1
|
EVALUATION OF AGREEMENT BETWEEN OSCILLOMETRIC AND DIRECT BLOOD PRESSURE MEASUREMENTS IN ANESTHETIZED TIGERS ( PANTHERA TIGRIS). J Zoo Wildl Med 2023; 53:777-784. [PMID: 36640079 DOI: 10.1638/2022-0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2022] [Indexed: 01/09/2023] Open
Abstract
Noninvasive blood pressure measurement is commonly performed with oscillometry; however, this technique provides clinically helpful information only if it is representative of the gold standard. Agreement between direct and oscillometric blood pressure measurements were performed in 14 anesthetized, captive tigers (Panthera tigris). A cuff, placed around the tail base and connected to a multiparameter monitor, was used to measure arterial blood pressure oscillometrically and provided systolic, mean, and diastolic pressures. At the same time, direct blood pressures were obtained from a dorsal pedal arterial catheter, and the oscillometric and direct readings were considered paired data points. Agreement between the two methods was evaluated by Bland-Altman plots. All animals completed the study and provided 196 paired data points. The bias (mm Hg) for systolic, mean, and diastolic arterial pressures was -3.7, -0.8, and -1.6, respectively. Limits of agreement (mm Hg) for systolic, mean, and diastolic arterial pressures were -31 to 24, -29 to 27, and -29 to 26, respectively. Oscillometry provided an acceptable amount of readings within 10 and 20 mm Hg of the gold standard. The oscillometric technique provided reasonable agreement with direct measurements. Therefore, in the conditions used in this study, oscillometric blood pressure measured via the ventral coccygeal artery provided reasonable estimates of invasive blood pressure in anesthetized tigers.
Collapse
|
2
|
Smith CK, Ashley AL, Zhu X, Cushing AC. Agreement between oscillometric and direct blood pressure measurements in anesthetized captive chimpanzees (Pan troglodytes). Am J Vet Res 2021; 82:963-969. [PMID: 34727067 DOI: 10.2460/ajvr.20.11.0194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the level of agreement (LOA) between direct and oscillometric blood pressure (BP) measurements and the ability of oscillometric measurements to accurately detect hypotension in anesthetized chimpanzees (Pan troglodytes). ANIMALS 8 captive, adult chimpanzees. PROCEDURES During prescheduled annual examinations, each chimpanzee underwent general anesthesia and patient monitoring for their examination, echocardiography for a concurrent study, and measurement of direct BP with the use of tibial artery catheterization and oscillometry with the use of a cuff placed around a brachium and a cuff placed around the second digit of the contralateral forelimb for the present study. Bland-Altman plots were generated to compare results for direct and oscillometric BP measurements. Mean bias and 95% LOAs were calculated for oscillometric measurements of systolic arterial pressure (SAP), diastolic arterial pressure (DAP), and mean arterial pressure (MAP) for each cuff site. Sensitivity and specificity in detecting hypotension were also determined for each cuff site. RESULTS There were 74 paired direct and brachial oscillometric measurements of each, SAP, MAP, and DAP and 66 paired direct and digit oscillometric measurements of each, SAP, MAP, and DAP. Only brachial oscillometric measurements of MAP had adequate sensitivity (78%) and specificity (95%) to accurately detect hypotension, and this technique also had the least mean bias (0.8 mm Hg; 95% LOA, -29 to 31 mm Hg). CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that brachial oscillometric measurement of MAP provided reasonable agreement with tibial arterial direct MAP measurement and performed well in diagnosing hypotension in anesthetized chimpanzees.
Collapse
Affiliation(s)
- Christopher K Smith
- From the Department of Small Animal Clinical Sciences (Smith, Cushing) and Office of Information and Technology (Zhu), College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996; and The Chattanooga Zoo, Chattanooga, TN 37404 (Ashley)
| | - Anthony L Ashley
- From the Department of Small Animal Clinical Sciences (Smith, Cushing) and Office of Information and Technology (Zhu), College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996; and The Chattanooga Zoo, Chattanooga, TN 37404 (Ashley)
| | - Xiaojuan Zhu
- From the Department of Small Animal Clinical Sciences (Smith, Cushing) and Office of Information and Technology (Zhu), College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996; and The Chattanooga Zoo, Chattanooga, TN 37404 (Ashley)
| | - Andrew C Cushing
- From the Department of Small Animal Clinical Sciences (Smith, Cushing) and Office of Information and Technology (Zhu), College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996; and The Chattanooga Zoo, Chattanooga, TN 37404 (Ashley)
| |
Collapse
|
3
|
Oldach MS, Ueda Y, Ontiveros ES, Fousse SL, Visser LC, Stern JA. Acute pharmacodynamic effects of pimobendan in client-owned cats with subclinical hypertrophic cardiomyopathy. BMC Vet Res 2021; 17:89. [PMID: 33622315 PMCID: PMC7903657 DOI: 10.1186/s12917-021-02799-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 02/16/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Prior studies have suggested that pimobendan is associated with several positive effects in cats, including improved survival in cats with congestive heart failure and improved left atrial function in research colony cats with hypertrophic cardiomyopathy (HCM) and normal cats. However, there is still a paucity of pharmacodynamic data refuting or supporting the use of pimobendan in a clinical cat population. This clinical trial aimed to evaluate the pharmacodynamic effects and tolerability of a single dose of pimobendan in cats with HCM. Echocardiograms and Doppler-derived systolic blood pressures were performed in 21 client-owned cats with subclinical HCM at baseline and 90-min after oral administration of 1.25 mg of pimobendan (Vetmedin). Seven additional cats were evaluated post-placebo administration to account for intra-day variability. RESULTS Heart rate, systolic blood pressure, and murmur grade were not significantly different between baseline and post-pimobendan evaluations. Left auricular blood flow velocity, left atrial size, and left ventricular fractional shortening were not significantly different between baseline and post-pimobendan evaluations. Mean (± standard deviation) tissue Doppler peak systolic velocity of the mitral annulus was significantly higher following pimobendan (7.4 cm/s ± 1.5 vs 8.5 ± 1.6; p = 0.02). Median (min, max) left-ventricular outflow tract maximum velocity was significantly higher following pimobendan [1.9 m/sec (1.5, 3.4) vs 2.6 m/sec (2.0, 4.0); p = 0.01]. Mean right-ventricular outflow tract maximum velocity was also significantly higher following pimobendan (1.5 m/s ± 0.51 vs 2.0 ± 0.53; p = 0.004). Mean left atrial fractional shortening was significantly higher following pimobendan (28% ± 6 vs 32% ± 7; p = 0.02). No adverse events were observed following pimobendan administration. Right ventricular outflow tract velocity was significantly higher following placebo in control cats (1.02 ± 0.21 versus 1.31 ± 0.31; p = 0.01). No other significant differences were detected. CONCLUSIONS In client-owned cats with HCM, pimobendan acutely increased left atrial function and mildly increased left ventricular systolic function. Left ventricular outflow tract velocity was increased after pimobendan. Pimobendan was well tolerated in the acute setting in cats with HCM. The findings of this prospective, acute-dosing study confirm previous findings in research animals and retrospective analyses and suggest that chronic dosing studies are safe and warranted.
Collapse
Affiliation(s)
- Maureen S Oldach
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, One Shields Avenue, Davis, CA, 95616, USA
| | - Yu Ueda
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, 27606, USA
| | - Eric S Ontiveros
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, One Shields Avenue, Davis, CA, 95616, USA
| | - Samantha L Fousse
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, One Shields Avenue, Davis, CA, 95616, USA
| | - Lance C Visser
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, One Shields Avenue, Davis, CA, 95616, USA
| | - Joshua A Stern
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, One Shields Avenue, Davis, CA, 95616, USA.
| |
Collapse
|
4
|
Lyberg M, Ljungvall I, Häggström J, Ahlund E, Pelander L. Impact of equipment and handling on systolic blood pressure measurements in conscious dogs in an animal hospital environment. J Vet Intern Med 2021; 35:739-746. [PMID: 33586197 PMCID: PMC7995364 DOI: 10.1111/jvim.16062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 01/26/2021] [Accepted: 02/01/2021] [Indexed: 11/26/2022] Open
Abstract
Background Situational hypertension and differences between devices complicate interpretations of systolic blood pressure (SBP) measurements in dogs. Hypothesis/Objectives To evaluate if time point of in‐clinic SBP measurement, type of oscillometric device, and operator affect SBP measurements in conscious dogs. Animals Sixty‐seven privately owned dogs with or without chronic kidney disease, divided into 2 study samples (A and B). Methods Cross‐sectional diagnostic study. In part A, SBP measurements in dogs were performed using 2 different devices (HDO and petMap) after acclimatization at 3 standardized time points during a clinical visit. In part B, SBP measurements (HDO) were performed in dogs by a trained final year veterinary student and by the owner alone, at the same occasion. Results For all dogs, there was no difference in mean SBP (mSBP) among the 3 time points for HDO (P = .12) or petMAP (P = .67). However, intraindividual mSBP differences of up to 60 mm Hg between time points were documented. Mean SBP obtained with petMAP was on average 14 (95% CI: 8‐20) mm Hg higher than mSBP obtained with HDO, and this difference increased with increasing SBP. Mean SBP measurements obtained by the trained student were 7 (95% CI: 2‐11) mm Hg higher than mSBP measurements obtained by the owner. Conclusions and Clinical Importance According to the results of this study, time point of in‐clinic SBP measurement in dogs is of minor importance, and instructing owners to perform measurements might reduce suspected situational hypertension. Differences in mSBP measured with HDO and petMAP underscore the need for validation of BP devices used clinically.
Collapse
Affiliation(s)
- Maria Lyberg
- University Animal Hospital, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Ingrid Ljungvall
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Jens Häggström
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | | | - Lena Pelander
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
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.
Collapse
|
7
|
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.
Collapse
|
8
|
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.
Collapse
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
| |
Collapse
|
9
|
Cerejo SA, Teixeira-Neto FJ, Garofalo NA, Rodrigues JC, Celeita-Rodríguez N, Lagos-Carvajal AP. Comparison of two species-specific oscillometric blood pressure monitors with direct blood pressure measurement in anesthetized cats. J Vet Emerg Crit Care (San Antonio) 2017; 27:409-418. [DOI: 10.1111/vec.12623] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 09/13/2015] [Accepted: 11/04/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Sofia A. Cerejo
- Department of Anesthesiology, Faculdade de Medicina; Universidade Estadual Paulista (UNESP); Botucatu Brazil
| | - Francisco J. Teixeira-Neto
- Department of Veterinary Surgery and Anesthesiology, Faculdade de Medicina Veterinária e Zootecnia; Universidade Estadual Paulista (UNESP); Botucatu Brazil
| | - Natache A. Garofalo
- Department of Anesthesiology, Faculdade de Medicina; Universidade Estadual Paulista (UNESP); Botucatu Brazil
- Department of Veterinary Surgery and Anesthesiology, Faculdade de Medicina Veterinária e Zootecnia; Universidade Estadual Paulista (UNESP); Botucatu Brazil
| | - Jéssica C. Rodrigues
- Department of Anesthesiology, Faculdade de Medicina; Universidade Estadual Paulista (UNESP); Botucatu Brazil
| | - Nathalia Celeita-Rodríguez
- Department of Veterinary Surgery and Anesthesiology, Faculdade de Medicina Veterinária e Zootecnia; Universidade Estadual Paulista (UNESP); Botucatu Brazil
| | - Angie P. Lagos-Carvajal
- Department of Anesthesiology, Faculdade de Medicina; Universidade Estadual Paulista (UNESP); Botucatu Brazil
| |
Collapse
|
10
|
Ramos SJ, da Cunha AF, Domingues M, Shelby AM, Stout RW, Acierno MJ. Comparison of blood pressure measurements of anesthetized dogs obtained noninvasively with a cylindrical blood pressure cuff and an anatomically modified conical blood pressure cuff. Am J Vet Res 2015; 77:59-64. [PMID: 26709937 DOI: 10.2460/ajvr.77.1.59] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare blood pressure measured noninvasively with an oscillometric device that involved use of a novel conical cuff and a traditional cylindrical blood pressure cuff. ANIMALS 17 adult hound-type dogs. PROCEDURES Dogs were anesthetized, and a 20-gauge, 1.5-inch catheter was inserted in the median sacral artery. The catheter was attached to a pressure transducer via fluid-filled noncompliant tubing, and direct blood pressure was recorded with a multifunction monitor. A specially fabricated conical cuff was placed on the antebrachium. Four sets of direct and indirect blood pressure measurements were simultaneously collected every 2 minutes. Four sets of measurements were then obtained by use of a cylindrical cuff. RESULTS The cylindrical cuff met American College of Veterinary Internal Medicine consensus guidelines for validation of indirect blood pressure measurements for mean arterial blood pressure (MAP), systolic arterial blood pressure (SAP), and diastolic arterial blood pressure (DAP). The conical cuff met the consensus guidelines for difference of paired measurements, SD, and percentages of measurements within 10 and 20 mm Hg of the value for the reference method, but it failed a correlation analysis. In addition, although bias for the conical cuff was less than that for the cylindrical cuff for SAP, MAP, and DAP measurements, the limits of agreement for the conical cuff were wider than those for the cylindrical cuff for SAP and MAP measurements. CONCLUSIONS AND CLINICAL RELEVANCE On the basis of results of this study, use of a conical cuff for oscillometric blood pressure measurement cannot be recommended.
Collapse
|
11
|
Acierno MJ, Domingues ME, Ramos SJ, Shelby AM, da Cunha AF. Comparison of directly measured arterial blood pressure at various anatomic locations in anesthetized dogs. Am J Vet Res 2015; 76:266-71. [PMID: 25710763 DOI: 10.2460/ajvr.76.3.266] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine whether directly measured arterial blood pressure differs among anatomic locations and whether arterial blood pressure is influenced by body position. ANIMALS 33 client-owned dogs undergoing anesthesia. PROCEDURES Dogs undergoing anesthetic procedures had 20-gauge catheters placed in both the superficial palmar arch and the contralateral dorsal pedal artery (group 1 [n = 20]) or the superficial palmar arch and median sacral artery (group 2 [13]). Dogs were positioned in dorsal recumbency, and mean arterial blood pressure (MAP), systolic arterial blood pressure (SAP), and diastolic arterial blood pressure (DAP) were recorded for both arteries 4 times (2-minute interval between successive measurements). Dogs were positioned in right lateral recumbency, and blood pressure measurements were repeated. RESULTS Differences were detected between pressures measured at the 2 arterial sites in both groups. This was especially true for SAP measurements in group 1, in which hind limb measurements were a mean of 16.12 mm Hg higher than carpus measurements when dogs were in dorsal recumbency and 14.70 mm Hg higher than carpus measurements when dogs were in lateral recumbency. Also, there was significant dispersion about the mean for all SAP, DAP, and MAP measurements. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that arterial blood pressures may be dependent on anatomic location and body position. Because this may affect outcomes of studies conducted to validate indirect blood pressure measurement systems, care must be used when developing future studies or interpreting previous results.
Collapse
Affiliation(s)
- Mark J Acierno
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803
| | | | | | | | | |
Collapse
|
12
|
Hatz LA, Hartnack S, Kümmerle J, Hässig M, Bettschart-Wolfensberger R. A study of measurement of noninvasive blood pressure with the oscillometric device, Sentinel, in isoflurane-anaesthetized horses. Vet Anaesth Analg 2014; 42:369-76. [PMID: 25082169 DOI: 10.1111/vaa.12213] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 10/24/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To 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 DESIGN Prospective study examining replicates of simultaneous NIBP and IBP measurements. ANIMALS Twenty-nine horses. METHODS Invasive 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. RESULTS Noninvasive 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 RELEVANCE According 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.
Collapse
Affiliation(s)
- Lea-Annina Hatz
- Section of Anaesthesiology, Equine Department, Vetsuisse Faculty University of Zurich, Zurich, Switzerland
| | - Sonja Hartnack
- Section of Epidemiology, Vetsuisse Faculty University Zurich, Zurich, Switzerland
| | - Jan Kümmerle
- Section of Surgery, Equine Department, Vetsuisse Faculty University of Zurich, Zurich, Switzerland
| | - Michael Hässig
- Section of Herd Health, Farm Animal Departement, Vetsuisse Faculty University of Zurich, Zurich, Switzerland
| | | |
Collapse
|
13
|
Vachon C, Belanger MC, Burns PM. Evaluation of oscillometric and Doppler ultrasonic devices for blood pressure measurements in anesthetized and conscious dogs. Res Vet Sci 2014; 97:111-7. [PMID: 24924217 DOI: 10.1016/j.rvsc.2014.05.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 02/05/2014] [Accepted: 05/04/2014] [Indexed: 11/29/2022]
Abstract
Two non-invasive blood pressure (NIBP) devices (oscillometry and Doppler) were compared to invasive blood pressure using a Bland-Altman analysis, in anesthetized and conscious dogs. When considering the systolic arterial pressure only during general anesthesia, both NIBP devices slightly underestimated the systolic arterial blood pressure however the precision and the limits of agreement for the Doppler were of a greater magnitude. This indicates a worse clinical performance by the Doppler. The performance of both NIBP devices deteriorated as measured in conscious animals. In general, for the oscillometric device, determination of invasive diastolic and mean arterial pressures was better than the invasive systolic arterial pressure. Overall, the oscillometric device satisfied more of the criteria set by the American College of Veterinary Internal Medicine consensus statement. Based upon these results, the oscillometric device is more reliable than the Doppler in the determination of blood pressure in healthy medium to large breed dogs.
Collapse
Affiliation(s)
- Catherine Vachon
- Faculté de Médecine Vétérinaire, Department of Clinical Sciences, University of Montreal, Canada.
| | - Marie C Belanger
- Faculté de Médecine Vétérinaire, Department of Clinical Sciences, University of Montreal, Canada
| | - Patrick M Burns
- Faculté de Médecine Vétérinaire, Department of Clinical Sciences, University of Montreal, Canada
| |
Collapse
|
14
|
Okushima S, Vettorato E, Corletto F. Chronotropic effect of propofol or alfaxalone following fentanyl administration in healthy dogs. Vet Anaesth Analg 2014; 42:88-92. [PMID: 24735086 DOI: 10.1111/vaa.12166] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 11/21/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare the effect of alfaxalone and propofol on heart rate (HR) and blood pressure (BP) after fentanyl administration in healthy dogs. STUDY DESIGN Prospective, randomised clinical study. ANIMALS Fifty healthy client owned dogs (ASA I/II) requiring general anaesthesia for elective magnetic resonance imaging for neurological conditions. METHODS All dogs received fentanyl 7 μg kg(-1) IV and were allocated randomly to receive either alfaxalone (n = 25) or propofol (n = 25) to effect until endotracheal (ET) intubation was possible. Heart rate and oscillometric BP were measured before fentanyl (baseline), after fentanyl (Time F) and after ET intubation (Time GA). Post-induction apnoea were recorded. Data were analysed using Fisher's exact test, Mann Whitney U test and one-way anova for repeated measures as appropriate; p value <0.05 was considered significant. RESULTS Dogs receiving propofol showed a greater decrease in HR (-14 beat minute(-1) , range -47 to 10) compared to alfaxalone (1 beat minute(-1) , range -33 to 26) (p = 0.0116). Blood pressure decreased over the three time periods with no difference between groups. Incidence of post-induction apnoea was not different between groups. CONCLUSION Following fentanyl administration, anaesthetic induction with propofol resulted in a greater negative chronotropic effect while alfaxalone preserved or increased HR. CLINICAL RELEVANCE Following fentanyl administration, HR decreases more frequently when propofol rather than alfaxalone is used as induction agent. However, given the high individual variability and the small change in predicted HR (-7.7 beats per minute after propofol), the clinical impact arising from choosing propofol or alfaxalone is likely to be small in healthy animals. Further studies in dogs with myocardial disease and altered haemodynamics are warranted.
Collapse
|