This page is part of the 10N-Matrix for a high quality conduct of pediatric anesthesia.
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Definition
Maintenance of expected systemic blood pressure within a normal range of the patient (age dependent).
So far the lower limits of acceptable perioperative blood pressure are suggested to be above the 5th percentile range of age dependent normal systolic blood pressure values. In premature neonates the mean arterial blood pressure should correspond to the post-conceptional age. However, there are no international consensus definitions of safe values of systemic blood pressure in children during anesthesia.
Importance
Deviations from patient specific norms may result in physiologically and clinically relevant impairments of organ and tissue perfusions.
Consequences
A significant change from pre-operatively measured systemic blood pressure values is frequently observed. Deviations can lead to inadequate organ perfusion and damage.
Prevention and treatment
Strive to achieve sufficient organ perfusion:
- measure blood pressure correctly and promptly
- measure blood pressure regularly and increase frequency when indicated
- consider inaccuracy and limitations of non-invasive blood pressure measurements
- maintain normovolemia and normal heart rate
- appropriate dosing of drugs
- compensate for sympathomimetic loss and consider use of vasoactive drugs
- consider monitoring perfusion by alternative means
- consider the potential inaccuracy and limitations of the measuring device and method
- avoid large fluctuations of blood pressure
Further reading
- coming soon…
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- No Fear / No Awareness
- Normovolemia
- Normotension
- Normal Heart Rate
- Normoxemia
- Normocapnia
- Normonatremia
- Normoglycemia
- Normothermia
- No Postoperative Discomfort:
- No Pain
- No PONV
- No Emergence Delirium