Kim Soo Hyun, Jung Euiseok, Han Hyo Myung, Lee Ka Young, Lee Sookyoung, Heo Eun A, Kim Min-Ju, Lee Jung-Bok, Lee Byong Sop, Kim Ellen Ai-Rhan, Kim Ki-Soo
Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea.
Department of Pediatric Nursing, Asan Medical Center Children's Hospital, Seoul, Korea.
J Perinatol. 2025 Sep 9. doi: 10.1038/s41372-025-02415-w.
To quantify agreement between oscillometric non-invasive blood pressure (NIBP) and invasive arterial blood pressure (IBP) in infants <500 g during the first postnatal week.
Retrospective cohort of infants with a birth weight <500 g admitted to a tertiary NICU (2011-2023). Paired IBP-NIBP readings obtained within 1 min were analyzed. Bland-Altman plots quantified bias and 95% limits of agreement for systolic (SBP), diastolic (DBP) and mean arterial pressure (MAP).
Thirty-six infants (median gestation of 26.2 weeks) contributed 337 paired measurements. Mean (±SD) IBP vs. NIBP were 47.3 ± 10.4 vs. 49.4 ± 9.3 mm Hg (SBP), 29.2 ± 7.0 vs. 28.3 ± 8.2 mm Hg (DBP) and 35.1 ± 7.7 vs. 35.2 ± 7.9 mm Hg (MAP). Mean bias was +2.1 ± 6.8 mm Hg (SBP), -0.9 ± 6.7 mm Hg (DBP) and +0.1 ± 5.4 mm Hg (MAP), satisfying AAMI/ESH/ISO criteria (≤5 mm Hg mean difference, ≤8 mm Hg SD). Bias remained <3 mm Hg without inotropes; MAP bias rose to +1.3 mm Hg with inotropic support.
Oscillometric NIBP compared to IBP provided acceptable agreement in hemodynamically stable neonates <500 g. Whereas, invasive arterial monitoring remains preferable in unstable neonates.
量化出生后第一周内体重<500g婴儿的示波法无创血压（NIBP）与有创动脉血压（IBP）之间的一致性。
对一所三级新生儿重症监护病房（2011 - 2023年）收治的出生体重<500g的婴儿进行回顾性队列研究。分析在1分钟内获得的配对IBP - NIBP读数。Bland - Altman图量化了收缩压（SBP）、舒张压（DBP）和平均动脉压（MAP）的偏差及95%一致性界限。
36名婴儿（中位孕周26.2周）贡献了337对测量值。IBP与NIBP的均值（±标准差）分别为47.3 ± 10.4与49.4 ± 9.3mmHg（SBP）、29.2 ± 7.0与28.3 ± 8.2mmHg（DBP）以及35.1 ± 7.7与35.2 ± 7.9mmHg（MAP）。平均偏差为+2.1 ± 6.8mmHg（SBP）、-0.9 ± 6.7mmHg（DBP）和+0.1 ± 5.4mmHg（MAP），满足美国医疗器械促进协会/欧洲高血压学会/国际标准化组织标准（平均差值≤5mmHg，标准差≤8mmHg）。在未使用血管活性药物时偏差仍<3mmHg；在使用血管活性药物支持时MAP偏差升至+1.3mmHg。
对于体重<500g血流动力学稳定的新生儿，示波法NIBP与IBP相比具有可接受的一致性。然而，对于不稳定的新生儿，有创动脉监测仍是更可取的。
