Accuracy and precision of oscillometric blood pressure in standing conscious horses.

Emil Olsen,Rebecca Robinson,Tilde Louise Skovgaard Pedersen,Pia Haubro Andersen

doi:10.1111/vec.12411

Abstract

Arterial blood pressure (BP) is a relevant clinical parameter that can be measured in standing conscious horses to assess tissue perfusion or pain. However, there are no validated oscillometric noninvasive blood pressure (NIBP) devices for use in horses. Seven healthy horses from a teaching and research herd. To evaluate the accuracy and precision of systolic arterial pressure (SAP), diastolic arterial pressure (DAP), and mean arterial pressure (MAP) in conscious horses obtained with an oscillometric NIBP device when compared to invasively measured arterial BP. An arterial catheter was placed in the facial or transverse facial artery and connected to a pressure transducer. A cuff for NIBP was placed around the tail base. The BP was recorded during normotension, dobutamine-induced hypertension, and subnormal BP induced by acepromazine administration. Agreement analysis with replicate measures was utilized to calculate bias (accuracy) and standard deviation (SD) of bias (precision). A total of 252 pairs of invasive arterial BP and NIBP measurements were analyzed. Compared to the direct BP measures, the NIBP MAP had an accuracy of -4 mm Hg and precision of 10 mm Hg. SAP had an accuracy of -8 mm Hg and a precision of 17 mm Hg and DAP had an accuracy of -7 mm Hg and a precision of 14 mm Hg. MAP from the evaluated NIBP monitor is accurate and precise in the adult horse across a range of BP, with higher variability during subnormal BP. MAP but not SAP or DAP can be used for clinical decision making in the conscious horse.

Highlights

Blood pressure (BP) measurement in critically ill, conscious, standing horses is useful for assessment of dynamic cardiovascular changes related to systemic inflammatory response syndrome (SIRS), septicemia, cardiac failure,[1] endotoxemia,[2] hypovolemia,[1,3,4] pain,[5] and equine metabolic syndrome.[6,7] The current reference standard for arterial blood pressure in horses is direct measurement of systolic arterial pressure (SAP) and diastolic arterial pressure (DAP).[8]
A total of 252 pairs of invasive arterial blood pressure (IBP) and noninvasive blood pressure (NIBP) measurements were obtained from 7 horses
The oscillometric SAP had a larger error during subnormal pressure conditions whereas DAP measurement was accurate but imprecise across all BP ranges

Summary

Introduction

Blood pressure (BP) measurement in critically ill, conscious, standing horses is useful for assessment of dynamic cardiovascular changes related to systemic inflammatory response syndrome (SIRS), septicemia, cardiac failure,[1] endotoxemia,[2] hypovolemia,[1,3,4] pain,[5] and equine metabolic syndrome.[6,7] The current reference standard for arterial blood pressure in horses is direct measurement of systolic arterial pressure (SAP) and diastolic arterial pressure (DAP).[8] Mean arterial blood pressure (MAP) is calculated from these values as a real-time estimate of average BP. MAP is affected by the relationship between cardiac output and systemic vascular resistance (SVR). If SVR is increased, MAP may be normal or high, but cardiac output, and blood flow, may be compromised.[9]

Objectives

Methods

Results

Conclusion