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Surgivet V60046(一种用于麻醉犬的无创血压监测仪)的临床评估。

Clinical evaluation of the Surgivet V60046, a non invasive blood pressure monitor in anaesthetized dogs.

作者信息

Deflandre Catherine J A, Hellebrekers Ludo J

机构信息

Department of Clinical Sciences, Small Animal Surgery, Faculty of Veterinary Medicine, University of Liege, Boulevard de Colonster, Liege, Belgium.

出版信息

Vet Anaesth Analg. 2008 Jan;35(1):13-21. doi: 10.1111/j.1467-2995.2007.00346.x. Epub 2007 Aug 13.

Abstract

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.

摘要

目的

比较Surgivet无创血压(NIBP)监测仪V60046与有创血压(IBP)技术在麻醉犬中的性能。

研究设计

前瞻性研究。

动物

34只因各种手术而麻醉的犬。

方法

采用多种麻醉方案。使用置于股动脉或足背动脉的导管进行有创血压测量。在对侧肢体上放置袖带以进行无创测量。在一系列压力下同时记录动脉血压(ABP)。为进行分析,确定了三个压力水平:高[收缩压(SAP)>121 mmHg]、正常(91 mmHg < SAP < 120 mmHg)和低(SAP < 90 mmHg)。使用Bland-Altmann分析对有创和无创测量结果进行比较。

结果

NIBP监测仪在所有水平上均持续低估血压。在SAP和平均动脉压(MAP)的低压力和正常压力水平下,偏差最小且精度最高。在低血压水平时,偏差±95%置信区间(CI)为:1.9±2.96 mmHg(SAP)、8.3±2.41 mmHg舒张压(DAP)和3.5±2.09 mmHg(MAP)。在正常血压水平时,偏差和CI为:1.2±2.13 mmHg(SAP)、5.2±2.32 mmHg(DAP)和2.1±1.54 mmHg(MAP)。在高血压水平时,偏差和CI为:22.7±5.85 mmHg(SAP)、5.5±3.13 mmHg(DAP)和9.4±3.52 mmHg(MAP)。在90.6%的低血压(MAP < 70 mmHg)病例中,Surgivet监测仪正确诊断出低血压。

结论

使用间接监测仪测量血压可通过SAP或MAP检测到低血压。在低血压和正常水平下,MAP的读数最为准确。该监测仪在高血压水平时缺乏准确性。

临床意义

当预计心血管系统会面临严重挑战时,采用有创方法记录ABP更为可取。对于常规使用,Surgivet监测仪为犬的NIBP监测提供了一种可靠且安全的方法,从而通过提供有关循环的准确信息有助于麻醉安全。

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