Bosiack Ann P, Mann F A, Dodam John R, Wagner-Mann Colette C, Branson Keith R
University of Missouri, College of Veterinary Medicine, Columbia, MO 65211, USA.
J Vet Emerg Crit Care (San Antonio). 2010 Apr 1;20(2):207-15. doi: 10.1111/j.1476-4431.2010.00520.x.
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.
Prospective clinical study.
University teaching hospital.
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).
Blood pressure measurement.
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<or=direct MAP>or=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.
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.
比较超声多普勒血流监测仪（DOP）、2种示波法无创血压监测仪（CAR和PAS）所测血压值与住院清醒犬有一定血压范围的有创血压（IBP）。
前瞻性临床研究。
大学教学医院。
11只客户拥有的犬，年龄在4个月至11.5岁之间（中位数6岁），体重在5.8至37.5千克之间（中位数30.2千克）。
血压测量。
对3种间接测量设备（DOP仅测收缩压）分别连续记录3次收缩压、舒张压和平均动脉压（MAP），同时记录同步的IBP测量值。数据分为3组：低血压组（直接MAP<80 mmHg）、正常血压组（80 mmHg≤直接MAP≤100 mmHg）和高血压组（直接MAP>100 mmHg）。采用Bland-Altman方法将每种间接测量方法与相应的直接动脉压进行比较。在低血压组中，每种间接测量方法均高估了相应的IBP。在正常血压组中，所有间接收缩压测量值以及PAS舒张压测量值均低估了相应的IBP。其余间接测量值高估了相应的IBP。在高血压组中，DOP和CAR收缩压测量值低估了相应的IBP，其余间接测量值高估了相应的IBP。在高血压犬中，示波法收缩压测量比MAP更准确。在低血压犬中，MAP测量比收缩压测量更准确。所有间接测量值在高血压犬中最准确。
我们研究中的无创血压监测仪未达到人类医学设定的验证标准。然而，正常血压组中的CAR舒张压和MAP测量值、高血压组中的CAR MAP测量值以及所有组中的PAS舒张压测量值接近这些标准。所有间接测量值在低血压时偏差更大。所有间接收缩压测量的精密度均低于MAP。
