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Age-adjusted MAP centiles for sick kids

Mean arterial pressure for children in US emergency department and prehospital settings
Archives of Disease in Childhood · 2026-10-06 · Added 8 October 2026

Large US observational study deriving and validating age-specific mean arterial pressure centile curves in prehospital, ED and critical-care datasets — lower age-adjusted MAP tracked with mortality and greater vasoactive and fluid use, though the curves fitted neonates in the EMS sample poorly.

Study type

Cross-sectional

Design

Retrospective observational study across three datasets (reference centile derivation and validation)

Participants

529,475 EMS encounters, 4,221,048 ED encounters and 4,784 critical care transports

Main finding

Calculated and measured MAP agreed closely (ICC 0.996); only 0.6% of EMS encounters fell below the 5th centile while 41.0% sat above the 95th, lower MAP was associated with increased mortality, vasoactive use and IV fluid use, and 16.9% of neonates in the EMS sample fell below the 5th centile

Caveat

US retrospective data where the centiles fit the EMS sample noticeably worse than ED/critical-care data, especially for neonates

Bottom line

Context only

Learning goal

Strengthen my recognition of age-adjusted hypotension in sick children using centile-based mean arterial pressure.

More

• Topic: Paediatrics
• Daily scan: 8 October 2026

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