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Neonatal blood pressure monitoring: visual assessment is an unreliable method for selecting cuff sizes

(2013) ACTA PAEDIATRICA. 102(10). p.961-964
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Abstract
Aim: To compare current practice of cuff size selection for non-invasive 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: 1) Method A - guidelines of the cuff manufacturer, 2) Method B - cuff width/limb circumference ratio 0.44-0.60 and 3) 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.
Keywords
non-invasive, oscillometric method, Blood pressure measurement, newborn, OSCILLOMETRIC TECHNIQUE, BIRTH-WEIGHT, ARM, RECOMMENDATIONS, NEWBORNS, PRETERM, INFANTS, TERM

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MLA
Devinck, Astrid, Hilde Keukelier, Isabelle De Savoye, et al. “Neonatal Blood Pressure Monitoring: Visual Assessment Is an Unreliable Method for Selecting Cuff Sizes.” ACTA PAEDIATRICA 102.10 (2013): 961–964. Print.
APA
Devinck, A., Keukelier, H., De Savoye, I., Desmet, L., & Smets, K. (2013). Neonatal blood pressure monitoring: visual assessment is an unreliable method for selecting cuff sizes. ACTA PAEDIATRICA, 102(10), 961–964.
Chicago author-date
Devinck, Astrid, Hilde Keukelier, Isabelle De Savoye, Lynn Desmet, and Koenraad Smets. 2013. “Neonatal Blood Pressure Monitoring: Visual Assessment Is an Unreliable Method for Selecting Cuff Sizes.” Acta Paediatrica 102 (10): 961–964.
Chicago author-date (all authors)
Devinck, Astrid, Hilde Keukelier, Isabelle De Savoye, Lynn Desmet, and Koenraad Smets. 2013. “Neonatal Blood Pressure Monitoring: Visual Assessment Is an Unreliable Method for Selecting Cuff Sizes.” Acta Paediatrica 102 (10): 961–964.
Vancouver
1.
Devinck A, Keukelier H, De Savoye I, Desmet L, Smets K. Neonatal blood pressure monitoring: visual assessment is an unreliable method for selecting cuff sizes. ACTA PAEDIATRICA. 2013;102(10):961–4.
IEEE
[1]
A. Devinck, H. Keukelier, I. De Savoye, L. Desmet, and K. Smets, “Neonatal blood pressure monitoring: visual assessment is an unreliable method for selecting cuff sizes,” ACTA PAEDIATRICA, vol. 102, no. 10, pp. 961–964, 2013.
@article{4148280,
  abstract     = {Aim: To compare current practice of cuff size selection for non-invasive 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: 1) Method A - guidelines of the cuff manufacturer, 2) Method B - cuff width/limb circumference ratio 0.44-0.60 and 3) 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.},
  author       = {Devinck, Astrid and Keukelier, Hilde and De Savoye, Isabelle and Desmet, Lynn and Smets, Koenraad},
  issn         = {0803-5253},
  journal      = {ACTA PAEDIATRICA},
  keywords     = {non-invasive,oscillometric method,Blood pressure measurement,newborn,OSCILLOMETRIC TECHNIQUE,BIRTH-WEIGHT,ARM,RECOMMENDATIONS,NEWBORNS,PRETERM,INFANTS,TERM},
  language     = {eng},
  number       = {10},
  pages        = {961--964},
  title        = {Neonatal blood pressure monitoring: visual assessment is an unreliable method for selecting cuff sizes},
  url          = {http://dx.doi.org/10.1111/apa.12328},
  volume       = {102},
  year         = {2013},
}

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