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Am J Perinatol 2024; 41(S 01): e1756-e1758
DOI: 10.1055/a-2071-3145
Short Communication

Variation between Clinician-Recorded and Downloaded Invasive Blood Pressure in Extremely Preterm Infants

Sujith S. Pereira 
1   Neonatal Unit, Homerton University Hospital, Homerton Healthcare National Health Services Foundation Trust, London, United Kingdom
2   Centre for Genomics and Child Health, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom
,
Ajay K. Sinha
2   Centre for Genomics and Child Health, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom
3   Neonatal Unit, Royal London Hospital, Bart's Health National Health Services Trust, London, United Kingdom
,
Divyen K. Shah
3   Neonatal Unit, Royal London Hospital, Bart's Health National Health Services Trust, London, United Kingdom
4   Centre for Neuroscience and Trauma, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom
,
Stephen T. Kempley
2   Centre for Genomics and Child Health, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom
› Author Affiliations
Funding The study was supported by fundraising by parents of our neonatal patients, administered by Barts Charity (registered charity number: 212563).
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Abstract

Objective This study aimed to examine the variation between clinician-recorded and continuously downloaded invasive blood pressure (BP).

Study Design Prospective study where invasive BP data were downloaded every 10 seconds for the first week of life. Hourly clinician-recorded BP was recorded. Agreement between the two methods were examined.

Results A total of 1,180 BP measurements were examined from 42 preterm infants with a mean (standard deviation [SD]) gestation and birthweight of 25.7 weeks (1.4) and 802 g (177) respectively. The mean (SD) bias was −0.11 mm Hg (3.17), but the 95% limits of agreement (LOA) varied between −6.3 and +6.1 mm Hg. Inotrope usage was significantly higher for BP measurements that fell in the 5% outliers when compared with those that fell within the 95% LOA (62.7 vs. 44.6%, p = 0.006).

Conclusion Clinicians showed no systematic bias to over- or underrecord BP, but some of the greatest differences were found in infants receiving inotropes.

Key Points

  • BP is a commonly recorded cardiovascular parameter in the neonatal intensive care unit.

  • Invasively measured BP remains the gold standard.

  • Clinician-recorded BP showed no systematic bias in over-or underrecording invasive BP.

Keywords

blood pressure - variation - continuously downloaded - clinician-recorded

Clinical Trial Registration

This study is registered with the Clinical Trial Registration (identifier: ISRCTN 83507686).




Publication History

Received: 01 January 2023

Accepted: 04 April 2023

Accepted Manuscript online:
11 April 2023

Article published online:
11 May 2023

© 2023. Thieme. All rights reserved.

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