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Neonatal blood pressure monitoring: visual assessment is an unreliable method for selecting cuff sizes
Author(s) -
Devinck A,
Keukelier H,
Savoye I,
Desmet L,
Smets K
Publication year - 2013
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.12328
Subject(s) - cuff , medicine , forearm , circumference , visual inspection , upper limb , surgery , statistics , mathematics , geometry
Aim To compare current practice of cuff size selection for noninvasive blood pressure measurement in a single‐centre, tertiary‐level neonatal intensive care unit (visual assessment of bladder width/limb length closest to 2/3) with common recommendations for appropriate cuff selection. Methods Visual assessment of the appropriate cuff size (‘2/3 rule’) for upper arm, forearm and calf in 103 neonates (309 cuff selections) was compared with the following recommendations: (i) Method A – guidelines of the cuff manufacturer, (ii) Method B – cuff width/limb circumference ratio 0.44–0.60 and (iii) Method C – cuff width/limb length ratio closest to 0.66. Results The upper arm cuff size was correctly chosen in 84% of cases (Method A), 43% (Method B) and 56% (Method C). The forearm cuff size was correctly chosen in 94% of cases (Method A), 68% (Method B) and 54% (Method C). The calf cuff size was correctly chosen in 96% of cases (Method A), 72% (Method B) and 63% (Method C). Conclusion The accuracy of selecting cuff size by visual assessment is low. Further research on accurate cuff selection for neonates, including at the forearm and calf, is warranted.