Comparison of Arm and Calf Automatic Noninvasive Blood Pressures in Pediatric Intensive Care Patients

The purpose of this study was to compare upper arm and calf automatic blood pressures (BPs) in a convenience sample of 221 children, ages 1 to 8 years, admitted to a pediatric intensive care unit of a 180-bed teaching hospital in the Mid-Atlantic region of the United States. Subjects were positioned in bed, with the head of bed elevated 30° and extremities resting on the bed. BP cuff size was based on arm and calf circumferences. BPs were measured simultaneously using bedside and portable Spacelabs monitors. Calf BPs were greater than arm BPs in approximately 73% of the sample. Paired t tests show statistically significant differences for systolic BPs and mean arterial pressures. Influence of demographics, agitation levels, medical diagnoses, and current medications was explored. Calf and arm BPs were not interchangeable in acutely ill children, ages 1 to 8 years.