Ringrose Jennifer S, Alabbas Abdullah, Jalali Afrooz, Khinda Harsimran, Morgan Catherine, Yiu Verna, Alexander R Todd, Padwal Raj
Departments of Medicine.
Women and Children's Health Research Institute.
Blood Press Monit. 2019 Apr;24(2):83-88. doi: 10.1097/MBP.0000000000000367.
Uncertainty exists regarding the accuracy of automated blood pressure (BP) measurement in children. We recorded oscillometric waveforms in children, derived oscillometric BPs using two standard algorithms, and compared the results to simultaneous auscultation.
Twenty children aged 2-12 years were recruited from a tertiary-care Pediatric Nephrology Clinic. Sex, height, weight, arm circumference, history of hypertension, and clinic BP were recorded. Two, simultaneously measured, oscillometric and auscultatory BP readings were obtained 30-60 s apart. The first reading was discarded and, the second, used for analyses. Fixed-ratio and slope-based algorithms were used for BP derivation.
Mean age was 7.95±2.82 years, 40% were female, mean arm circumference was 21.86±4.06 cm, and 50% had hypertension or a history of hypertension. Mean auscultatory BP for all participants (systolic±SD/diastolic±SD) was 93.40±11.80/50.50±9.04 mmHg, oscillometric fixed-ratio BP was 99.20±11.90/57.35±7.15 mmHg and oscillometric slope-based algorithm was 91.60±13.94/60.65±7.71 mmHg. Compared to auscultation, the fixed-ratio method differed by 5.80±12.72/6.85±7.51 mmHg (P=0.06 and <0.01) and the slope-based method differed by -1.80±13.59/10.15±8.07 mmHg (P=0.56 and <0.01). Differences from auscultation were statistically significant for diastolic BP with both fixed-ratio and slope-based methods for all age categories but of greatest magnitude in the youngest children.
Oscillometric BP derived using two commonly used algorithms differed by more than 5 mmHg in either systolic BP or diastolic BP from simultaneous auscultatory BP in children aged 2-11. These findings emphasize the need for greater understanding of the functionality and accuracy of oscillometry in children.
儿童自动血压测量的准确性存在不确定性。我们记录了儿童的示波波形，使用两种标准算法得出示波血压，并将结果与同时进行的听诊结果进行比较。
从一家三级医疗儿科肾脏病诊所招募了20名2至12岁的儿童。记录性别、身高、体重、臂围、高血压病史和诊所血压。间隔30 - 60秒同时测量两次示波和听诊血压读数。第一次读数被丢弃，第二次用于分析。使用固定比率和基于斜率的算法进行血压推导。
平均年龄为7.95±2.82岁，40%为女性，平均臂围为21.86±4.06厘米，50%有高血压或高血压病史。所有参与者的平均听诊血压（收缩压±标准差/舒张压±标准差）为93.40±11.80/50.50±9.04 mmHg，示波固定比率血压为99.20±11.90/57.35±7.15 mmHg，基于斜率的示波算法为91.60±13.94/60.65±7.71 mmHg。与听诊相比，固定比率法相差5.80±12.72/6.85±7.51 mmHg（P = 0.06和<0.01），基于斜率的方法相差 -1.80±13.59/10.15±8.07 mmHg（P = 0.56和<0.01）。对于所有年龄组，固定比率法和基于斜率的方法在舒张压与听诊结果的差异均具有统计学意义，但在最年幼的儿童中差异最大。
在2至11岁儿童中，使用两种常用算法得出的示波血压与同时进行的听诊血压相比，收缩压或舒张压相差超过5 mmHg。这些发现强调需要更深入了解儿童示波测量法的功能和准确性。
