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Parra Martínez C, Rico Pérez B, Kaartinen J. Evaluation of the agreement between lingual and thoracic limb noninvasive blood pressure with invasive blood pressure measurements in anaesthetized horses. Vet Anaesth Analg 2024; 51:1-9. [PMID: 37852861 DOI: 10.1016/j.vaa.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 08/03/2023] [Accepted: 08/10/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVE To evaluate the agreement between noninvasive arterial blood pressure (NIBP) measured from the tongue and thoracic limb with invasive blood pressure (IBP), and to compare NIBP measured from the tongue and thoracic limb in anaesthetized horses. STUDY DESIGN Prospective clinical study. ANIMALS A group of eight client-owned healthy horses anaesthetized for scheduled procedures, American Society of Anesthesiologists classification I-II, weighing (mean ± standard deviation) 498 ± 91 kg and aged 7.8 ± 6.75 years. METHODS Animals were premedicated with intravenous (IV) romifidine (0.04-0.08 mg kg-1) and methadone (0.1 mg kg-1). General anaesthesia was induced IV with ketamine (2.5 mg kg-1) and midazolam (0.05 mg kg-1) and maintained with isoflurane. The facial artery was catheterized for IBP measurements. Systolic (SAP), mean (MAP) and diastolic (DAP) arterial pressures were recorded from the NIBPtongue, NIBPlimb and IBP every 20 minutes during the procedure. Agreement between NIBP and IBP was evaluated based on the American College of Veterinary Internal Medicine criteria and American Association for Medical Instrumentation criteria using the Bland-Altman method. RESULTS The mean bias and precision between IBP and NIBP measured from the tongue met the standards for all pressure ranges (< 10 mmHg and < 15 mmHg, respectively). NIBP measurements from the tongue and thoracic limb tended to underestimate IBP measurements. During hypotension, MAPtongue and DAPtongue overestimated IBP, but both precision and accuracy met the criteria. The overall accuracy and precision of NIBPlimb was poorer than NIBPtongue. The percentage of NIBPtongue that differed from IBP by < 10 mmHg was higher than that recorded with NIBPlimb for SAP (46% versus 25%), MAP (77% versus 28%) and DAP (79% versus 19%). CONCLUSIONS AND CLINICAL RELEVANCE The tongue is a clinically suitable alternative for assessing arterial blood pressure compared with the thoracic limb and can reliably detect hypotension in healthy anaesthetized horses.
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Affiliation(s)
| | - Bartolome Rico Pérez
- Clinical Science and Services, The Royal Veterinary College, Hawkshead Lane, Hatfield, UK
| | - Johanna Kaartinen
- Clinical Science and Services, The Royal Veterinary College, Hawkshead Lane, Hatfield, UK
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Kim D, Kim J, Shin D, Lee I, Son WG. Agreement Between Tongue-Based Oscillometric and Invasive Blood Pressure in Anesthetized Dogs of Various Weights. J Am Anim Hosp Assoc 2023; 59:136-141. [PMID: 37167250 DOI: 10.5326/jaaha-ms-7325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2023] [Indexed: 05/13/2023]
Abstract
This study aimed to evaluate the agreement between oscillometric blood pressure (OBP) measured from the tongue and invasive blood pressure (IBP) measured from the dorsal pedal artery in anesthetized dogs of various body weights. Forty-five client-owned dogs undergoing general anesthesia for surgery or imaging scan were included; weights ranged from 2.5 to 42.6 kg. Agreement between paired IBP and OBP during normotension was verified with reference standards used in small animals and humans. The data were stratified by body weight (≤5 kg versus >5 kg). In the >5 kg group (n = 29), the bias ± standard deviation for mean (2.1 ± 7.9 mm Hg) and diastolic pressure (-2.7 ± 7.9 mm Hg) exhibited reliability that met human standards (<5 ± 8 mm Hg). However, in the ≤5 kg group (n = 16), the bias ± standard deviation met only veterinary standards (≤10 ± 15 mm Hg) for mean (3.1 ± 10.2 mm Hg) and diastolic pressure (-2.5 ± 12.6 mm Hg). Agreement for systolic pressure did not meet either standard for both groups. This study demonstrates that tongue-based OBP is a close estimate of mean/diastolic blood pressure in anesthetized dogs (>5 kg) during normotension by small-animal and human criteria.
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Affiliation(s)
- Dalhae Kim
- From the Department of Anesthesia and Pain Management, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea (D.K., J.K., D.S., I.L., W-g.S.)
| | - Jiyoung Kim
- From the Department of Anesthesia and Pain Management, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea (D.K., J.K., D.S., I.L., W-g.S.)
| | - Donghwi Shin
- From the Department of Anesthesia and Pain Management, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea (D.K., J.K., D.S., I.L., W-g.S.)
| | - Inhyung Lee
- From the Department of Anesthesia and Pain Management, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea (D.K., J.K., D.S., I.L., W-g.S.)
| | - Won-Gyun Son
- From the Department of Anesthesia and Pain Management, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea (D.K., J.K., D.S., I.L., W-g.S.)
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Sant Cassia EV, Tordiffe ASW. Agreement of high-definition oscillometry at two cuff locations with invasively measured arterial blood pressures in anaesthetised cheetahs. Vet Anaesth Analg 2023; 50:170-179. [PMID: 36669927 DOI: 10.1016/j.vaa.2022.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 09/15/2022] [Accepted: 11/20/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate the agreement between high-definition oscillometry (HDO) used on the metatarsus or tail base with invasive arterial blood pressures measured in the dorsal pedal artery in anaesthetised cheetahs. STUDY DESIGN Prospective clinical study. ANIMALS A group of 13 captive adult cheetahs. METHODS Cheetahs were immobilised with medetomidine (32-45 μg kg-1) and tiletamine/zolazepam (0.93-1.39 mg kg-1) administered intramuscularly, and anaesthesia was maintained with either isoflurane in oxygen or continuous propofol infusion. Invasive blood pressure was measured via a 20 gauge intra-arterial catheter in the dorsal pedal artery in the metatarsus and used as a reference method for pressures simultaneously estimated using HDO on the contralateral metatarsus and tail base. Bland-Altman plots (for repeated measurements) and criteria defined by the American College of Veterinary Internal Medicine (ACVIM) were used to compare agreement according to the anatomical location of the cuff, the anaesthetic maintenance agent and magnitude of the blood pressure. RESULTS A total of 147 paired measurements were obtained with HDO on the metatarsus and 135 on the tail. Agreement with invasive pressures was better when HDO was used on the tail (rather than on the metatarsus) with all ACVIM criteria being met. Mean bias (a positive bias meaning that HDO overestimated the invasively measured pressures) ± standard deviation of differences for systolic, diastolic and mean arterial pressures were -7.0 ± 13.9, 4.2 ±12.1 and 4.6 ±11.2 mmHg, respectively, for HDO on the tail, and -11.9 ±15.1, 2.8 ±16.5 and 2.1 ±13.2 mmHg, respectively, for HDO on the metatarsus. Agreement was better during isoflurane anaesthesia than propofol, and at lower blood pressures than at higher. CONCLUSIONS AND CLINICAL RELEVANCE When used on the tail base of anaesthetised cheetahs, HDO met the ACVIM validation criteria for a noninvasive device, as compared to invasively measured pressures in the dorsal pedal artery.
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Affiliation(s)
| | - Adrian S W Tordiffe
- Department of Paraclinical Sciences, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa
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Murphy KM, Rishniw M, Silverstein DC. Use of vasopressors for treatment of vasodilatory hypotension in dogs and cats by Diplomates of the American College of Veterinary Emergency and Critical Care. J Vet Emerg Crit Care (San Antonio) 2022; 32:714-722. [PMID: 35829666 DOI: 10.1111/vec.13230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 04/30/2021] [Accepted: 06/20/2021] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To identify the most common practices of Diplomates of the American College of Veterinary Emergency and Critical Care (DACVECCs) as they relate to the recognition and treatment of hypotension in dogs and cats, particularly concerning the use of vasopressors in vasodilatory shock states. DESIGN A survey regarding vasopressor use was sent to all active DACVECCs using the Veterinary Information Network. Questions focused on respondent characteristics, method of recognition of hypotension, triggers for initiation of vasopressor therapy, first- and second-line vasopressor choice, and methods of determining response to therapy. SUBJECTS A total of 734 DACVECCs were invited to participate, and 203 Diplomates (27.7%) completed the survey. RESULTS For both dogs and cats, the most common first-line vasopressor was norepinephrine (87.9% in dogs and 83.1% in cats). The most common second-choice vasopressor was vasopressin (44.2% in dogs and 39.0% in cats). Cutoff values for initiating vasopressor therapy varied between species and modality used for blood pressure measurement. In general, most DACVECCs chose to initiate vasopressor therapy at a Doppler blood pressure <90 mm Hg or a mean arterial pressure of <60 or <65 mm Hg when using oscillometric or direct arterial blood pressure measurements in dogs and cats. CONCLUSIONS Most DACVECCs adhere to published human guidelines when choosing a first-line vasopressor. However, there is significant variability in blood pressure measurement technique, cutoffs for initiation of vasopressor use, and choice of second-line vasopressors.
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Affiliation(s)
- Kellyann M Murphy
- Department of Clinical Studies and Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA
| | - Mark Rishniw
- Veterinary Information Network, Davis, California, USA
| | - Deborah C Silverstein
- Department of Clinical Studies and Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA
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Bias Associated with Peripheral Non-Invasive Compared to Invasive Arterial Blood Pressure Monitoring in Healthy Anaesthetised and Standing Horses Using the Bionet BM7Vet. Vet Sci 2022; 9:vetsci9020052. [PMID: 35202305 PMCID: PMC8878245 DOI: 10.3390/vetsci9020052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/22/2022] [Accepted: 01/26/2022] [Indexed: 12/10/2022] Open
Abstract
To compare arterial blood pressure (ABP) measured invasively (IBP) to ABP measured non-invasively (NIBP) via oscillometry in healthy anaesthetised and standing horses using the Bionet BM7Vet. Fourteen horses were anaesthetised for elective procedures (anaesthetised group) and 10 horses were enrolled for standing blood pressure manipulation (standing group). In both groups, IBP and NIBP-corrected to heart level were measured every 3 min using the Bionet BM7Vet. The overall mean difference (bias), standard deviation and limits of agreement (LOA) were calculated for paired IBP and NIBP systolic (SAP), mean (MAP) and diastolic (DAP) blood pressure measurements. In anaesthetised horses, the NIBP cuff was placed at either the proximal tail base or the metacarpus. Invasive MAP was used to retrospectively characterise measurements into hypotensive (≤70 mm Hg), normotensive (71–110 mm Hg) or hypertensive (≥111 mm Hg) subgroups. In standing horses, the NIBP cuff was placed at the tail base only and invasive MAP was manipulated to achieve hypertension (≥126 mm Hg) and hypotension (≤90 mm Hg) using phenylephrine and acepromazine, respectively. When measuring NIBP at the tail in anaesthetised horses, the Bionet BM7Vet failed on 8/185 occasions and overestimated SAP, MAP and DAP during hypotension and normotension. The biases (lower, upper LOA) for MAP were −11.4 (−33.3, 10.5) and −6.0 (−25.8, 13.8) mm Hg, respectively. Hypertension could not be evaluated. When measuring NIBP at the metacarpus in anaesthetised horses, the Bionet BM7Vet failed on 24/65 occasions and underestimated SAP, MAP and DAP when all ABP subgroups were combined. The bias (lower, upper LOA) for pooled MAP was 3.6 (−44.3, 51.6) mm Hg. When measuring NIBP at the tail in standing horses, the Bionet BM7Vet failed on 64/268 occasions and underestimated SAP, MAP and DAP during hypotension, normotension and hypertension. The biases (lower, upper LOA) for MAP were 16.3 (−10.5, 43.1), 16.6 (−19.5, 52.7) and 30.0 (−8.1, 68.0) mm Hg, respectively. Monitoring NIBP on the Bionet BM7Vet in anaesthetised horses overestimated ABP at the tail and underestimated ABP at the metacarpus. The device inaccurately detected hypotension and should be used cautiously. In standing horses, the Bionet BM7Vet underestimated ABP at the tail, especially during pharmacologically induced hypertension.
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Tucker C, Winner A, Reeves R, Cooper ES, Hall K, Schildt J, Brown D, Guillaumin J. Resuscitation Patterns and Massive Transfusion for the Critical Bleeding Dog-A Multicentric Retrospective Study of 69 Cases (2007-2013). Front Vet Sci 2022; 8:788226. [PMID: 35071385 PMCID: PMC8766795 DOI: 10.3389/fvets.2021.788226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/17/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: To describe resuscitation patterns of critically bleeding dogs, including those receiving massive transfusion (MT). Design: Retrospective study from three universities (2007-2013). Animals: Critically bleeding dogs, defined as dogs who received ≥ 25 ml/kg of blood products for treatment of hemorrhagic shock caused by blood loss. Measurements and Main Results: Sixty-nine dogs were included. Sources of critical bleeding were trauma (26.1%), intra/perioperative surgical period (26.1%), miscellaneous (24.6%), and spontaneous hemoabdomen (23.1%). Median (range) age was 7 years (0.5-18). Median body weight was 20 kg (2.6-57). Median pre-transfusion hematocrit, total protein, systolic blood pressure, and lactate were 25% (10-63), 4.1 g/dl (2-7.1), 80 mm Hg (20-181), and 6.4 mmol/L (1.1-18.2), respectively. Median blood product volume administered was 44 ml/kg (25-137.4). Median plasma to red blood cell ratio was 0.8 (0-4), and median non-blood product resuscitation fluid to blood product ratio was 0.5 (0-3.6). MT was given to 47.8% of dogs. Survival rate was 40.6%. The estimated odds of survival were higher by a factor of 1.8 (95% CI: 1.174, 3.094) for a dog with 1 g/dl higher total protein above reference interval and were lower by a factor of 0.6 (95% CI: 0.340, 0.915) per 100% prolongation of partial thromboplastin time above the reference interval. No predictors of MT were identified. Conclusions: Critical bleeding in dogs was associated with a wide range of resuscitation patterns and carries a guarded to poor prognosis.
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Affiliation(s)
- Claire Tucker
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, United States.,TetraMed, Fort Collins, CO, United States
| | - Anna Winner
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Ryan Reeves
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Edward S Cooper
- Department of Clinical Sciences, The Ohio State University, Columbus, OH, United States
| | - Kelly Hall
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, United States.,TetraMed, Fort Collins, CO, United States
| | - Julie Schildt
- Department of Clinical Sciences, The University of Tennessee, Knoxville, Knoxville, TN, United States
| | - David Brown
- Department of Statistics, Colorado State University, Fort Collins, CO, United States
| | - Julien Guillaumin
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, United States.,TetraMed, Fort Collins, CO, United States
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Felisberto RO, Gonzalez AG, Flaherty D, Casoria V, Auckburally A. Validation of oscillometric blood pressure measurement using a Datex S/5 Compact multiparameter monitor in anaesthetized adult dogs. Vet Anaesth Analg 2021; 49:156-164. [DOI: 10.1016/j.vaa.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 11/15/2021] [Accepted: 12/04/2021] [Indexed: 10/19/2022]
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Kim D, Kim H, Shin D, Kim J, Lee I, Son WG. Evaluation of the tongue for oscillometric measurement of arterial pressure in anesthetized Beagle dogs. Vet Anaesth Analg 2021; 49:149-155. [PMID: 35000840 DOI: 10.1016/j.vaa.2021.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 11/15/2021] [Accepted: 11/15/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the agreement between oscillometric blood pressure (OBP) measured from the tongue and invasive blood pressure (IBP), and to compare OBPs measured from the tongue with OBPs measured from the pelvic limb and tail. STUDY DESIGN Prospective experimental study. ANIMALS A total of eight adult Beagle dogs weighing 11.1 ± 1.2 kg. METHODS Animals were premedicated with intravenous (IV) acepromazine (0.005 mg kg-1). Anesthesia was induced with alfaxalone (3 mg kg-1) IV and maintained with isoflurane. The dorsal pedal artery was catheterized for IBP measurements. Systolic (SAP), diastolic (DAP) and mean (MAP) arterial pressure were simultaneously measured from the tongue, pelvic limb and tail. Based on invasive SAP, hypertension (>140 mmHg), normotension (90-140 mmHg) and hypotension (<90 mmHg) were induced by controlling end-tidal isoflurane concentrations and/or dobutamine/dopamine administration. Agreement between paired IBP and OBP measurements was analyzed with reference standards for noninvasive blood pressure devices used in small animals and humans. RESULTS Regardless of cuff placement, the mean bias ± standard deviation between IBP and OBP met veterinary (≤10 ± 15 mmHg) and human (<5 ± 8 mmHg) standards for MAP and DAP. SAP measurements provided by the OBP device showed unacceptable agreement with IBP, and the bias between methods increased at higher blood pressures, regardless of cuff site. During hypotension, tongue OBP showed the largest percentage of absolute difference <10 mmHg in relation to IBP for SAP (90%), MAP (97%), and DAP (93%), compared with pelvic limb (60%, 97% and 82%, respectively) and tail OBP (54%, 92% and 77%, respectively). CONCLUSIONS AND CLINICAL RELEVANCE The tongue is a clinically useful site for measuring OBP in anesthetized Beagle dogs, providing reliable estimates of MAP and DAP. The tongue could replace other cuff placement sites and may be a relatively suitable site for assessing hypotension.
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Affiliation(s)
- Dalhae Kim
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, South Korea
| | - Hyunseok Kim
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, South Korea
| | - Donghwi Shin
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, South Korea
| | - Jiyoung Kim
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, South Korea
| | - Inhyung Lee
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, South Korea
| | - Won-Gyun Son
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, South Korea.
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Cumming SH, Martinez‐Taboada F. Dopamine and dobutamine may be ineffective at managing hypotension in anaesthetised koalas (
Phascolarctos cinereus
). VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Scott H. Cumming
- Department of Anaesthesia University Veterinary Teaching Hospital Sydney University of Sydney Camperdown New South Wales Australia
| | - Fernando Martinez‐Taboada
- Department of Anaesthesia University Veterinary Teaching Hospital Sydney University of Sydney Camperdown New South Wales Australia
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Sedgwick S, Lorenzutti AM, Araos JB, Gleed RD, Martin-Flores M. Evaluation of an oscillometric blood pressure monitor in anesthetized dogs: Agreement with direct measurements and ability to detect hypotension. Res Vet Sci 2021; 135:162-166. [PMID: 33524826 DOI: 10.1016/j.rvsc.2021.01.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/06/2021] [Accepted: 01/13/2021] [Indexed: 10/22/2022]
Abstract
We evaluated the agreement between oscillometric and direct blood pressure monitors in anesthetized dogs and evaluated the ability of the oscillometric method to detect MAP <60 mmHg. Forty client-owned dogs, three months to 14 years old, 4.6-50.2 kg, under general anesthesia were studied. Systolic (SAP), mean (MAP) and diastolic (DAP) arterial pressures were measured directly via an arterial catheter and with an oscillometric cuff (Cardell Touch monitor). Paired values were compared with mixed effect models. Bias and limits of agreement (LOA) were calculated. The sensitivity and false negative rate to detect hypotension (invasive MAP <60 mmHg) using an oscillometric MAP <60 and < 70 mmHg were calculated. A receiver operating characteristics (ROC) curve was constructed and the area under the curve calculated. SAP and DAP differed between methods (both P < 0.001), but MAP did not (P = 0.5). Bland-Altman plots showed small biases but wide LOA for all variables. The sensitivity to detect hypotension was 40% with a false negative rate of 60% when using an oscillometric MAP <60 mmHg, and 68% and 32%, respectively, with a MAP <70 mmHg. The area under the ROC curve for MAP was 0.82. While the oscillometric MAP did not differ from invasive values, the device failed to recognize hypotensive events when 60 mmHg was used as the threshold to detect hypotension. Higher MAP values increased the ability to correctly recognize hypotension, but at the expense of a higher incidence of false positives.
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Affiliation(s)
- Samantha Sedgwick
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Augusto M Lorenzutti
- Catedra de Farmacologia y Toxicologia, Facultad de Ciencias Agropecuarias, Universidad Catolica de Cordoba, Argentina
| | - Joaquin B Araos
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Robin D Gleed
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Manuel Martin-Flores
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA.
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Waxman S, Fuensalida S, Sánchez F, Zárate I, Turnes E, Rodríguez C, Otero P. Agreement between noninvasive oscillometric and invasive blood pressure measurements in isoflurane-anesthetized guinea pigs (Cavia porcellus). Vet Anaesth Analg 2020; 48:252-255. [PMID: 33558132 DOI: 10.1016/j.vaa.2020.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 11/06/2020] [Accepted: 11/19/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess the agreement between an oscillometric device and invasive blood pressure (IBP) measurements in anesthetized healthy adult guinea pigs. STUDY DESIGN Prospective experimental study. ANIMALS A total of eight adult Hartley guinea pigs. METHODS All 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). RESULTS The 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 RELEVANCE The 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.
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Affiliation(s)
- Samanta Waxman
- Department of Anesthesiology, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina; National Scientific and Technical Research Council (Consejo Nacional de Investigaciones Científicas y Técnicas de Argentina, CONICET), Buenos Aires, Argentina.
| | - Santiago Fuensalida
- Department of Anesthesiology, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Fernanda Sánchez
- Department of Anesthesiology, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Indiana Zárate
- Department of Anesthesiology, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Emmanuel Turnes
- Department of Surgery, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Casilda Rodríguez
- Department of Toxicology and Pharmacology, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
| | - Pablo Otero
- Department of Anesthesiology, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina
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Jacobs-Fohrman ZR, Barnes TS, McEwen MM, Goodwin WA. Clinical evaluation of arterial blood pressure in anesthetized dogs by use of a veterinary-specific multiparameter monitor. Am J Vet Res 2020; 81:635-641. [PMID: 32701000 DOI: 10.2460/ajvr.81.8.635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare noninvasive blood pressure (NIBP) measurements with invasive blood pressure (IBP) measurements of arterial blood pressure (ABP) in anesthetized dogs as obtained with a veterinary-specific multiparameter monitor. ANIMALS 21 client-owned healthy female dogs anesthetized for routine ovariohysterectomy. PROCEDURES ABP measurements were obtained with a single veterinary-specific multiparameter monitor via a pneumatic cuff placed over the medial dorsal metatarsal artery (NIBP) and a transducer connected to a catheter placed in the contralateral artery (IBP). The 224 paired ABP measurements (complete data set) were categorized into 3 subsets-hypotension, normotension, and hypertension-on the basis of invasive measurements of mean arterial blood pressure (MAP). The NIBP and IBP measurements of systolic and diastolic arterial blood pressure (SAP and DAP, respectively) and MAP were compared. RESULTS NIBP measurements were frequently lower than IBP measurements. The greatest underestimation was for the hypertension subset of NIBP measurements, with biases for SAP of 15.7 mm Hg, DAP of 14.1 mm Hg, and MAP of 12.0 mm Hg. Considering the complete data set, precision was acceptable (SD of the differences between paired measurements ≤ 15 mm Hg for DAP [9.0 mm Hg] and MAP [12.1 mm Hg]); however, precision was not acceptable for SAP (SD, 18.6 mm Hg). CONCLUSIONS AND CLINICAL RELEVANCE NIBP measurements with the studied veterinary-specific multiparameter monitor generally agreed with IBP measurements during hypotensive and normotensive periods for anesthetized healthy female dogs undergoing routine ovariohysterectomy. However, inaccuracies, frequently underestimations, were observed during periods of hypertension, and therefore, NIBP measurements should be interpreted cautiously.
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Cremer J, da Cunha AF, Paul LJ, Liu CC, Acierno MJ. Assessment of a commercially available veterinary blood pressure device used on awake and anesthetized dogs. Am J Vet Res 2020; 80:1067-1073. [PMID: 31763937 DOI: 10.2460/ajvr.80.12.1067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare results of a commercially available device for oscillometrically measured blood pressure (OBP) with invasively measured blood pressure (IBP) in awake and anesthetized dogs. ANIMALS 19 adult dogs (mean ± SD body weight, 17.8 ± 7.5 kg). PROCEDURES Blood pressures were measured in dogs while they were awake and anesthetized with isoflurane. The OBP was recorded on a thoracic limb, and IBP was simultaneously recorded from the median caudal artery. Agreement between OBP and IBP was evaluated with the Bland-Altman method. Guidelines of the American College of Veterinary Internal Medicine (ACVIM) were used for validation of the oscillometric device. RESULTS In awake dogs, mean bias of the oscillometric device was -11.12 mm Hg (95% limits of agreement [LOA], -61.14 to 38.90 mm Hg) for systolic arterial blood pressure (SAP), 9.39 mm Hg (LOA, -28.26 to 47.04 mm Hg) for diastolic arterial blood pressure (DAP), and -0.85 mm Hg (LOA, -40.54 to 38.84 mm Hg) for mean arterial blood pressure (MAP). In anesthetized dogs, mean bias was -12.27 mm Hg (LOA, -47.36 to 22.82 mm Hg) for SAP, -3.92 mm Hg (LOA, -25.28 to 17.44 mm Hg) for DAP, and -7.89 mm Hg (LOA, -32.31 to 16.53 mm Hg) for MAP. The oscillometric device did not fulfill ACVIM guidelines for the validation of such devices. CONCLUSIONS AND CLINICAL RELEVANCE Agreement between OBP and IBP results for awake and anesthetized dogs was poor. The oscillometric blood pressure device did not fulfill ACVIM guidelines for validation. Therefore, clinical use of this device cannot be recommended.
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Liu RN, Wei XJ, Li SP, Jiang C, Zhao Y. Comparison of invasive dynamic blood pressure between superior mesenteric artery and common carotid artery in rats. World J Emerg Med 2020; 11:102-108. [PMID: 32076476 DOI: 10.5847/wjem.j.1920-8642.2020.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The purpose of this study was to identify the consistency of invasive dynamic blood pressure (BP) monitoring between the superior mesenteric artery (SMA) and the common carotid artery (CCA). METHODS Eight male Sprague-Dawley rats were cannulated in SMA and CCA simultaneously for BP monitoring, respectively. The abdominal aorta was prepared for the induction of BP change through clamping/de-clamping by a microvascular clip. The dynamic BP monitoring was performed by a polygraph system. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) values would be recorded during different time periods: the baseline (T1), the increasing period after clamping (T2), the platform period during clamping (T3), the decreasing period after de-clamping (T4), and the final platform period (T5). Three trials were performed on each rat with 15-minute intervals between consecutive monitoring. RESULTS Systolic BP showed no significant differences between SMA and CCA. However, significant difference was found in diastolic blood pressure except at T5 (P=0.534). Mean arterial pressure of two arteries were significantly different only at T1 (P=0.015). The strength of association was significantly high between BP measurements through SMA and CCA (P<0.001). The Bland-Altman analyses showed that mean bias of MAP changed no more than 5 mmHg and standard deviation less than 8 mmHg during T2 and T4, respectively. CONCLUSION The study indicates SMA might be an alternative site for invasive BP monitoring during abdominal aorta occlusion and release, especially in cerebrovascular-related research.
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Affiliation(s)
- Rui-Ning Liu
- Emergency Department of Zhongnan Hospital, Wuhan University, Wuhan 430071, China
| | - Xiao-Jun Wei
- Emergency Department of Zhongnan Hospital, Wuhan University, Wuhan 430071, China
| | - Shao-Ping Li
- Emergency Department of Zhongnan Hospital, Wuhan University, Wuhan 430071, China
| | - Cheng Jiang
- Emergency Department of Zhongnan Hospital, Wuhan University, Wuhan 430071, China
| | - Yan Zhao
- Emergency Department of Zhongnan Hospital, Wuhan University, Wuhan 430071, China
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Validation of the oscillometric blood pressure monitor Vet20 SunTech in anesthetized healthy cats. Vet Anaesth Analg 2020; 47:309-314. [PMID: 32173288 DOI: 10.1016/j.vaa.2019.12.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 11/25/2019] [Accepted: 12/15/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To 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 DESIGN Prospective clinical study. ANIMALS A total of 33 client-owned cats (20 females and 13 males). METHODS Cats 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. RESULTS Data 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 RELEVANCE The Vet20 did not meet all validation criteria by the ACVIM. However, all criteria except correlation were met.
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Comparison of oscillometric, Doppler and invasive blood pressure measurement in anesthetized goats. PLoS One 2018; 13:e0197332. [PMID: 29791515 PMCID: PMC5965870 DOI: 10.1371/journal.pone.0197332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 04/30/2018] [Indexed: 11/30/2022] Open
Abstract
Arterial blood pressure (BP) can be measured directly using an invasive intra-arterial method. This method is considered a gold standard, however it is potentially hazardous and requires expensive equipment and professional skills. Therefore, two non-invasive methods–Doppler ultrasonic sphygmomanometry and oscillometry–have been introduced in veterinary medicine. Their accuracy has so far been reliably evaluated in various animal species, however only one study included a small group of goats. Therefore, we carried out a large-scale study which aimed to evaluate agreement between the two non-invasive methods and invasive intra-arterial BP measurement in anesthetized goats at various age. The study included 122 goats of two Polish local breeds (Polish White Improved and Polish Fawn Improved): 67 adult females, 35 adult males, and 20 two-month-old female kids. Goats were anesthetized with the intravenous mixture of xylazine and ketamine. BP was measured simultaneously with the three methods in each goat with 7 measurements on average taken. The study showed that according to the criteria of the American College of Veterinary Internal Medicine (ACVIM) oscillometric method yielded BP measurements sufficiently consistent with invasive intra-arterial method in anesthetized adult goats– 95% of oscillometric BP measurements were expected to differ from invasive BP measurements by at most ±20–25 mmHg. The agreement was worse in goat kids–oscillometry significantly overestimated invasive BP measurements, which resulted in highly asymmetrical 95% limits of agreement. Doppler systolic BP very poorly conformed to invasive systolic BP both in adult goats and in kids and all the ACVIM criteria were violated. Concluding, oscillometry, but not Doppler ultrasonic sphygmomanometry, may be regarded as an alternative to invasive BP measurement in large-scale scientific studies involving adult goats, however, individual oscillometric BP measurements should be treated with caution as estimated 95% limits of agreement were wide.
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Zrimšek P, Sredenšek J, Vengušt M, Seliškar A. Evaluation of oscillometric blood pressure monitor BLT M9000 VET in anaesthetised healthy adult dogs. J Small Anim Pract 2018; 59:474-479. [PMID: 29318621 DOI: 10.1111/jsap.12811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 11/04/2017] [Accepted: 11/13/2017] [Indexed: 11/30/2022]
Abstract
To examine agreement in anaesthetised dogs between invasive blood pressure measurements and measurements obtained with an oscillometric blood pressure monitor. MATERIALS AND METHODS Paired invasive and oscillometric measurements were taken in 24 dogs every 5 minutes during anaesthesia (9 to 37 measurements per dog). Agreement between measurement methods was explored using Bland-Altman plots. To determine the accuracy of the oscillometric measurements, the results were compared with the guidelines recommended by the American College of Veterinary Internal Medicine and the Association for the Advancement of Medical Instrumentation. RESULTS In total, 493 paired readings were obtained: 98·6% of oscillometric readings were successful. Biases (±standard deviation) for oscillometric readings of systolic arterial blood pressure and mean arterial blood pressure were 2·1 (±11·5) and -9·8 (±7·6) mm Hg, indicating slight over- and under-estimation, respectively, versus invasive measurements. More than 50% and 80% of systolic arterial and mean arterial pressure measurements were within 10 and 20 mmHg of invasively measured values, respectively. A large negative bias (-14·1 ±9·2 mmHg) against invasive measurements revealed that the oscillometric measures of diastolic arterial blood pressure measurements were under-estimated. CLINICAL SIGNIFICANCE In healthy adult anaesthetised dogs, this oscillometric monitor met the American College of Veterinary Internal Medicine requirements for systolic arterial and mean arterial pressure measurement but failed to meet the requirements for the measurement of diastolic arterial pressure.
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Affiliation(s)
- P Zrimšek
- Institute for Preclinical Sciences, Veterinary Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - J Sredenšek
- Small Animal Clinic, Veterinary Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - M Vengušt
- Veterinary Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - A Seliškar
- Small Animal Clinic, Veterinary Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia
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da Cunha AF, Ramos SJ, Domingues M, Shelby A, Beaufrère H, Stout R, Acierno MJ. Validation of noninvasive blood pressure equipment: which peripheral artery is best for comparison studies in dogs? Vet Anaesth Analg 2017; 44:1068-1075. [DOI: 10.1016/j.vaa.2017.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 04/28/2017] [Accepted: 07/22/2017] [Indexed: 10/19/2022]
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Fujiyama M, Sano H, Chambers JP, Gieseg M. Evaluation of an indirect oscillometric blood pressure monitor in anaesthetised dogs at three different anatomical locations. N Z Vet J 2017; 65:185-191. [DOI: 10.1080/00480169.2017.1295000] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- M Fujiyama
- Massey University Veterinary Teaching Hospital, Tennent Drive, Palmerston North 4442, New Zealand
- Current address: Japan Veterinary Cardiovascular Medical Center, 2-7-3 Nakagawa, Tsuduki-ku, Yokohama, Japan
| | - H Sano
- Massey University Veterinary Teaching Hospital, Tennent Drive, Palmerston North 4442, New Zealand
| | - JP Chambers
- Massey University Veterinary Teaching Hospital, Tennent Drive, Palmerston North 4442, New Zealand
| | - M Gieseg
- Veterinary Health Research, Waikato Innovation Park, Hamilton 3240, New Zealand
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