In a systematic review, Susannah Fleming and colleagues (March 19, p 1011) derived evidence-based centile charts for heart rate and respiratory rate in children, compared these with reference ranges published in existing paediatric resuscitation guidelines, and found striking disagreement. Their study provides robust data for updating resuscitation guidelines. Nevertheless it would have been even more useful if blood pressure had been included in their investigation. Fleming and colleagues' summary of included studies (webappendix pp 8-11) shows that blood pressure measurements were reported in at least 15 papers. With appropriate search strategies, further studies could have been identified, and similar methods could have created centile charts for blood pressure. Surprisingly, blood pressure was mentioned neither in Fleming and colleagues' discussion of reference ranges nor in the accompanying Comment by Rosalind Smyth.
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