Automated blood pressure measurement in children.

: Techniques to measure blood pressure are even more complicated in children and particularly in infants as in adults, since appropriate cuff sizes and special reference values are necessary. In pediatric patients oscillometry is the automated method of choice and is in use since more than 15 years (Dinamap). Recently, ambulatory blood pressure measurement (ABPM) with an oscillometric device (SpaceLabs) has become a valuable too in the diagnosis and therapeutic monitoring of arterial hypertension of children and adolescents. Normal casual blood pressure measurements have been studied in large studies demonstrating an increase of systolic and diastolic blood pressure with age, or even more with body height. These reference values are not applicable to evaluate ABPM. Recent studies in single centers as well as a multicenter study (of 1141 participants) have provided pediatric reference values for ABPM. Daytime mean systolic blood pressure increased with height from 111 to 120 mm Hg in girls (body height 120 to 180 cm) as well as in boys from 112 to 124 mm Hg. However, daytime mean diastolic blood pressure did not change during maturation and was 72 to 74 mm Hg irrespective of height and sex. The upper normal values (95th percentile) were 13-15 mm Hg above the mean. Since there is a striking difference between normal casual blood pressure and normal ABPM in children, it is essential to use appropriate blood pressure references.