Feasibility of noninvasive continuous finger arterial blood pressure measurements in very young children, aged 0-4 years.

Our goal was to study the feasibility of continuous noninvasive finger blood pressure (BP) monitoring in very young children, aged 0-4 y. To achieve this, we designed a set of small-sized finger cuffs based on the assessment of finger circumference. Finger arterial BP measured by a volume clamp device (Finapres technology) was compared with simultaneously measured intra-arterial BP in 15 very young children (median age, 5 mo; range, 0-48), admitted to the intensive care unit for vital monitoring. The finger cuff-derived BP waveforms showed good resemblance with the invasive arterial waveforms (mean root-mean-square error, 3 mm Hg). The correlation coefficient between both methods was 0.79 +/- 0.19 systolic and 0.74 +/- 0.24 diastolic. The correlation coefficient of beat-to-beat changes between both methods was 0.82 +/- 0.18 and 0.75 +/- 0.21, respectively. Three measurements were related to measurement errors (loose cuff application; wrong set-point). Excluding these erroneous measurements resulted in clinically acceptable measurement bias (-3.8 mm Hg) and 95% limits of agreement (-10.4 to + 2.8 mm Hg) of mean BP values. We conclude that continuous finger BP measurement is feasible in very young children. However, cuff application is critical, and the current set-point algorithm needs to be revised in very young children.