Comparison of two species-specific oscillometric blood pressure monitors with direct blood pressure measurement in anesthetized cats.

OBJECTIVE: To compare the performance of 2 species-specific oscillometric blood pressure (OBP) monitors (petMAPclassic and petMAPgraphic ) with direct blood pressure measurement in anesthetized cats. DESIGN: Prospective, experimental study. SETTING: Veterinary teaching hospital. ANIMALS: Eight adult cats (3.2-5.5 kg). INTERVENTIONS: During isoflurane anesthesia, OBP cuffs were placed on the thoracic limb and on the base of the tail while invasive blood pressure (IBP) was recorded from a dorsal pedal artery. End-tidal isoflurane concentrations, with or without intravenous dopamine (n = 8), norepinephrine (n = 1), or phenylephrine (n = 1) were adjusted to change invasive mean arterial pressure (MAP) between 40 to 100 mm Hg. Data were analyzed by the Bland-Altman method and 4-quadrant plots. MEASUREMENTS AND MAIN RESULTS: Mean biases and limits of agreement (LOA: ± 1.96 SD) (mm Hg) recorded between the petMAPclassic (thoracic limb) and IBP for systolic arterial pressure (SAP), diastolic arterial pressure (DAP), and MAP were 4.2 ± 28.5, -6.1 ± 13.2, and -1.9 ± 14.6, respectively; mean biases and LOA (mm Hg) recorded with the tail cuff were 7.2 ± 31.3 (SAP), -6.1 ± 11.6 (DAP), and -1.1 ± 11.7 (MAP). Mean biases and LOA (mm Hg) between petMAPgraphic (thoracic limb) and IBP were 7.7 ± 27.0 (SAP), -4.3 ± 11.5 (DAP), 0.2 ± 13.0 (MAP); values recorded with the tail cuff were 10.9 ± 29.6 (SAP), -4.4 ± 11.7 (DAP), and -0.1 ± 12.1 (MAP). Concordance rates after excluding arterial pressure changes ≤ 5 mm Hg was ≥ 93% for both devices. CONCLUSIONS: Although both OBP monitors provide unacceptable SAP estimations, MAP values derived from both monitors and DAP measured by the petMAPgraphic result in acceptable agreement with the reference method according to the Association for the Advancement of Medical Instrumentation (mean bias ≤ 5 mm Hg with LOA ≤ ± 16 mm Hg). Both monitors provide acceptable trending ability for SAP, DAP, and MAP.

Changes in pulse pressure variation and plethysmographic variability index caused by hypotension-inducing hemorrhage followed by volume replacement in isoflurane-anesthetized dogs.

OBJECTIVE: To compare changes in pulse pressure variation (PPV) and plethysmographic variability index (PVI) induced by hemorrhage followed by volume replacement (VR) in isoflurane-anesthetized dogs. ANIMALS: 7 healthy adult dogs. PROCEDURE: Each dog was anesthetized with isoflurane and mechanically ventilated. End-tidal isoflurane concentration was adjusted to maintain mean arterial pressure (MAP) at 60 to 70 mm Hg before hemorrhage. Controlled hemorrhage was initiated and continued until the MAP decreased to 40 to 50 mm Hg, then autologous blood removed during hemorrhage was retransfused during VR. Various physiologic variables including PPV and PVI were recorded immediately before (baseline) and after controlled hemorrhage and immediately after VR. RESULTS: Mean ± SD PPV and PVI were significantly increased from baseline after hemorrhage (PPV, 20 ± 6%; PVI, 18 ± 4%). After VR, the mean PPV (7 ± 3%) returned to a value similar to baseline, whereas the mean PVI (10 ± 3%) was significantly lower than that at baseline. Cardiac index (CI) and stroke index (SI) were significantly decreased from baseline after hemorrhage (CI, 2.07 ± 0.26 L/min/m(2); SI, 20 ± 3 mL/beat/m(2)) and returned to values similar to baseline after VR (CI, 4.25 ± 0.63 L/min/m(2); SI, 36 ± 6 mL/beat/m(2)). There was a significant positive correlation (r(2) = 0.77) between PPV and PVI after hemorrhage. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that both PPV and PVI may be useful for identification of dogs that respond to VR with increases in SI and CI (ie, dogs in the preload-dependent limb of the Frank-Starling curve).