Perioperative Medicine  |   November 2016
Reference Values for Noninvasive Blood Pressure in Children during Anesthesia: A Multicentered Retrospective Observational Cohort Study
Author Notes
  • From the Department of Anesthesiology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands (J.C.d.G., W.P., J.J.D., W.A.v.K.); Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands (J.C.d.G.); Department of Anesthesia, Sophia Children’s Hospital, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands (J.C.d.G.); Netherlands Organization for Applied Scientific Research TNO, Leiden, The Netherlands (S.v.B.); Department of Methodology and Statistics, FSS, University of Utrecht, Utrecht, The Netherlands (S.v.B.); and Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan (O.O.N., S.K.).
  • Submitted for publication February 5, 2016. Accepted for publication July 7, 2016.
    Submitted for publication February 5, 2016. Accepted for publication July 7, 2016.×
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    Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are available in both the HTML and PDF versions of this article. Links to the digital files are provided in the HTML text of this article on the Journal’s Web site (www.anesthesiology.org).×
  • J.C.d.G. and W.P. contributed equally as co-first authors.
    J.C.d.G. and W.P. contributed equally as co-first authors.×
  • Address correspondence to Dr. de Graaff: Department of Anesthesiology, Mail stop Q04.2.313, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands. j.c.degraaff-3@umcutrecht.nl. Information on purchasing reprints may be found at www.anesthesiology.org or on the masthead page at the beginning of this issue. Anesthesiology’s articles are made freely accessible to all readers, for personal use only, 6 months from the cover date of the issue.
Article Information
Perioperative Medicine / Clinical Science / Cardiovascular Anesthesia / Pediatric Anesthesia
Perioperative Medicine   |   November 2016
Reference Values for Noninvasive Blood Pressure in Children during Anesthesia: A Multicentered Retrospective Observational Cohort Study
Anesthesiology 11 2016, Vol.125, 904-913. doi:10.1097/ALN.0000000000001310
Anesthesiology 11 2016, Vol.125, 904-913. doi:10.1097/ALN.0000000000001310
Abstract

Background: Although noninvasive blood pressure (NIBP) monitoring during anesthesia is a standard of care, reference ranges for blood pressure in anesthetized children are not available. We developed sex- and age-specific reference ranges for NIBP in children during anesthesia and surgery.

Methods: In this retrospective observational cohort study, we included NIBP data of children with no or mild comorbidity younger than 18 yr old from the Multicenter Perioperative Outcomes Group data set. Sex-specific percentiles of the NIBP values for age were developed and extrapolated into diagrams and reference tables representing the 50th percentile (0 SD), +1 SD, −1 SD, and the upper (+2 SD) and lower reference ranges (−2 SD).

Results: In total, 116,362 cases from 10 centers were available for the construction of NIBP age- and sex-specific reference curves. The 0 SD of the mean NIBP during anesthesia varied from 33 mmHg at birth to 67 mmHg at 18 yr. The low cutoff NIBP (2 SD below the 50th percentile) varied from 17 mmHg at birth to 47 mmHg at 18 yr old.

Conclusions: This is the first study to present reference ranges for blood pressure in children during anesthesia. These reference ranges based on the variation of values obtained in daily care in children during anesthesia could be used for rapid screening of changes in blood pressure during anesthesia and may provide a consistent reference for future blood pressure–related pediatric anesthesia research.