Blood pressure measurement in

Dr. A. M. Elseed and colleagues (Archives, 1973, 48, 932) referred to 4 methods of indirect measurement of blood pressure: palpation, auscultation, flush, and Doppler. May I draw your attention to a fifth method which will measure systolic and diastolic blood pressure with reproducible results, even in very small infants-oscillometry. This method was first used by Mlle. L. Koessler (1912). By using a Pachon oscillometer, measurements were improved and used extensively by Balard (1912a, b, 1913), including observations on newboms in the first day of life. Using a similar instrument with a specially designed double chamber cuff, originally designed by Gallavardin (1922), I did measurements on term and premature infants (Kafka, 1967). Nelson (1968) designed an electronic oscillo-meter which could be used with the commercially available single chamber cuff. This instrument has proved to be very effective, as shown in a study con-ducted by Dr. Oh and myself (Kafka and Oh 1971). The oscillometric method for indirect blood pressure measurements has obvious advantages. (1) It measures systolic and diastolic blood pressure. (2) Reliable and reproducible measurements can be taken on the upper as well as on the lower limb. (3) Measurements can be taken in very small infants. (4) The method will still be usable in conditions where blood pressure drops to low levels as in shock-like states or where there are low diastolic values due to shunts or low systolic measurements as in coarctation. The rounding off of figures of blood pressure values widely used in clinical medicine is not acceptable for statistical studies, according to Armitage and Rose (1966)