Yamaoka Tyfane T, Flaherty Derek, Pawson Patricia, Scott Marian, Auckburally Adam
Institute of Biodiversity, Animal Health and Comparative Medicine, School of Veterinary Medicine, University of Glasgow, Glasgow, UK.
Institute of Biodiversity, Animal Health and Comparative Medicine, School of Veterinary Medicine, University of Glasgow, Glasgow, UK.
Vet Anaesth Analg. 2017 May;44(3):492-501. doi: 10.1016/j.vaa.2016.05.008. Epub 2017 Jan 11.
To assess agreement between noninvasive blood pressure (NIBP) oscillometrically-derived values from a multiparameter monitor (Datex Ohmeda S/5 Compact) with those obtained by invasive blood pressure (IBP) measurement in anaesthetised horses undergoing elective surgery.
Prospective clinical study.
A total of 40 healthy adult horses.
Horses were anaesthetised with various anaesthetic protocols (based on clinical requirements). Depending on positioning, cannulation of the facial or lateral metatarsal artery was performed for IBP measurement. The cannula was connected via a transducer to the monitor. An appropriately sized NIBP cuff was placed around the tail base and connected to the same monitor. Systolic (SAP), mean (MAP) and diastolic (DAP) arterial blood pressures were continuously recorded from the invasive system, and at 3 minute intervals from the oscillometric system, throughout the surgical procedure using a Datex iCollect program. An appropriate arithmetic correction factor was applied to the oscillometric results where the cuff was not level with the heart. Assessment of the degree of agreement between invasive and noninvasive readings at each time point was performed using a modified Bland-Altman analysis.
While in many horses there was relatively close correlation between the values obtained over time, there was substantial variability in individual animals which resulted in wide Bland-Altman limits of agreement. The oscillometric device over-reads by approximately 32, 23 and 22 mmHg, and under-reads by 26, 17 and 19 mmHg for SAP, MAP and DAP, respectively, compared with the IBP values. However, using the mean difference and standard deviation, the device conforms to American College of Veterinary Internal Medicine (ACVIM) standards.
Oscillometric blood pressure measurement using the Datex Ohmeda S/5 Compact multiparameter monitor conforms to ACVIM standards when the NIBP cuff is placed on the tail. However, because of the wide variability in measurements, we cannot recommend this technique to guide therapy in anaesthetised adult horses.
评估在接受择期手术的麻醉马匹中，多参数监护仪（Datex Ohmeda S/5 Compact）通过示波法得出的无创血压（NIBP）值与有创血压（IBP）测量值之间的一致性。
前瞻性临床研究。
总共40匹健康成年马。
采用各种麻醉方案（根据临床需求）对马匹进行麻醉。根据体位，对面部或外侧跖骨动脉进行插管以测量IBP。插管通过换能器连接到监护仪。将尺寸合适的NIBP袖带放置在尾根周围，并连接到同一监护仪。在整个手术过程中，使用Datex iCollect程序从有创系统连续记录收缩压（SAP）、平均动脉压（MAP）和舒张压（DAP），并从示波法系统每隔3分钟记录一次。当袖带与心脏不在同一水平时，对示波法结果应用适当的算术校正因子。使用改良的Bland-Altman分析评估每个时间点有创和无创读数之间的一致性程度。
虽然在许多马匹中，随着时间推移获得的值之间存在相对密切的相关性，但个别动物存在很大差异，导致Bland-Altman一致性界限较宽。与IBP值相比，示波法设备的SAP、MAP和DAP分别高估约32、23和22 mmHg，低估26、17和19 mmHg。然而，使用平均差值和标准差，该设备符合美国兽医内科学会（ACVIM）标准。
当将NIBP袖带放置在尾部时，使用Datex Ohmeda S/5 Compact多参数监护仪进行示波法血压测量符合ACVIM标准。然而，由于测量值差异较大，我们不推荐使用该技术来指导麻醉成年马的治疗。
