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麻醉状态下的蟒科蛇类无创振荡式血压监测评估

Evaluation of noninvasive oscillometric blood pressure monitoring in anesthetized boid snakes.

作者信息

Chinnadurai Sathya K, Wrenn Amy, DeVoe Ryan S

机构信息

Department of Clinical Sciences and Environmental Medicine Consortium, North Carolina State University, Raleigh, NC 27606, USA.

出版信息

J Am Vet Med Assoc. 2009 Mar 1;234(5):625-30. doi: 10.2460/javma.234.5.625.

Abstract

OBJECTIVE

To determine the accuracy of a noninvasive oscillometric monitor in the measurement of arterial blood pressure in anesthetized boid snakes.

DESIGN

Evaluation study.

ANIMALS

4 boa constrictors (Boa constrictor), 2 carpet pythons (Morelia spilota), and 2 reticulated pythons (Python reticulatus).

PROCEDURES

After induction of anesthesia with isoflurane, each snake was instrumented with an arterial catheter connected to a pressure transducer and oscilloscope to obtain invasive measurements of systolic (SAP), diastolic (DAP), and mean (MAP) arterial blood pressure as well as a pressure waveform. A cuff connected to an oscillometric device was placed on the tail immediately distal to the vent for noninvasive measurements. Heart rate, respiratory rate, and invasive and noninvasive measurements of SAP, DAP, and MAP were obtained every 5 minutes for 45 minutes. Delivered isoflurane concentration was increased in 15-minute increments to induce hypotension. Repeatability of each device and fixed and proportional biases between devices were calculated.

RESULTS

Throughout most of the measured ranges of blood pressures, the oscillometric unit overestimated the SAP and underestimated the DAP and MAP, compared with respective direct measurements. When the invasively determined SAP was > 100 mm Hg, the oscillometric unit underestimated all 3 variables. Fixed bias was significant for SAP and DAP, and proportional bias was significant for SAP and MAP.

CONCLUSIONS AND CLINICAL RELEVANCE

When using an oscillometric blood pressure monitor on anesthetized boid snakes, veterinarians can potentially monitor changes in blood pressure, although the displayed readings may underestimate DAP and MAP and overestimate SAP. Indirect measurements of blood pressure made with the oscillometric device cannot substitute for direct measurements.

摘要

目的

确定一种无创示波监测仪在测量麻醉状态下蟒科蛇类动脉血压时的准确性。

设计

评估研究。

动物

4条红尾蚺(Boa constrictor)、2条地毯蟒(Morelia spilota)和2条网纹蟒(Python reticulatus)。

方法

用异氟烷诱导麻醉后,给每条蛇插入一根连接压力传感器和示波器的动脉导管,以获取收缩压(SAP)、舒张压(DAP)和平均动脉压(MAP)的有创测量值以及压力波形。将连接到示波装置的袖带置于泄殖腔远端的尾部,进行无创测量。在45分钟内,每隔5分钟获取心率、呼吸频率以及SAP、DAP和MAP的有创和无创测量值。以15分钟为增量增加异氟烷浓度以诱导低血压。计算每个装置的重复性以及装置之间的固定偏差和比例偏差。

结果

在大部分测量的血压范围内,与各自的直接测量值相比,示波装置高估了SAP,低估了DAP和MAP。当有创测定的SAP>100 mmHg时,示波装置低估了所有3个变量。SAP和DAP的固定偏差显著,SAP和MAP的比例偏差显著。

结论及临床意义

在麻醉的蟒科蛇类中使用示波血压监测仪时,兽医可以潜在地监测血压变化,尽管显示的读数可能低估DAP和MAP并高估SAP。用示波装置进行的间接血压测量不能替代直接测量。

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