If possible, obtain BP measurement during quiet or sleep state.Cuff width to arm (or calf) circumference ratio as indicated on cuff.The preferred site is the right arm however, forearm, calf or thigh may be used providing correct cuff size used.To minimise errors of non-invasive BP measurements, the following guidelines are recommended: Unless the baby has an in-dwelling arterial line, the only reliable and accurate way of measuring blood pressure indirectly is by using the oscillometric method. Refractory hypotension should be treated with a dopamine infusion and occasionally followed by an adrenaline infusion and corticosteroids although the latter should only be administered in a tertiary neonatal intensive care unit (NICU).
The first line of treatment is volume administration with 10-20 mL/kg normal saline, which should be limited to this amount to avoid complications, especially in preterm infants. In general hypotension is often due to a combination of: The recognition and treatment of hypotension is particularly important to avoid complications such as cerebral ischaemic injury or intraventricular haemorrhage. We recommend that you also refer to more contemporaneous evidence in the interim.īlood pressure disorders encountered in neonates, monitoring of blood pressure and normal ranges. Please note that all guidance is currently under review and some may be out of date. BP values increase following birth, with greater rates of increase seen in preterm infants compared with term infants and is primarily the result of an increase in stroke volume Flynn, J.T
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