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袖带尺寸、袖带放置位置、血压状态和监测技术会影响麻醉状态下的蝙蝠(马来大狐蝠)的间接动脉血压监测。

Cuff size, cuff placement, blood pressure state, and monitoring technique can influence indirect arterial blood pressure monitoring in anesthetized bats (Pteropus vampyrus).

作者信息

Paranjape Vaidehi V, Gatson Bonnie J, Bailey Kate, Wellehan James F X

机构信息

Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA.

Safe Harbor Veterinary Anesthesia Support LLC, Gainesville, FL.

出版信息

Am J Vet Res. 2023 Mar 19;84(5). doi: 10.2460/ajvr.22.12.0208. Print 2023 May 1.

Abstract

OBJECTIVE

Evaluate agreement between 2 non-invasive blood pressure (NIBP) techniques and invasive arterial blood pressure (IBP) in anesthetized bats using various cuff sizes and cuff positioning while also evaluating its performance during hypertension and hypotension.

ANIMALS

8 bats (1.1 ± 0.2 kg).

PROCEDURES

Bats were anesthetized with isoflurane in oxygen. NIBP was measured using oscillometric (NIBP-O) and Doppler (NIBP-D) techniques in the pectoral limb (PEC) and pelvic limbs (PEL) using 3 cuff sizes (1, 2, and 3). NIBP measurements were compared with IBP; systolic (SAPinvasive), mean (MAPinvasive), and diastolic arterial blood pressure (DAPinvasive) during normotension, hypertension, and hypotension. Hypotension was induced with isoflurane (3.8 ± 1.2%) and hypertension with norepinephrine (3 ± 0.5 µg/kg/min). Data analysis included Bland-Altman analyses and 3-way ANOVA. Results were reported as mean bias (95% CI).

RESULTS

NIBP-O monitor reported 29% errors, and experienced more failures with hypertension, cuff placement on PEC, and using a size 1 cuff. Across states, an agreement between NIBP-D and MAPinvasive with cuff 2 on PEL (-3 mmHg [-8, 1]), and NIBP-D and SAPinvasive with cuff 3 on PEC (2 mmHg [-5, 9 mmHg]) was achieved. NIBP-D over-estimated SAPinvasive and MAPinvasive during hypertension in both limbs with cuffs 1 and 2. Except during hypotension, NIBP-O underestimated MAPinvasive and DAPinvasive using a size 2 cuff on PEL.

CLINICAL RELEVANCE

In anesthetized bats, NIBP-O is unreliable for estimating IBP. NIBP-D shows acceptable agreement with MAPinvasive with cuff size 2 on PEL, and with SAPinvasive with cuff size 3 on PEC across a wide range of IBP values.

摘要

目的

评估在麻醉的蝙蝠中,使用不同袖带尺寸和袖带位置的两种无创血压(NIBP)技术与有创动脉血压(IBP)之间的一致性,同时评估其在高血压和低血压期间的性能。

动物

8只蝙蝠(1.1±0.2千克)。

方法

用异氟烷在氧气中麻醉蝙蝠。使用示波法(NIBP-O)和多普勒法(NIBP-D)在胸肢(PEC)和盆腔肢(PEL)测量无创血压,使用3种袖带尺寸(1、2和3)。将无创血压测量值与有创血压进行比较;包括正常血压、高血压和低血压期间的收缩压(有创收缩压,SAPinvasive)、平均压(有创平均压,MAPinvasive)和舒张压(有创舒张压,DAPinvasive)。用异氟烷(3.8±1.2%)诱导低血压,用去甲肾上腺素(3±0.5微克/千克/分钟)诱导高血压。数据分析包括布兰德-奥特曼分析和三因素方差分析。结果以平均偏差(95%置信区间)报告。

结果

NIBP-O监测仪报告的误差为29%,在高血压、袖带置于PEC以及使用1号袖带时出现更多失败情况。在不同状态下,在PEL上使用2号袖带时,NIBP-D与MAPinvasive之间达成一致(-3毫米汞柱[-8,1]),在PEC上使用3号袖带时,NIBP-D与SAPinvasive之间达成一致(2毫米汞柱[-5,9毫米汞柱])。在高血压期间,使用1号和2号袖带时,NIBP-D在两个肢体上均高估了SAPinvasive和MAPinvasive。除低血压期间外,在PEL上使用2号袖带时,NIBP-O低估了MAPinvasive和DAPinvasive。

临床意义

在麻醉的蝙蝠中,NIBP-O在估计IBP方面不可靠。在广泛的IBP值范围内,NIBP-D在PEL上使用2号袖带时与MAPinvasive,以及在PEC上使用3号袖带时与SAPinvasive显示出可接受的一致性。

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