BLOOD PRESSURE MONITORING IN NEONATES: COMPARISON OF UMBILICAL AND PERIPHERAL ARTERY PRESSURE MEASUREMENTS

Abstract

Continuous monitoring of blood pressure is now an integral part of modern neonatal intensive care. The most widely practised method is via an indwelling umbilical arterial catheter for which normal values have been established.In the last few years peripheral artery cannulation has become an increasingly popular technique. Maintenance of blood pressure with volume expansion & inotropes is becoming increasingly recognised as important in the overall management of infants in neonatal intensive care units. As such it is of paramount importance to know whether the normal values established for umbilical arterial catheters can be used for peripheral arterial measurements.Infants of varying gestational ages (26-39wks), weights (740-3200g) & post-delivery age (days 1-7) with both umbilical & peripheral arterial catheters in place were available for study. (Usually infants with necrotising enterocolitis having an umbilical catheter replaced with a peripheral arterial catheter - radial/tibial). 34 simultaneous pressure recordings were done in 11 infants. There was an excellent correlation between the 2 recordings r=0.98 for systolic + r=0.97 for diastolic pressures. Therefore, normal pressure graphs obtained by umbilical arterial pressure measurements are applicable for peripheral arterial catheters.