Correlation between invasive and noninvasive blood pressure measurements in severely burned children

Janos Cambiaso-Daniel; Victoria G Rontoyanni; Guillermo Foncerrada; Anthony Nguyen; Karel D Capek; Paul Wurzer; Jong O Lee; Gabriel Hundeshagen; Charles D Voigt; Ludwik K Branski; Celeste C Finnerty; David N Herndon

doi:10.1016/j.burns.2018.03.001

Correlation between invasive and noninvasive blood pressure measurements in severely burned children

Burns. 2018 Nov;44(7):1787-1791. doi: 10.1016/j.burns.2018.03.001. Epub 2018 Aug 25.

Authors

Affiliations

¹ Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children, Galveston, TX USA; Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Austria. Electronic address: janos.cambiaso-daniel@medunigraz.at.
² Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children, Galveston, TX USA; Metabolism Unit, Shriners Hospitals for Children, Galveston, TX, USA. Electronic address: virodoyi@utmb.edu.
³ Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children, Galveston, TX USA. Electronic address: gffoncer@utmb.edu.
⁴ School of Medicine, University of Texas Medical Branch, Galveston, TX, USA. Electronic address: antvnguy@utmb.edu.
⁵ Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children, Galveston, TX USA. Electronic address: kdcapek@utmb.edu.
⁶ Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Austria. Electronic address: paul.wurzer@medunigraz.at.
⁷ Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children, Galveston, TX USA. Electronic address: jolee@utmb.edu.
⁸ Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children, Galveston, TX USA; Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Department of Plastic Surgery, University of Heidelberg, Ludwigshafen, Germany. Electronic address: gahundes@utmb.edu.
⁹ Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children, Galveston, TX USA. Electronic address: CharlesVoigt@creighton.edu.
¹⁰ Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children, Galveston, TX USA; Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Austria. Electronic address: lubransk@utmb.edu.
¹¹ Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children, Galveston, TX USA; Institute for Translational Sciences, University of Texas Medical Branch, Galveston, TX, USA. Electronic address: ccfinner@utmb.edu.
¹² Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children, Galveston, TX USA. Electronic address: dherndon@utmb.edu.

Abstract

Introduction: Accurate blood pressure monitoring is essential for burn management, with the intra-arterial line method being the gold standard. Here we evaluated agreement between cuff and intra-arterial line methods.

Methods: Data from burned children admitted from 1997 to 2016 were retrospectively reviewed. Simultaneously collected intra-arterial and cuff measurements were cross-matched and linear regression performed to assess agreement for systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP).

Results: We identified 9969 matches for SBP, DBP, and MAP in 872 patients (579 male) aged 8±5years with burns covering 52±20% of the total body surface area and a hospitalization lasting 33±31 days. Intra-arterial lines had a complication rate of 1%. The mean bias (95% CI) between methods was 1.3 (0.5, 2.1) mm Hg for SBP, -6.4 (-7.0, -5.7) mmHg for DBP, and -5.8 (-6.4, -5.3) mmHg for MAP. The standard deviation of the bias (95% limit of agreement) was 12.1 (-22.5, 25.1) mmHg for SBP, 9.9 (-25.8, 13.0) mmHg for DBP, and 8.7 (-22.8, 11.1) mmHg for MAP.

Conclusions: Cuff measurements vary widely from those of intra-arterial lines, which have a low complication rate. Intra-arterial lines are advisable when tight control of the hemodynamic response is essential.

Keywords: Arterial line; Critical care; Cuff pressure; Intensive care unit; Monitoring.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Arterial Pressure*
Blood Pressure Determination / methods*
Burns*
Catheterization, Peripheral*
Child
Child, Preschool
Female
Humans
Hypertension / diagnosis*
Hypotension / diagnosis*
Male
Trauma Severity Indices

Abstract

Publication types

MeSH terms

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