Determinação da pressão arterial pelo Método do “flush” em recém-nascidos: estudo comparativo com métodos Doppler, oscilométrico e Oximetria de pulso

• Ano de defesa: 2008
• Autor(a) principal: Ribeiro, Manoel Antonio da Silva
• Orientador(a): Fiori, Renato Machado
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Pontifícia Universidade Católica do Rio Grande do Sul; Porto Alegre
• Palavras-chave em Português: MEDICINA; PEDIATRIA; RECÉM-NASCIDO; PRESSÃO SANGUÍNEA; HIPOTENSÃO; DIAGNÓSTICO CLÍNICO
• Link de acesso: http://hdl.handle.net/10923/4735

BACKGROUND: There are few studies, none blinded, on noninvasive blood pressure (BP) measurements in infants with the flush and pulse oximetry methods. Doppler ultrasound has been considered the standard technique for noninvasive BP in infants. OBJECTIVE: To compare blood pressure determined by the flush, pulse oximetry and oscillometry methods with that measured by Doppler ultrasound. METHODS: Blood pressure measurements were sequentially obtained in healthy full-term, stable preterm, and critically ill infants. All measurements were videotaped, edited separately, codified, and independently analyzed by three neonatologists. RESULTS: A total of 57 measurements were performed in 44 newborns infants. The flush method and oximetry showed better correlation with Doppler ultrasound than oscillometry (correlation coefficient of 0. 89, 0. 85 and 0. 71, respectively, P<0. 01). The mean difference±SD and CI95% regarding the measurements taken by the Doppler ultrasound was – 5. 2±7. 9 (-21. 1 to 10. 7) mmHg for the flush method, 0. 4±8. 9 (-17. 5 to 18. 2) mmHg for pulse oximetry, and 6. 4±16. 1 (-25. 8 to 8. 6) mmHg for oscillometry. The flush showed better sensitivity than both oximetry and oscillometry methods for hypotension diagnosis (P< 0. 002). CONCLUSIONS: The flush and pulse oximetry methods are reliable and appropriate techniques to measure BP in newborns in NICU, and the flush seems more accurate to detect hypotension than the oscillometric method.