Pellegrini-Caliumi G, Agostino R, Nodari S, Maffei G, Moretti C, Bucci G
Acta Paediatr Scand. 1982 Sep;71(5):791-7. doi: 10.1111/j.1651-2227.1982.tb09521.x.
We compared simultaneous measurement of aortic, direct (Dir) and of indirect (Ind) systolic (S), mean (M) and diastolic (D) arterial pressure (AP) determined by an automatic oscillometric instrument (DINAMAP) in neonates with birthweight of 1000-3680 g. DINAMAP measurements were performed with cuffs of increasing width and length, recommended by the manufacturer for increasing arm circumference, and with a Standard sized cuff (2.5 X 15 cm), previously considered as suitable for neonates of any body size. In addition, we compared simultaneous measurements of Dir SAP and of Ind SAP determined by a Doppler technique and the Standard cuff. In DINAMAP SAP measurements with the Standard cuff, a statistically significant correlation between arm circumference and delta Ind-Dir SAP values (i.e. the difference between simultaneous Ind and Dir SAP measurements) was found. In DINAMAP MAP measurements with the cuff recommended for arm circumference, a statistically significant difference of the mean delta Ind-Dir MAP values was observed in infants whose arm was or was not completely encircled by the bladder of the cuff. In SAP as well as in MAP DINAMAP determinations, the overall error of measurement with the Standard cuff was smaller than with the recommended cuff. The Doppler method was found considerably more accurate than the DINAMAP method for the determination of SAP. In spite of these limitations, the DINAMAP method with the Standard cuff was considered to be reasonably accurate for the clinical determination of SAP and MAP, provided that several consecutive measurements are performed and averaged in order to minimize the error of measurement. When considering DAP measurements the error was so unacceptably high that the DINAMAP method cannot be recommended for clinical use. The need for a careful consideration of the cuff characteristics when evaluating new methods for the indirect measurement of AP in the neonate is emphasized.
我们比较了使用自动示波仪（DINAMAP）对出生体重为1000 - 3680克的新生儿同时测量主动脉、直接（Dir）和间接（Ind）收缩压（S）、平均压（M）和舒张压（D）的动脉压（AP）。DINAMAP测量使用了宽度和长度不断增加的袖带，这是制造商推荐用于增加臂围的，还使用了标准尺寸袖带（2.5×15厘米），该袖带先前被认为适用于任何体型的新生儿。此外，我们比较了通过多普勒技术和标准袖带同时测量的Dir收缩期动脉压（SAP）和Ind SAP。在使用标准袖带进行DINAMAP的SAP测量中，发现臂围与Ind - Dir SAP值差值（即同时进行的Ind和Dir SAP测量之间的差异）存在统计学显著相关性。在使用推荐用于臂围的袖带进行DINAMAP平均动脉压（MAP）测量时，观察到袖带气囊完全或未完全环绕手臂的婴儿中，平均Ind - Dir MAP值存在统计学显著差异。在SAP以及MAP的DINAMAP测定中，使用标准袖带的总体测量误差小于使用推荐袖带的误差。发现多普勒方法在测定SAP方面比DINAMAP方法准确得多。尽管有这些局限性，但如果进行几次连续测量并取平均值以尽量减少测量误差，使用标准袖带的DINAMAP方法在临床测定SAP和MAP方面被认为具有合理的准确性。当考虑舒张压（DAP）测量时，误差高得令人无法接受，以至于不推荐将DINAMAP方法用于临床。强调在评估新生儿动脉压间接测量新方法时需要仔细考虑袖带特性。
