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临床条件下麻醉马匹三条外周动脉所测有创血压之间的一致性。

Agreement between invasive blood pressures measured in three peripheral arteries in anaesthetized horses under clinical conditions.

作者信息

Wilson Keely A T, Raisis Anthea L, Drynan Eleanor A, Lester Guy D, Hosgood Giselle L

机构信息

Department of Veterinary Anaesthesia and Analgesia, College of Veterinary Medicine, School of Veterinary and Life sciences, Murdoch University Veterinary Hospital, Murdoch, Australia.

Department of Veterinary Anaesthesia and Analgesia, College of Veterinary Medicine, School of Veterinary and Life sciences, Murdoch University Veterinary Hospital, Murdoch, Australia.

出版信息

Vet Anaesth Analg. 2018 May;45(3):338-344. doi: 10.1016/j.vaa.2017.11.004. Epub 2018 Jan 17.

Abstract

OBJECTIVE

To determine agreement between invasive blood pressures measured in three peripheral arteries in anaesthetized horses undergoing elective surgery.

STUDY DESIGN

Prospective balanced incomplete block design.

ANIMALS

A total of 18 client-owned horses.

METHODS

Invasive blood pressure (IBP) was measured simultaneously in one of the following three combinations: 1) transverse facial and facial artery; 2) transverse facial and metatarsal artery; and 3) facial and metatarsal artery. The agreement in blood pressure measured for each combination was performed in six horses. At each sample time, systolic (SAP), mean (MAP) and diastolic (DAP) arterial pressures were measured concurrently in each artery, and the mean of three consecutive measurements was recorded. The position of horse, heart rate and use of dobutamine were also recorded. Bland-Altman analysis was used to assess agreement between sites.

RESULTS

A total of 54 paired measurements were obtained, with 18 paired measurements from each combination. All paired measurements showed poor and haphazard (nonsystematic) agreement. The widest limit of agreement was 51 mmHg for SAP measured in the facial artery and metatarsal artery, with a bias of -11 mmHg. The smallest limit of agreement was 16 mmHg for MAP measured in the transverse facial and metatarsal artery, with a bias of 1 mmHg.

CONCLUSIONS AND CLINICAL RELEVANCE

There was poor and haphazard agreement for SAP, MAP and DAP measured in each pair of peripheral arteries in this study. These results show that blood pressure measured in different peripheral arteries cannot be used interchangeably. This has implications for studies that use IBP as an outcome variable and studies determining agreement between noninvasive blood pressure and IBP measurements in horses under general anaesthesia.

摘要

目的

确定接受择期手术的麻醉马匹三条外周动脉所测有创血压之间的一致性。

研究设计

前瞻性平衡不完全区组设计。

动物

共18匹客户拥有的马匹。

方法

以以下三种组合之一同时测量有创血压(IBP):1)面横动脉和面部动脉;2)面横动脉和跖骨动脉;3)面部动脉和跖骨动脉。每种组合的血压测量一致性在6匹马中进行。在每个采样时间,同时测量每条动脉的收缩压(SAP)、平均压(MAP)和舒张压(DAP),并记录连续三次测量的平均值。还记录了马匹的体位、心率和多巴酚丁胺的使用情况。采用Bland-Altman分析评估不同部位之间的一致性。

结果

共获得54对测量值,每种组合有18对测量值。所有配对测量显示一致性差且无规律(非系统性)。面部动脉和跖骨动脉所测SAP的最大一致性界限为51 mmHg,偏差为 -11 mmHg。面横动脉和跖骨动脉所测MAP的最小一致性界限为16 mmHg,偏差为1 mmHg。

结论及临床意义

本研究中,每对外周动脉所测SAP、MAP和DAP的一致性差且无规律。这些结果表明,不同外周动脉所测血压不能互换使用。这对将IBP作为结果变量的研究以及确定全身麻醉下马匹无创血压与IBP测量之间一致性的研究具有重要意义。

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