Blood pressure reference values

Course of blood pressures during neonates’ first week of life in the NICU

Instructions

We have estimated reference ranges for the blood pressure of neonates. To find the appropriate range of blood pressure values for a child, please enter his / her gestational age and postnatal age. These reference values are only applicable to neonates admitted to NICU


Type P02.3 P16 Median P84 P97.7
Mean BP
Systolic BP
Diastolic BP

Developed by:

Sten Willemsen
Accompanying: Arjan C. van Zadelhoff*, Jarinda A. Poppe*, Sten Willemsen, Katya Mauff, Willem van Weteringen, Tom G. Goos, Irwin K.M. Reiss, Marijn J. Vermeulen, Jurgen C. de Graaff. Course of blood pressures during neonates’ first week of life in the NICU; development of model and interactive website. Submitted.

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Abstract:

Background: Blood pressure measurements are important to monitor the neonate’s vital function and values are known to be dependent of gestational and postnatal age. The present reference ranges for mean blood pressure in neonates have been derived from small sample sizes and combined data of non-invasive and invasive blood pressure measurements. We aimed to define reference values for non-invasive mean, systolic, and diastolic blood pressure during the first week of life in otherwise healthy preterm and term neonates defined by gestational and postnatal age.

Methods:strong> In this retrospective cohort study in Neonatal intensive care unit in a Dutch tertiary paediatric hospital we included neonates admitted between 2016-2018, with exclusion of those with severe comorbidities (major cardiac malformations, intracerebral haemorrhage, and intubation longer than 6h). We defined the median (P50) with -2SD (P2.3), -1SD (P16), +1SD (P84) and +2SD (P97.7) for gestational age and postnatal age using quantile regression and provide percentiles online on an interactive website: http://bloodpressure-neonate.com/.

Results: A total of 607 neonates, with 5885 measurements, fulfilled the inclusion criteria. The P50 of mean blood pressure in the extreme preterm infants steeply increase during the first day after birth and gradually increased within a week from 27 to 49 mmHg at 24 gestational age and from 49 to 61 mmHg at 41 weeks gestational age.

Conclusions: The presented reference values for blood pressure in neonates in the NICU for various gestational age groups may guide clinical decision making in healthy and diseased neonates during anaesthesia and sedation.