Risk of over-diagnosis of hypotension in children: a comparative analysis of over 50,000 blood pressure measurements
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Maintaining a ‘normal’ blood pressure (BP) and avoiding hypotension are key goals in critically ill children . Invasive arterial blood pressure (IABP) and non-invasive oscillometric blood pressure (NIBP) measurements are typically used interchangeably despite reports of bias and lack of precision [2, 3, 4, 5].
We compared concurrently recorded IABP and NIBP in two paediatric intensive care units (PICUs). Data were collected from two sources: (1) the electronic health record (EHR) (Intellivue Critical Care and Anaesthesia, Philips Electronics, Netherlands), typically recorded each hour (April 2009–October 2015 from one PICU; April 2012–December 2015 from the other), and (2) from the Etiometry T3 (Etiometry, Boston, MA, USA) system, recorded directly from the patient’s bedside monitor at 5-s intervals (June 2015–June 2016) in one PICU. While concurrence of measurement is assumed from EHR data, this is guaranteed using high-resolution monitor data.
After exclusion of...
KeywordsSystolic Blood Pressure Diastolic Blood Pressure Linear Regression Model Paediatric Intensive Care Unit Electronic Health Record
No direct funding was received for this study. Part of this work was undertaken at UCL GOS Institute of Child Health, which received a proportion of funding from the Department of Health’s NIHR Biomedical Research Centre’s funding scheme.
SR, MJP, SN and DPI conceived and designed the study; SR, LR, RD and DPN collected and verified the data; SR and LR analysed the data; SR, MJP and DPI drafted the manuscript, and all authors contributed to and approved the final version of the manuscript.
Compliance with ethical standards
Ethical approval and consent to participate
Ethical approval was not sought as we used routinely collected clinical data retrospectively. Consent to participate was not sought as this is a retrospective observational study and no patient-identifiable data are presented.
Consent to publish
Consent was not sought as no patient-identifiable data are reported.
Availability of data and materials
The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.
Conflicts of interest
The authors declare that they have no conflict of interest.