Intraoperative blood pressure levels in young and anaesthetised children: are we getting any closer to the truth?

PURPOSE OF REVIEW

Blood pressure is a basic feature of monitoring during anaesthesia. However, it is very unclear what blood pressures are normal during anaesthesia in children. Furthermore, the clinical consequences of low blood pressure are also uncertain. Similarly, it is unclear when to initiate therapy for hypotension during anaesthesia. This review summarizes the most recent development on the interpretation of blood pressure measurements in children and the relation of low blood pressure to clinical outcome.

RECENT FINDINGS

Recently published (multicentre) database studies show that alleged complications of intraoperative hypotension (brain ischaemia, kidney dysfunction, myocardial ischaemia and multiple organ dysfunction) are very rare in children after anaesthesia noncardiac procedures. Furthermore, other studies show that a considerable number of patients have blood pressure lower than a threshold according to the current standards treatment of Paediatric Life Support.

SUMMARY

The recently published reference tables can guide anaesthesiologist in daily practice to define intraoperative hypotension. However, there are situations in which a higher blood pressure is recommendable and an individual approach is required.