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The accuracy of blood pressure measured by arterial line and non-invasive cuff in critically ill children

Overview of attention for article published in Critical Care, June 2016
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (87th percentile)
  • Average Attention Score compared to outputs of the same age and source

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22 tweeters
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1 Facebook page

Citations

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15 Dimensions

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45 Mendeley
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Title
The accuracy of blood pressure measured by arterial line and non-invasive cuff in critically ill children
Published in
Critical Care, June 2016
DOI 10.1186/s13054-016-1354-x
Pubmed ID
Authors

Rachel Joffe, Jonathan Duff, Gonzalo Garcia Guerra, Jodie Pugh, Ari R. Joffe

Abstract

The accuracy of arterial lines (AL) using the flush test or stopcock test has not been described in children, nor has the difference between invasive arterial blood pressure (IABP) versus non-invasive cuff (NIBP) blood pressure. After ethics approval and consent, we performed the flush test and stopcock test on AL (to determine over damping, under damping, and optimal damping), and determined the difference (NIBP-IABP) in systolic, diastolic, and mean blood pressure (ΔSBP, ΔDBP, and ΔMAP). The primary outcome was incidence (95 % CI) of optimally damped AL. Predictors of ΔBP (effect size (95 % CI)) were determined using multiple linear regression. There were 147 AL tests in 100 enrolled patients with mean age 44.7 (SD 56) months, weight 16.8 (SD 18.3) kg, male 59 %, postoperative-cardiovascular 52 %, peripheral-AL 78 %, inotropes 29 %, vasodilators 15 %, and ventilated 73 %. The flush test performed in 66 patients (45 %) showed optimal damping in 30 (46 %; 95 % CI 34, 57 %), over damping in 25 (38 %) and under damping in 11 patients (17 %). The stopcock test was over-damped in 128/146 patients (88 %), with the same damping as the flush test in 24/64 (38 %). In optimally damped (flush test) AL, ΔSBP, ΔDBP, and ΔMAP were 0.8 (SD 12.2), -5.2 (SD 8.7), and -4.9 (7.6) respectively. A second set of AL tests was done 2 h later on the same day in 62 patients; AL damping often changed (10/28 flush tests) and ΔBPs correlated poorly (r = 0.31-0.55). Predictors (effect size) of ΔDBP were vasodilator infusion (15.6 (2.9 to 28.3); p = 0.016) and optimal damping (-7.2 (-12.2 to 2.2); p = 0.005); and of ΔMAP were vasodilator infusion (10.0 (-0.3 to 20.4); p = 0.057) and optimal damping (-4.0 (-8 to 0.1); p = 0.058). There were no independent predictors of damping category (n = 66 flush tests). Optimally damped AL occur in half of critically ill children, and this is not predictable. There is much variability in ∆BP between NIBP and the gold standard IABP, and this varies even in the same patient on the same day, and is not easily predictable. In critically ill children, NIBP may not be accurate enough to guide management, and more attention to ensuring the AL is optimally damped is needed.

Twitter Demographics

The data shown below were collected from the profiles of 22 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 45 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Italy 2 4%
Unknown 43 96%

Demographic breakdown

Readers by professional status Count As %
Researcher 8 18%
Other 7 16%
Student > Bachelor 6 13%
Student > Postgraduate 5 11%
Student > Master 4 9%
Other 11 24%
Unknown 4 9%
Readers by discipline Count As %
Medicine and Dentistry 24 53%
Nursing and Health Professions 8 18%
Engineering 2 4%
Agricultural and Biological Sciences 2 4%
Biochemistry, Genetics and Molecular Biology 1 2%
Other 1 2%
Unknown 7 16%

Attention Score in Context

This research output has an Altmetric Attention Score of 13. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 21 June 2016.
All research outputs
#1,246,689
of 14,079,161 outputs
Outputs from Critical Care
#1,231
of 4,432 outputs
Outputs of similar age
#32,288
of 265,217 outputs
Outputs of similar age from Critical Care
#38
of 76 outputs
Altmetric has tracked 14,079,161 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 91st percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 4,432 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 14.9. This one has gotten more attention than average, scoring higher than 72% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 265,217 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 87% of its contemporaries.
We're also able to compare this research output to 76 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 50% of its contemporaries.