CONTINUOUS NONINVASIVE FINGER BLOOD-PRESSURE MONITORING IN CHILDREN

We evaluated the performance of continuous non-invasive finger arteria l pressure measurement using the volume-clamp technique (Finapres). Th e study was designed to compare finger arterial pressure with brachial blood pressure estimated by the auscultatory method in 217 children ( 90 bays and 127 girls) aged 4-16 years and in 38 adults (aged 18-45 ye ars). Finger and brachial artery pressure readings were obtained conse cutively from the ipsilateral side in the supine position. Finger arte rial pressure waveforms were recorded in all children except 4 with sm all and thin fingers. There was good agreement for systolic pressure w ith only a slight underestimation of 1.9 mmHg and 5.1 mmHg lower for d iastolic pressure. This difference most probably reflects inaccuracy o f the auscultatory cuff method rather than an error in the Finapres. T here was large inter-individual variability in Finapres recordings whi ch might be due to differences in vasomotor tone, as demonstrated by s ystolic amplification in 5 patients with anorexia. However, Finapres s howed a small within-subject variability (3.8 mmHg for systolic and 4. 1 mmHg for diastolic pressure) determined in 5 patients during phenyle phrine infusion, and as good reproducibility as the auscultatory metho d. These results suggest that finger arterial pressure measurement in children older than 6 years of age has similar accuracy as that in adu lts, and that this method is useful for clinical applications in child ren, especially for the non-invasive evaluation of autonomic control a nd cardiovascular reflexes involving transient and rapid blood pressur e changes.