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1.
ObjectiveTo use American College of Veterinary Internal Medicine (ACVIM) criteria to evaluate a high-definition oscillometric (HDO) blood pressure monitoring device versus invasive blood pressure (IBP) measurement in normotensive rabbits anaesthetized with two different anaesthetic protocols.Study designProspective experimental study.AnimalsA group of 20 healthy adult New Zealand White rabbits weighing 4.36 ± 0.37 kg (mean ± standard deviation).Materials and methodsRabbits were premedicated with butorphanol 0.5 mg kg–1 and midazolam 0.5 mg kg–1 subcutaneously (SC, group BMA) or ketamine 25 mg kg–1 and medetomidine 0.4 mg kg–1 SC (group KM). Anaesthesia was induced with alfaxalone administered intravenously (group BMA) or isoflurane by face mask (group KM) and maintained with isoflurane in oxygen. IBP was measured from the central auricular artery. The cuff for the HDO monitor was placed distal to the left elbow and distal to the left tarsus. Agreement between invasive and HDO measurements was evaluated using Bland–Altman method.ResultsIn group KM there was better agreement between the HDO device and IBP when the cuff was placed on the thoracic limb, with 100% and 91% of the readings for mean (MAP) and diastolic arterial pressure (DAP), respectively, within 10 mmHg of the IBP measurements. The agreement, although worse, also met the ACVIM criteria for systolic arterial pressure (SAP; 53% of the readings within 10 mmHg). In group BMA, the device met the criteria with the cuff on the thoracic limb only, and only for MAP and DAP (73% and 75% of the measurements within 10 mmHg of the IBP, respectively) but not for SAP (12%).Conclusion and clinical relevanceThe HDO device met most of the ACVIM criteria for noninvasive blood pressure measurement in anaesthetized rabbits, specifically when the cuff was placed distal to the elbow and the anaesthetic protocol included ketamine and medetomidine.  相似文献   

2.
ObjectiveTo compare high definition oscillometry (HDO) to invasive blood pressure measurement in anaesthetized dogs.Study designProspective, clinical trial.AnimalsFifty dogs weighing 1.95–79 kg (mean 23.5 kg).Materials and methodsAnaesthetic and peri–anaesthetic management was chosen according to each dog's physical status and anaesthetist's preference. Direct arterial blood pressure measurements were performed using a catheter placed in the dorsal pedal artery and an electronic pressure transducer connected to a multiparameter monitor. Non–invasive blood pressure measurements were performed using an appropriately sized cuff placed around the tail base. Comparisons between the two methods were made using Bland and Altman plots. The data are reported as mean bias (lower, upper limits of agreement). Further analysis was performed after separating the data into the following categories based on invasive mean arterial blood pressure (MAP): high (MAP > 100 mmHg), medium (70 mmHg < MAP < 100 mmHg) and low (MAP < 70 mmHg) blood pressure (BP). The two methods were compared as used clinically.ResultsEight hundred measurement pairs for invasive and HDO BP readings were compared. Overall, the HDO measured lower values for SAP and DAP but higher for MAP than the invasive method. The lowest bias (upper, lower limits of agreement) were obtained for MAP, ?1 (?22, 19) mmHg. The biggest discrepancy between the methods was reflected by a large bias (limits of agreement) 5 (?34, 45) mmHg, was for SAP. The results for DAP were between those for SAP and MAP with a bias (limits of agreement) of 3 (?20, 27) mmHg. When the values were separated into the pressure range categories the HDO measured higher in the high, medium and low BP groups, with the exception of SAP in the low BP group.ConclusionsWhen considering the mean bias, the accuracy of HDO compared well with direct arterial blood pressure, but the precision was poor, as determined by wide limits of agreement.Clinical relevanceUsing trends and serial measurements rather than a single measurement for clinical decision making is recommended with both methods, when used as reported here.  相似文献   

3.
ObjectiveTo assess the agreement between an oscillometric device and invasive blood pressure (IBP) measurements in anesthetized healthy adult guinea pigs.Study designProspective experimental study.AnimalsA total of eight adult Hartley guinea pigs.MethodsAll animals were anesthetized; a carotid artery was surgically exposed and catheterized for IBP measurements. A size 1 cuff placed on the right thoracic limb was connected to an oscillometric device for noninvasive blood pressure (NIBP) assessment. Concurrent pairs of systolic (SAP), diastolic (DAP) and mean (MAP) arterial pressures were recorded simultaneously with both methods every 3 minutes for 30 minutes. Agreement between IBP and NIBP measurements was determined using the Bland–Altman method, considering the recommended standards for the validation of NIBP measurement devices proposed by the American College of Veterinary Internal Medicine (ACVIM).ResultsThe bias and the 95% limits of agreement were: –14 (–31 to 3) mmHg, –2 (–14 to 10) mmHg and –1 (–13 to 11) mmHg for SAP, DAP and MAP, respectively.Conclusions and clinical relevanceThe oscillometric device used in this study to measure NIBP did not meet ACVIM criteria for validation. It showed good agreement for DAP and MAP but not for SAP measurements. Considering the small size of these animals and the resulting difficulty in performing percutaneous arterial catheterization, this device might be a useful tool to assess MAP and DAP during anesthetic procedures in adult guinea pigs.  相似文献   

4.
ObjectiveTo compare noninvasive (NIBP) with invasive blood pressure (IBP) measurements from a Datex S/5 Compact monitor in anaesthetized adult dogs, and to evaluate it according to the American College of Veterinary Internal Medicine (ACVIM) and the Association for the Advancement of Medical Instrumentation (AAMI) criteria.Study designProspective clinical study.AnimalsA group of 34 client-owned adult dogs.MethodsDogs were anaesthetized for different surgical procedures using different anaesthetic protocols. IBP was measured using a catheter placed in a dorsal pedal artery. A blood pressure cuff was placed over the contralateral dorsal pedal artery for NIBP measurement. Data were recorded using the Datex iCollect program, and paired readings were matched every 3 minutes for 60 minutes. Bland-Altman and error grid analyses were used to estimate the agreement between IBP and NIBP measurements, and its clinical significance, respectively. Data were reported as mean bias [lower, upper limits of agreement (LoA)].ResultsThe Datex S/5 monitor conformed to most ACVIM criteria. The correlation coefficient was less than 0.9 for systolic, diastolic, and mean arterial pressures (MAP). The best agreement between the noninvasive and invasive methods was observed for MAP, with LoA (–17 to 13 mmHg) and higher percentage of NIBP readings within 5 (55.6%), 10 (81.7%) and 20 (98.6%) mmHg of the IBP values. The Datex S/5 NIBP technology did not meet the AAMI validation criteria and less than 95% of the paired measurements were found within the green zone of the error grid analysis.Conclusions and clinical relevanceThe Datex S/5 monitor conformed to most ACVIM criteria but not with the more rigorous AAMI standards. Despite good agreement between IBP and NIBP for MAP measurements, care must be taken when using this device to guide therapeutic interventions of blood pressure in anaesthetized healthy adult dogs.  相似文献   

5.
ObjectiveTo determine the accuracy of an oscillometric blood pressure monitor in anesthetized sheep.Study designProspective study.AnimalsTwenty healthy adult sheep, 11 males and nine females, weighing 63.6 ± 8.6 kg.MethodsAfter premedication with buprenorphine or transdermal fentanyl, anesthesia was induced with ketamine‐midazolam and maintained with isoflurane and ketamine, 1.2 mg kg?1 hour?1, ± lidocaine, 3 mg kg?1 hour?1. Invasive blood pressure measurements were obtained from an auricular arterial catheter and noninvasive measurements were from a cuff on the metatarsus or antebrachium. Simultaneous invasive and noninvasive measurements were recorded over a range (55–111 mmHg) of mean arterial pressures (MAP). Isoflurane concentration was increased to decrease MAP and decreasing the isoflurane concentration and infusing dobutamine achieved higher pressures. Invasive and noninvasive measurements were compared.ResultsCorrelation (R2) was good between the two methods of measurement (average of three consecutive readings) for systolic (SAP) (0.87), diastolic (DAP) (0.86), and mean (0.90) arterial pressures (p < 0.001). Bias ± SD between noninvasive and invasive measurements for SAP was 3 ± 8 mmHg, for DAP was ?10 ± 7 mmHg, and MAP was ?7 ± 6 mmHg. There was no significant difference between the average of three measurements and use of the first measurement. Correlations using the first measurement were SAP (0.82), DAP (0.84), and MAP (0.89). Bias ± SD for SAP was 3 ±10 mmHg, for DAP was ?11 ± 7 mmHg, and MAP was ?7 ± 6 mmHg. The oscillometric monitor slightly overestimated SAP and underestimated DAP and MAP for both average values and the first reading.Conclusions and clinical relevanceThis oscillometric model provided MAP measurements that were acceptable by ACVIM standards. MAP measurements with this monitor were lower than those found with the invasive technique so a clinical diagnosis of hypotension may be made in sheep that are not hypotensive.  相似文献   

6.
OBJECTIVE: To compare the performance of the Surgivet Non-Invasive Blood Pressure (NIBP) monitor V60046 with an invasive blood pressure (IBP) technique in anaesthetized dogs. STUDY DESIGN: A prospective study. ANIMALS: Thirty-four dogs, anaesthetized for a variety of procedures. METHODS: Various anaesthetic protocols were used. Invasive blood pressure measurement was made using a catheter in the femoral or the pedal artery. A cuff was placed on the contralateral limb to allow non invasive measurements. Recordings of arterial blood pressures (ABPs) were taken at simultaneous times for a range of pressures. For analysis, three pressure levels were determined: high [systolic blood pressure (SAP) > 121 mmHg], normal (91 mmHg < SAP < 120 mmHg) and low (SAP < 90 mmHg). Comparisons between invasive and non invasive measurements were made using Bland-Altmann analysis. RESULTS: The NIBP monitor consistently underestimated blood pressure at all levels. The lowest biases and greatest precision were obtained at low and normal pressure levels for SAP and mean arterial pressure (MAP). At low blood pressure levels, the biases +/- 95% confidence interval (CI) were 1.9 +/- 2.96 mmHg (SAP), 8.3 +/- 2.41 mmHg diastolic arterial pressure (DAP) and 3.5 +/- 2.09 mmHg (MAP). At normal blood pressure levels, biases and CI were: 1.2 +/- 2.13 mmHg (SAP), 5.2 +/- 2.32 mmHg (DAP) and 2.1 +/- 1.54 mmHg (MAP). At high blood pressure levels, the biases and CI were 22.7 +/- 5.85 mmHg (SAP), 5.5 +/- 3.13 mmHg (DAP) and 9.4 +/- 3.52 mmHg (MAP). In 90.6% of cases of hypotension (MAP < 70 mmHg), the low blood pressure was correctly diagnosed by the Surgivet. CONCLUSIONS: Measurement of blood pressure with the indirect monitor allowed detection of hypotension using either SAP or MAP. The most accurate readings were determined for MAP at hypotensive and normal levels. The monitor lacked accuracy at high pressures. CLINICAL RELEVANCE: When severe challenges to the cardiovascular system are anticipated, an invasive method of recording ABP is preferable. For routine usage, the Surgivet monitor provided a reliable and safe method of NIBP monitoring in dogs, thereby contributing to the safety of anaesthesia by providing accurate information about the circulation.  相似文献   

7.

Objective

To assess the validity and reliability of Doppler ultrasonography (DOP) as compared with invasive arterial blood pressure measurements in anaesthetized dogs weighing less than 5 kg.

Study design

Controlled, prospective, clinical study.

Animals

A total of 41 privately owned dogs weighing less than 5 kg.

Methods

The dogs were anaesthetized, and an intra-arterial catheter was placed aseptically in the dorsal pedal artery of the pelvic limb to perform invasive blood pressure (IBP) measurement. The contralateral metatarsal surface of the foot was clipped in order to perform DOP. Both techniques were used to record blood pressure measurements every 5 minutes during surgical procedures. The blood pressure measurements were categorized into two groups: hypotensive [mean arterial pressure (MAP) < 60 mmHg] and normotensive (MAP between 60 and 120 mmHg). A linear mixed model was used to compare the DOP and IBP values. The results were evaluated according to the requirements of the American College of Veterinary Internal Medicine (ACVIM) guidelines for the validation of devices.

Results

DOP provided higher values compared to the systolic arterial blood pressure (SAP) and MAP of IBP measurements. The closest agreement between the two techniques was found for SAP; the bias was 8.8, and limits of agreement (LOA) were –32.9 and 50.4. Similar results were observed when the IBP technique was categorized. The closest agreement was for SAP in animals categorized as normotensive; the bias was 8.2, and LOAs were –32.8 and 49.2. The level of agreement between DOP and IBP did not meet the ACVIM recommendations.

Conclusions and clinical relevance

Our results suggest there is poor agreement between DOP and IBP measurements in anaesthetized dogs weighing less than 5 kg. Hence, the use of DOP in these animals could be misleading.  相似文献   

8.
ObjectiveTo determine the agreement of high definition oscillometry (HDO) with direct arterial blood pressure measurements in normotensive, hypotensive and hypertensive horses during general anaesthesia.Study designExperimental study.AnimalsSeven healthy warmblood horses, aged 3–11 years, weighing 470–565 kg.MethodsMeasurements from a HDO device with the cuff placed around the base of the tail were compared with pressures measured invasively from the facial artery. High blood pressures were induced by intravenous (IV) administration of dobutamine (5 μg kg−1 minute−1) over ten minutes followed by norepinephrine (0.1 mg kg−1 IV) and low pressures by increasing the inspired fraction of isoflurane and administration of nitroglycerine (0.05 mg kg−1 IV). For analysis three pressure levels were determined: high (MAP>110 mmHg), normal (60 mmHgResultsA total of 245 paired measurements of systolic (SAP), mean (MAP) and diastolic (DAP) pressures were obtained. The HDO device underestimated blood pressure at hypertensive and normotensive levels and overestimated blood pressure at hypotensive levels. Best agreement was obtained for SAP and MAP within normotensive limits. At normotension, bias ± standard deviation for SAP, MAP and DAP were 0.1 ± 19.4 mmHg, 0.5 ± 14.0, 4.7 ± 15.6, respectively. At high pressure levels bias and SD were 26.1 ± 37.3 (SAP), 4.2 ± 19.4 (MAP), 1.5 ± 16.8 (DAP) and at low pressures -20.0 ± 20.9 (SAP), -11.4 ± 19.6 (MAP), -4.7 ± 20.1 (DAP), with HDO measurements at a MAP <50 mmHg often failing.Conclusion and clinical relevanceGood agreement with invasive arterial blood pressures was obtained with HDO at normotensive levels in horses. At high and low pressure ranges HDO was unreliable. Therefore, if haemodynamic instability is expected, invasive measurement remains preferable.  相似文献   

9.
The present study compared 2 indirect methods, Doppler sphygmomanometry and oscillometry, for measurement of the systemic blood pressure level in 100 conscious, client-owned dogs in a clinical setting on 2 separate occasions. The mean systemic blood pressure values, measured by Doppler sphygmomanometry on 2 separate occasions, were 156 +/- 38.2 mmHg and 150 +/- 34.1 mmHg, respectively. Using oscillometry, the mean systolic blood pressure values were 138 +/- 36.9 mm Hg and 133 +/- 33.5 mm Hg on 2 separate occasions. There were significant differences between the systemic blood pressure readings for both methods on the same occasion (P<0.001). The coefficients of variance from 5 consecutive measurements in the same dog obtained by Doppler sphygmomanometry on the 2 separate occasions were 4.1 +/- 3.2% and 3.1 +/- 1.7%; that of the oscillometric method on the 2 separate occasions were 18.7 +/- 11.3% and 17.2 +/- 12.5%. The coefficients of variance of these 2 methods were statistically different on each occasion (P<0.001). Five consecutive systemic blood pressure readings were obtained for each dog within 6 min on both occasions using Doppler sphygmomanometry. More than 15 min was required to complete 5 consecutive systemic blood pressure readings by oscillometric sphygmomanometry for all dogs on each occasion. The results of this study indicate that Doppler sphygmomanometry provides more efficient and precise measurements of the systemic blood pressure level than oscillometric testing in conscious dogs in a clinical setting.  相似文献   

10.
OBJECTIVE: To examine the agreement between direct arterial blood pressure measurements obtained from 2 arteries and indirect blood pressure measurements obtained with an oscillometric blood pressure monitor (OBPM) during normotension and phenylephrine-induced hypertension in dogs. ANIMALS: 16 male Beagles. PROCEDURES: In anesthetized dogs, arterial catheters were placed in the lingual and dorsal pedal arteries for measurement of arterial blood pressure. A blood pressure cuff was placed on either the dog's fore- or hind limb and connected to an OBPM. Systolic, diastolic, and mean arterial blood pressures (SAP, DAP, and MAP, respectively) were recorded from both arteries and the OBPM every 5 minutes for 30 minutes (baseline), during a 30-minute period in which dogs received a phenylephrine infusion IV to induce hypertension, and for 30 minutes after discontinuation of the infusion. Mean differences in blood pressure values and confidence intervals were calculated to compare the indirect and direct measurement techniques. RESULTS: In dogs, oscillometry underestimated SAP during normotension, and the difference between oscillometric and direct measurements increased during hypertension. Oscillometry underestimated DAP, but the difference between oscillometric and direct measurements decreased during hypertension. There was close agreement among techniques for MAP determinations. Biases between direct measurements and OPBM blood pressure values measured from dogs' forelimbs or hind limbs were not significantly different. CONCLUSIONS AND CLINICAL RELEVANCE: In normotensive dogs, oscillometric measurements of MAP and SAP agreed more closely with direct arterial pressure measurements than oscillometric estimates of DAP. Oscillometric measurement of MAP was accurate during both normotension and hypertension in dogs.  相似文献   

11.
To evaluate the effect of an adaptation period on systemic blood pressure readings, systolic blood pressure was measured in 12 young adult untrained beagles over several weeks by means of a Doppler flow detector and oscillometric devices. The pressure decreased gradually and significantly, and levelled out after 14 days. The median (range) of values obtained by Doppler were 166 (149 to 200) mmHg initially, 145 (119 to 176) mmHg on day 9, 138 (118 to 165) mmHg on day 10, 127 (111 to 139) mmHg on day 35, 124 (115 to 143) mmHg on day 94 and 127 (114 to 142) mmHg on day 161. All the later measurements were significantly lower than the initial measurement. Male dogs had higher blood pressures than females on each occasion. The blood pressure readings obtained with one of the oscillometric devices and the Doppler device were comparable and correlated significantly.  相似文献   

12.
Objectives : To evaluate high-definition and conventional oscillometry in comparison with direct blood pressure measurements in anaesthetised dogs. Methods : Eight simultaneous readings for systolic, diastolic and mean pressure were obtained directly and with each of two devices in nine anaesthetised dogs. Measurement procedure and validation were based on the 2007 ACVIM guidelines. Results : Sixty-three simultaneous readings were evaluated for each device and direct measurements. The mean differences (bias) to direct values were within 10 mmHg for both devices although bias for systolic and diastolic blood pressures was higher for Memodiagnostic. The standard deviations of differences (precision) were within 15 mmHg for Dinamap but exceeded for Memodiagnostic. Correlation coefficients were higher for Dinamap than Memodiagnostic but both failed to reach a correlation of 0·9. Over 50% of values lay within 10 mmHg of direct measures for both devices, but this percentage was greater for Dinamap than Memodiagnostic. Over 80% of values lay within 20 mmHg of direct measures for Dinamap but not for Memodiagnostic. Clinical Significance : Both devices failed to meet ACVIM guideline validation. However, Dinamap only failed with regards to correlation. Memodiagnostic failed on several requirements, and based on poor correlation, accuracy and precision, this device cannot be currently recommended for dogs under anaesthesia.  相似文献   

13.
ObjectiveTo evaluate a veterinary-specific oscillometric noninvasive blood pressure (NIBP) system according to the guidelines of the American College of Veterinary Internal Medicine (ACVIM) Consensus Statement.Study designProspective clinical study.AnimalsA total of 33 client-owned cats (20 females and 13 males).MethodsCats were premedicated with methadone (0.3 mg kg−1) and alfaxalone (2 mg kg−1) intramuscularly. After 15 minutes anesthesia was induced with isoflurane (3%) in 100% oxygen by facemask while breathing spontaneously. A 22 gauge catheter was placed in the median caudal artery and systolic (SAP), diastolic (DAP) and mean (MAP) arterial pressures were measured. NIBP measurements were collected by placing the cuff (40% of limb circumference) on the right or left antebrachium. The agreement between the two methods was evaluated with the Bland–Altman methods, and the oscillometric NIBP device was evaluated using the ACVIM guidelines for validation of devices.ResultsData from 30 of the 33 cats were analyzed. Five paired measurements were taken from each cat, totaling 150 paired measurements. Mean bias (limits of agreements) for SAP, DAP and MAP were 2.7 (−22.7 to 28.1), 0.9 (−22.3 to 24.2) and 1.3 (−20.4 to 23.0). The oscillometric NIBP passed all validation criteria, except correlation which was <0.9 for SAP, DAP and MAP.Conclusions and clinical relevanceThe Vet20 did not meet all validation criteria by the ACVIM. However, all criteria except correlation were met.  相似文献   

14.
Objective: To determine the accuracy of indirect blood pressure (BP) measurements obtained with a pulse oximeter as compared with direct measurements in dogs under isoflurane anesthesia. The Doppler and oscillometric BP monitors were included for comparison. Design: Prospective, experimental study. Animals: Twenty healthy dogs (23 ± 8 kg) anesthetized for research or teaching. Interventions: Dogs were anesthetized with propofol or thiopental and maintained using positive pressure ventilation with isoflurane in 100% O2. Random adjustment of BP was achieved by inhalant adjustment or dopamine infusion to achieve low (≤85 mmHg), normal (90–120 mmHg), or high systolic BP (≥125 mmHg). Triplicate measurements for BP were taken with direct (dorsal pedal artery), Doppler (forelimb), oscillometric (same forelimb), and plethysmographic (pulse oximeter on tongue) methods. Measurements and main results: Using regression analysis and a modified Bland–Altman's technique, the lowest bias was achieved with the Doppler. Systolic BP readings at low, normal, and high BP were within 10 mmHg of direct recordings 95%, 70%, and 30% of the time for pulse oximetry; 95%, 85%, and 55% of the time for Doppler; 42%, 65%, and 30% of the time for oscillometric determination, respectively. Oscillometric mean BP readings were within 10 mmHg of direct measurements 53%, 60%, and 45% of the time, respectively. Conclusions: The pulse oximeter is an acceptable method for measuring BP in anesthetized dogs if assessment of trends is sufficient. All indirect methods showed greater bias and poorer precision at high BP. The Doppler may be the preferred indirect method.  相似文献   

15.
Indirect blood pressure measurements were compared in 28 conscious cats using Doppler and oscillometric blood pressure-measuring devices. Ten cats were used to compare Doppler measurements between two examiners and 18 cats were used to compare Doppler and oscillometric measurements. The Doppler machine obtained systolic and diastolic blood pressure readings in 100% and 51% of attempts, respectively. With the oscillometric machine, systolic and diastolic blood pressure readings were obtained in 52% of the attempts. With the Doppler, measures of mean systolic blood pressure between two examiners were positively correlated, but there was no correlation for diastolic blood pressure measures. When comparing the results obtained by Doppler and oscillometric machines there was no significant difference between mean systolic blood pressure readings, but the oscillometric machine produced significantly higher estimates of diastolic blood pressure. In both cases, the standard deviations for the oscillometric machine were considerably larger than those for the Doppler machine. The first reading of systolic blood pressure obtained with the Doppler machine was an excellent predictor of the mean of five readings, but this was not so for the oscillometric machine. It took less than 5 min to obtain five readings in 37.5% of cases with the Doppler machine but this was true for only 5% of cases with the oscillometric machine. Two cats with ophthalmological lesions consistent with systemic hypertension were identified. In these two patients, systolic blood pressure measurements were between 200 and 225 mmHg when measured by Doppler, and between 140 and 150 mmHg when measured by the oscillometric machine. This suggests that a lower reference range for normal systolic blood pressure values should be used for the oscillometric device.  相似文献   

16.

Objective

To assess agreement between noninvasive blood pressure (NIBP) oscillometrically-derived values from a multiparameter monitor (Datex Ohmeda S/5 Compact) with those obtained by invasive blood pressure (IBP) measurement in anaesthetised horses undergoing elective surgery.

Study design

Prospective clinical study.

Animals

A total of 40 healthy adult horses.

Methods

Horses were anaesthetised with various anaesthetic protocols (based on clinical requirements). Depending on positioning, cannulation of the facial or lateral metatarsal artery was performed for IBP measurement. The cannula was connected via a transducer to the monitor. An appropriately sized NIBP cuff was placed around the tail base and connected to the same monitor. Systolic (SAP), mean (MAP) and diastolic (DAP) arterial blood pressures were continuously recorded from the invasive system, and at 3 minute intervals from the oscillometric system, throughout the surgical procedure using a Datex iCollect program. An appropriate arithmetic correction factor was applied to the oscillometric results where the cuff was not level with the heart. Assessment of the degree of agreement between invasive and noninvasive readings at each time point was performed using a modified Bland-Altman analysis.

Results

While in many horses there was relatively close correlation between the values obtained over time, there was substantial variability in individual animals which resulted in wide Bland-Altman limits of agreement. The oscillometric device over-reads by approximately 32, 23 and 22 mmHg, and under-reads by 26, 17 and 19 mmHg for SAP, MAP and DAP, respectively, compared with the IBP values. However, using the mean difference and standard deviation, the device conforms to American College of Veterinary Internal Medicine (ACVIM) standards.

Conclusions and clinical relevance

Oscillometric blood pressure measurement using the Datex Ohmeda S/5 Compact multiparameter monitor conforms to ACVIM standards when the NIBP cuff is placed on the tail. However, because of the wide variability in measurements, we cannot recommend this technique to guide therapy in anaesthetised adult horses.  相似文献   

17.
Comparison of test characteristics allows a clinician to choose the optimal diagnostic test method for an individual patient. This study assessed the comparative test characteristics of noninvasive (NI) blood pressure measurement methods (oscillometric and Doppler) and used this information to develop optimal cutoff values for diagnosis of systolic hypertension in dogs by these NI methods. Simultaneous NI (oscillometric or Doppler methods) and invasive (arterial puncture [AP]) systolic blood pressure (SBP) measurements were obtained prospectively from normal dogs and dogs suspected of having systemic hypertension based on clinical signs. Oscillometric SBP readings were obtained from the distal hind limb (Osc-L, n = 54) or the proximal tail (T. n = 27). Doppler BP measurements were obtained using a forelimb cuff (n = 57). AP-SBP was categorized as hypertensive if > or = 160 mmHg, and sensitivity (Se). specificity (Sp), and likelihood ratios (LR) were calculated for diagnostic cutoff values ranging from 130 to 220 mmHg. Receiver operator characteristic (ROC) curves were analyzed to determine optimal cutoff values for diagnosis of AP-SBP > or = 160 mmHg. Optimal NI SBP cutoff values considered to reflect AP values > or = 160 mmHg were: Osc-L = 160 mmHg (Se: 65%, Sp: 85%. LR = 4.33: 1), Osc-T = 150 mmHg (Se: 84%, Sp: 75%, LR = 3.36: 1), and Doppler = 160 mmHg (Se: 71%,  相似文献   

18.
ObjectiveTo evaluate the agreement between invasive blood pressure (IBP) and Doppler ultrasound blood pressure (DUBP) using three cuff positions and oscillometric blood pressure (OBP) in anesthetized dogs.Study designProspective study.AnimalsNine adult dogs weighing 14.5–29.5 kg.MethodsThe cuff was placed above and below the tarsus, and above the carpus with the DUBP and above the carpus with the OBP monitor. Based on IBP recorded via a dorsal pedal artery catheter, conditions of low, normal, and high systolic arterial pressures [SAP (mmHg) <90, between 90 and 140, and >140, respectively] were induced by changes in isoflurane concentrations and/or dopamine administration. Mean biases ± 2 SD (limits of agreement) were determined.ResultsAt high blood pressures, regardless of cuff position, SAP determinations with the DUBP underestimated invasive SAP values by more than 20 mmHg in most instances. With the DUBP, cuff placement above the tarsus yielded better agreement with invasive SAP during low blood pressures (0.2 ± 16 mmHg). The OBP underestimated SAP during high blood pressures (?42 ± 42 mmHg) and yielded better agreement with IBP for mean (MAP) and diastolic (DAP) arterial pressure measurements [overall bias: 2 ± 15 mmHg (MAP) and 0.2 ± 16 mmHg (DAP)].ConclusionsAgreement of SAP determinations with the DUBP is poor at SAP > 140 mmHg, regardless of cuff placement. Measurement error of the DUBP with the cuff placed above the tarsus is clinically acceptable during low blood pressures. Agreement of MAP and DAP measurements with this OBP monitor compared with IBP was clinically acceptable over a wide pressure range.Clinical relevanceWith the DUBP device, placing the cuff above the tarsus allows reasonable agreement with IBP obtained via dorsal pedal artery catheterization. Only MAP and DAP provide reasonable estimates of direct blood pressure with the OBP monitor evaluated.  相似文献   

19.
Objective – To compare blood pressure measurements obtained via ultrasonic Doppler flow monitor (DOP) and 2 oscillometric noninvasive blood pressure monitors (CAR and PAS) to invasive blood pressure (IBP) in hospitalized, conscious dogs with a range of blood pressures. Design – Prospective clinical study. Setting – University teaching hospital. Animals – Eleven client‐owned dogs aged between 4 months and 11.5 years (median 6 y), and weighing between 5.8 and 37.5 kg (median 30.2 kg). Interventions – Blood pressure measurement. Measurements and Main Results – Three consecutive measurements of systolic, diastolic, and mean arterial pressure (MAP) were recorded for each of the 3 indirect devices (only systolic for DOP), along with concurrent IBP measurements. The data were categorized into 3 groups: hypotensive (direct MAP<80 mm Hg), normotensive (80 mm Hg≤direct MAP≥100 mm Hg), and hypertensive (direct MAP>100 mm Hg). Each indirect method was compared with the corresponding direct arterial pressure using the Bland‐Altman method. Within the hypotensive group, each indirect method overestimated the corresponding IBP. Within the normotensive group all indirect systolic measurements and the PAS diastolic measurements underestimated the corresponding IBP. The remaining indirect measurements overestimated the corresponding IBP. Within the hypertensive group, DOP and CAR systolic measurements underestimated the corresponding IBP, and the remaining indirect measurements overestimated the corresponding IBP. In hypertensive dogs oscillometric systolic measurements were more accurate than MAP. In hypotensive dogs MAP measurements were more accurate than systolic measurements. All indirect measurements were most accurate in hypertensive dogs. Conclusions – The noninvasive blood pressure monitors in our study did not meet the validation standards set in human medicine. However, CAR diastolic and MAP measurements within the normotensive group, CAR MAP measurements within the hypertensive group, and PAS diastolic measurements in all groups were close to these standards. All indirect measurements showed greater bias during hypotension. Precision was poorer for all indirect systolic measurements than for MAP.  相似文献   

20.
ObjectiveTo assess accuracy of noninvasive blood pressure (NIBP) measured by oscillometric device Sentinel compared to invasive blood pressure (IBP) in anaesthetized horses undergoing surgery. To assess if differences between the NIBP measured by the Sentinel and IBP are associated with recumbency, cuff placement, weight of the horse or acepromazine premedication and to describe usefulness of the Sentinel.Study designProspective study examining replicates of simultaneous NIBP and IBP measurements.AnimalsTwenty-nine horses.MethodsInvasive blood pressure was measured via a catheter in the facial artery, transverse facial artery or metatarsal artery. NIBP was measured using appropriate size cuffs placed on one of two metacarpal or metatarsal bones or the tail in random order. With both techniques systolic (SAP), mean (MAP), and diastolic (DAP) arterial blood pressures and heart rates (HR) were recorded. A mixed effects model compared the IBP to the NIBP values and assessed potential effects of catheter placement, localisation of the cuffs in combination with recumbency, weight of the horse or acepromazine premedication.ResultsNoninvasive blood pressure yielded higher measurements than IBP. Agreement varied with recumbency and cuff position. Estimated mean differences between the two methods decreased from SAP (lateral recumbency: range -5.3 to -56.0 mmHg; dorsal recumbency: range 0.8 to -20.7 mmHg), to MAP (lateral recumbency: range -1.8 to -19.0 mmHg; dorsal recumbency: range 13.9 to -16.4 mmHg) to DAP (lateral recumbency: range 0.5 to -6.6 mmHg; dorsal recumbency: range 21.0 to -15.5 mmHg). NIBP measurement was approximately two times more variable than IBP measurement. No significant difference between IBP and NIBP due to horse's weight or acepromazine premedication was found. In 227 of 1047 (21.7%) measurements the Sentinel did not deliver a result.Conclusion and clinical relevanceAccording to the high variability of NIBP compared to IBP, NIBP measurements as measured by the Sentinel in the manner described here are not considered as an appropriate alternative to IBP to measure blood pressure in anaesthetized horses.  相似文献   

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