A comparison of direct arterial pressure and non-invasive arterial pressure measurement by oscillometry in preterm infants

Publisher Summary Accurate measurement of arterial pressure is vital to neonatal intensive care. Management of severe asphyxia, blood loss, septicaemia, congenital heart disease, dehydration, neonatal surgery, and the use of vasodilator and paralyzing drugs all demand knowledge of arterial pressure. This chapter presents a study for the comparison of direct arterial pressure and noninvasive arterial pressure measurement by oscillometry in preterm infants. The oscillometric method gave an approximation to direct systolic and mean arterial pressure over the ranges encountered in preterm infants. The error was greater with diastolic pressure, but diastolic pressure has little role to play in diagnosis or decision making in neonatal intensive care. The clinician must be aware that 3.8–6. 2% of oscillometric systolic or mean arterial pressures will err by more than 10 mmHg. It is found that if one is in the range of 35–45 mmHg, 10 mmHg is a clinically significant error. It is shown that how total reliance on a single oscillometric measurement could lead to inappropriate treatment such as plasma infusion or intravenous dopamine. It is essential that the inflatable part of any blood pressure cuff must encircle the arm and this was true of the Omega cuffs.