- invasively measured value tends to be too high. The deviance is partly reversed for larger infants (dependency on size significant for mean and diastol ic pressure, p < 0.001). The difference between monitor systems is clearly signi ficant (p < 0.001). Hewlett- PackardTM gives the lowest pressure values for all pressures. Thus, CriticareTM and DinamapTM tended to show values too high in th e smallest infants,while Hewlett- PackardTM tended to give values too low in la rger infants. Birthweight, present weight and arm circumference affected measure ment deviance approximately equally strongly, while factors such as the infant s sex, need of breath support and umbilical or radial arterial line were non- significant. Conclusions: Blood pressure should preferably be measured invasivel y in severely ill neonates and preterm infants, being aware of pitfalls with mea surements using different oscillometer monitors and the size/arm circumference o f the infant.
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