SynthesisCritical care (London, England)2019
A comparison of clinical paediatric guidelines for hypotension with population-based lower centiles: a systematic review.
Synthesis in Critical care (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Paediatric neuromuscular scoliosis and post-operative blood pressure targets: a retrospective analysis.Spine deformity · 2026Article
- Respiratory Therapy Peculiarities for Acute Respiratory Distress Syndrome in Children with Sepsis: A Narrative Review.Medical journal of the Islamic Republic of Iran · 2026Review
- Management of arterial hypotension in critically Ill children: a narrative review and practical approach.Frontiers in pediatrics · 2026Review
- Provider Perspectives on the Role of Hypotension in Pediatric Kidney Transplant: A Pediatric Nephrology Research Consortium Study.Pediatric transplantation · 2025Article
- Association of Dynamic Arterial Elastance With Fluid Responsiveness in Critically Ill Children.Critical care explorations · 2025Observational
- Predicting Peri-Operative Cardiorespiratory Adverse Events in Children with Idiopathic Pulmonary Arterial Hypertension Undergoing Cardiac Catheterization Using Echocardiography: A Cohort Study.Pediatric cardiology · 2025Article
- Anthracycline-induced hypertension in pediatric cancer survivors: unveiling the long-term cardiovascular risks.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2024Review
- Pediatric Sepsis in General Emergency Departments: Association Between Pediatric Sepsis Case Volume, Care Quality, and Outcome.Annals of emergency medicine · 2024Article
- c4c: Paediatric pharmacovigilance: Methodological considerations in research and development of medicines for children - A c4c expert group white paper.British journal of clinical pharmacology · 2022Review
- Monitoring oral propranolol for infantile hemangiomata.Dermatologic therapy · 2022Article
- Shock Index in the early assessment of febrile children at the emergency department: a prospective multicentre study.Archives of disease in childhood · 2022Observational
- [Paediatric Life Support].Notfall & rettungsmedizin · 2021Review
- Intramuscular ketamine provides better sedation and scan conditions in children undergoing magnetic resonance imaging: A single-blinded observational study.Journal of neurosciences in rural practiceArticle
- Assessment of Intraoperative Hemodynamics and Recovery Characteristics in Pediatric Patients Receiving Buprenorphine and Propofol Anesthesia for Cleft Palate Surgery: A Prospective Observational Study.Anesthesia, essays and researchesArticle
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDifferent definitions exist for hypotension in children. In this study, we aim to identify evidence-based reference values for low blood pressure and to compare these with existing definitions for systolic hypotension.
methodsWe searched online databases until February 2019 (including MEDLINE, EMBASE, Web of Science) using a comprehensive search strategy to identify studies that defined age-related centiles (first to fifth centile) for non-invasive systolic blood pressure in healthy children < 18 years. Existing cut-offs for hypotension were identified in international guidelines and textbooks. The age-related centiles and clinical cut-offs were compared and visualized using step charts.
resultsFourteen studies with population-based centiles were selected, of which 2 addressed children < 1 year. Values for the fifth centile differed 8 to 17 mmHg for age. We identified 13 clinical cut-offs of which only 5 reported accurate references. Age-related cut-offs for hypotension showed large variability (ranging from 15 to 30 mmHg). The clinical cut-offs varied in agreement with the low centiles. The definition from Paediatric Advanced Life Support agreed well for children < 12 years but was below the fifth centiles for children > 12 years. For children > 12 years, the definition of Parshuram's early warning score agreed well, but the Advanced Paediatric Life Support definition was above the fifth centiles.
conclusionsThe different clinical guidelines for low blood pressure show large variability and low to moderate agreement with population-based lower centiles. For children < 12 years, the Paediatric Advanced Life Support definition fits best but it underestimates hypotension in older children. For children > 12 years, the Advanced Paediatric Life Support overestimates hypotension but Parshuram's cut-off for hypotension in the early warning score agrees well. Future studies should focus on developing reference values for hypotension for acutely ill children.
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