The Effect of Clothes on Blood Pressure Measurement in Normotensive and Hypertensive Subjects in a Real-Life Setting.

INTRODUCTION: The effect of clothing on the recording of blood pressure in a normotensive and hypertensive population remains essential to diagnosing and managing. METHODS: This is a cross-sectional study to measure blood pressure using a validated oscillometric sphygmomanometer in two populations. The records were made over the thicker sleeve arm and non-sleeved arm (either on bare arm or indicating the removal of the outermost garment). Clothing was categorized according to how patients attended the outpatient clinic based on the real world. RESULTS: A total of 75 patients were included with a diagnosis of hypertension whose mean age was 67.1 years (SD ± 16.3). The group of normotension included 63 patients whose mean age was 21.1 years (SD ± 2.2). There was not variability related to technique or inherent to the condition of the subject on the first and second measurements of blood pressure. In the comparative analysis, the group with normotension did not report a significant difference in systolic or diastolic blood pressure due to the effect of clothing during the first or second measurement (p > 0.05). In the group with hypertension, a significant difference was observed in the first measurement, between the group over-the-sleeve and non-sleeved arm (systolic blood pressure, p: 0.021 and diastolic, p: 0.001). However, when the variable order of measurement was analyzed by randomizing the initial registry with or without clothing was not found a statistical difference. CONCLUSION: Clothing does not a significant difference in the measure of blood pressure in a normotensive or hypertensive population.

Non-invasive central aortic pressure measurement: what limits its application in clinical practice?

The following article highlights the need for methodological transparency and consensus for an accurate and non-invasive assessment of central aortic blood pressure (aoBP), which would contribute to increasing its validity and value in both clinical and physiological research settings. The recording method and site, the mathematical model used to quantify aoBP, and mainly the method applied to calibrate pulse waveforms are essential when estimating aoBP and should be considered when analyzing and/or comparing data from different works, populations and/or obtained with different approaches. Up to now, many questions remain concerning the incremental predictive ability of aoBP over peripheral blood pressure and the possible role of aoBP-guided therapy in everyday practice. In this article, we focus on "putting it on the table" and discussing the main aspects analyzed in the literature as potential determinants of the lack of consensus on the non-invasive measurement of aoBP.

Agreement analysis of stroke volume and cardiac output measurement between a oscillometric device and transthoracic echocardiogram in normotensive individuals: a preliminary report.

INTRODUCTION: The evaluation of stroke volume (SV) is useful in research and patient care. To accomplish this, an ideal device should be noninvasive, continuous, reliable, and reproducible. The Mobil-O-Graph (MOG) is a noninvasive oscillometric matrix validated for measuring aortic and peripheral blood pressure, which through conversion algorithms can estimate hemodynamic parameters. OBJECTIVES: To compare the MOG measurement of stroke volume, cardiac output, and cardiac index with the transthoracic echocardiogram (TTE). METHODS: Healthy volunteers aged 18 years or older were included. Two-dimensional TTEs were performed by a single operator. Subsequently, the measurement of noninvasive hemodynamics with MOG was performed with the operator blind to the results of the echocardiogram. Correlation analyses between stroke volume, cardiac output, and cardiac index parameters were performed. The degree of agreement between the methods was verified using the Bland-Altman method. RESULTS: A total of 38 volunteers were enrolled with a mean age of 27.6.ß...ß3.8 years; 21 (55%) were male The SV by TTE was 76.8.ß...ß19.5.ßmL and 75.7.ß...ß19.3.ßmL by MOG, Rho.ß=.ß0.726, p.ß<.ß0.0001. The CO by TTE was 5.04.ß...ß0.8 mL.min-1 and 5.1.ß...ß0.8.ßmL.min-1 by MOG Rho.ß=.ß0.510, p.ß=.ß0.001. Bland-Altman plots showed a good concordance between the two techniques. CONCLUSIONS: Our study shows that the measurement of SV and CO by noninvasive hemodynamics with the MOG device offers a good concordance with the TTE with very few values beyond the confidence limits.

Agreement analysis of stroke volume and cardiac output measurement between a oscillometric device and transthoracic echocardiogram in normotensive individuals: a preliminary report

Abstract Introduction The evaluation of stroke volume (SV) is useful in research and patient care. To accomplish this, an ideal device should be noninvasive, continuous, reliable, and reproducible. The Mobil-O-Graph (MOG) is a noninvasive oscillometric matrix validated for measuring aortic and peripheral blood pressure, which through conversion algorithms can estimate hemodynamic parameters. Objectives To compare the MOG measurement of stroke volume, cardiac output, and cardiac index with the transthoracic echocardiogram (TTE). Methods Healthy volunteers aged 18 years or older were included. Two-dimensional TTEs were performed by a single operator. Subsequently, the measurement of noninvasive hemodynamics with MOG was performed with the operator blind to the results of the echocardiogram. Correlation analyses between stroke volume, cardiac output, and cardiac index parameters were performed. The degree of agreement between the methods was verified using the Bland-Altman method. Results A total of 38 volunteers were enrolled with a mean age of 27.6 ± 3.8 years; 21 (55%) were male The SV by TTE was 76.8 ± 19.5 mL and 75.7 ± 19.3 mL by MOG, Rho = 0.726, p< 0.0001. The CO by TTE was 5.04 ± 0.8 mL.min-1 and 5.1 ± 0.8 mL.min-1 by MOG Rho = 0.510, p= 0.001. Bland-Altman plots showed a good concordance between the two techniques. Conclusions Our study shows that the measurement of SV and CO by noninvasive hemodynamics with the MOG device offers a good concordance with the TTE with very few values beyond the confidence limits.

Reference values of office central blood pressure, pulse wave velocity, and augmentation index recorded by means of the Mobil-O-Graph PWA monitor.

Assessment of central blood pressure (BP), pulse wave velocity (PWV), and augmentation index (AIx) measurements may improve cardiovascular risk stratification. This study aimed to establish reference office values for central BP, PWV, and AIx by means of a Mobil-O-Graph PWA monitor and to evaluate the impact of cardiovascular risk factors (CVRFs) on these measurements. We cross-sectionally evaluated clinical characteristics, central BP, PWV, AIx, and peripheral BP measurements among 867 apparently healthy individuals (age = 46.0 ± 15.5 years, 39% males) who were free of obesity, hypertension, active smoking, dyslipidemia, and diabetes (CVRF-No) and 5632 individuals (age = 57.0 ± 14.7 years, 44% males) with at least one of these major CVRFs (CVRF-Yes). Reference values for central BP, PWV, and AIx were provided for the CVRF-No and CVRF-Yes groups, stratified by age and sex. PWV and AIx exhibited curvilinear increases with age, and there was an interaction between age and sex for central systolic BP and PWV in both the CVRF-No and CVRF-Yes groups. The results of a multivariable analysis including the whole sample (n = 6499) showed that obesity had a direct association with central BP, while diabetes was directly related to PWV. In addition, alcohol intake was directly associated with central BP, while performance of physical activity was inversely related to AIx. In conclusion, values of office-measured central BP, PWV, and AIx obtained in an apparently healthy population and in a population with CVRFs are now available according to age and sex and may be useful to build thresholds for use in clinical practice.

Method of Blood Pressure Measurement in Neonates and Infants: A Systematic Review and Analysis.

OBJECTIVES: To determine the recommended blood pressure (BP) measurement methods in neonates after systematically analyzing the literature regarding proper BP cuff size and measurement location and method. STUDY DESIGN: A literature search was conducted in MEDLINE, PubMed, Embase, Cochrane Library, and CINAHL from 1946 to 2017 on BP in neonates <3 months of age (PROSPERO ID CRD42018092886). Study data were extracted and analyzed with separate analysis of Bland-Altman studies comparing measurement methods. RESULTS: Of 3587 nonduplicate publications identified, 34 were appropriate for inclusion in the analysis. Four studies evaluating BP cuff size support a recommendation for a cuff width to arm circumference ratio of approximately 0.5. Studies investigating measurement location identified the upper arm as the most accurate and least variable location for oscillometric BP measurement. Analysis of studies using Bland-Altman methods for comparison of intra-arterial to oscillometric BP measurement show that the 2 methods correlate best for mean arterial pressure, whereas systolic BP by the oscillometric method tends to overestimate intra-arterial systolic BP. Compared with intra-arterial methods, systolic BP, diastolic BP, and mean arterial pressure by oscillometric methods are less accurate and precise, especially in neonates with a mean arterial pressure <30 mm Hg. CONCLUSIONS: Proper BP measurement is critical in neonates with naturally lower BP and attention to BP cuff size, location, and method of measurement are essential. With decreasing use of intra-arterial catheters for long-term BP monitoring in neonates, further studies are urgently needed to validate and develop oscillometric methodology with enhanced accuracy.

Comparison of auscultatory and oscillometric BP measurements in children with obesity and their effect on the diagnosis of arterial hypertension / Comparación de la medición de PA auscultatoria y oscilométrica en niños con obesidad y su efecto en el diagnóstico de hipertensión arterial

Abstract: Objective: The level of agreement between two blood pressure (BP) reading methods, auscultatory vs oscillometric, was examined using a mercury sphygmomanometer and an electronic device in children and adolescents with different levels of obesity. The readings were compared to determine their impact on the diagnosis of pre-hypertension/hypertension. Methods: Blood pressure readings were taken in children with obesity (body mass index ≥ 95th percentile) and severe obesity (≥120% 95th percentile). Bland-Altman analysis and Intraclass Correlation Coefficient were used to determine the agreement between measurements. Results: The mercury sphygmomanometer readings were lower than those obtained with the electronic device for both systolic and diastolic BP (P = .01 and P = .001, respectively). The mean systolic and diastolic BP differences between the oscillometric vs first mercury reading were 4.2/10.2 mm Hg, respectively. A large difference was observed between the BP measurement methods. The ICC showed regular to moderate reliability for the systolic BP (.595), but poor for the diastolic BP (.330). Screening using the first of three mercury measurements showed that 10.4% of the children and adolescents had BPs within the pre-hypertension/hypertension range. This was reduced to 5.2% when the mean of three mercury readings was used. Conclusions: Large discrepancies were observed in both the systolic and diastolic BP. These differences are not clinically acceptable as to consider the two instruments interchangeable. The electronic device readings were higher, and they overestimated the diagnosis of hypertension. © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma Mèxico S.A. This is an open access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Resumen: Objetivo: Para conocer el grado de concordancia entre 2 métodos de medición de presión arterial (PA), auscultatorio vs oscilométrico se utilizó un esfigmomanómetro de mercurio y un dispositivo electrónico en niños y adolescentes con diferentes grados de obesidad. Las lecturas fueron comparadas para conocer su impacto en el diagnóstico de prehipertensión/hipertensión. Método: Se midió la PA a niños con obesidad (percentil 95 del índice masa corporal) y obesidad severa (120% del percentil 95). Utilizamos análisis de Bland-Altman y Coeficiente de Correlación Intraclase (CCI) para conocer acuerdo entre mediciones. Resultados: Las lecturas con esfigmomanómetro de mercurio fueron más bajas que con el electrónico para la PA sistólica y diastólica (p = 0.01 y 0.001, respectivamente). El promedio de las diferencias en sistólica y diastólica entre oscilométrico vs. primera medición con mercurio fue de 4.2/10.2 mm Hg respectivamente. Se observó una gran diferencia de las mediciones entre los métodos de medición de PA. El CCI mostró una confiabilidad regular a moderada para la sistólica (0.595) pero pobre para la diastólica (0.330). El tamizaje con una medición mediante mercurio mostró que el 10.4% de los niños y adolescentes tenían PA en el rango de prehipertensión/hipertensión, pero se redujo a un 5.2% con el promedio de 3 mediciones. Conclusiones: Se observaron grandes discrepancias en la PA sistólica y diastólica. Tales diferencias no son clínicamente aceptables como para considerar equivalentes los 2 instrumentos. Las mediciones realizadas en este estudio con dispositivo electrónico fueron más altas y sobre estimaron el diagnóstico de hipertensión. © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. Este es un artículo Open Access bajo la licencia CC BY-NC-ND (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Comparison of auscultatory and oscillometric BP measurements in children with obesity and their effect on the diagnosis of arterial hypertension.

OBJECTIVE: The level of agreement between two blood pressure (BP) reading methods, auscultatory vs oscillometric, was examined using a mercury sphygmomanometer and an electronic device in children and adolescents with different levels of obesity. The readings were compared to determine their impact on the diagnosis of pre-hypertension/hypertension. METHODS: Blood pressure readings were taken in children with obesity (body mass index ≥ 95th percentile) and severe obesity (≥120% 95th percentile). Bland-Altman analysis and Intraclass Correlation Coefficient were used to determine the agreement between measurements. RESULTS: The mercury sphygmomanometer readings were lower than those obtained with the electronic device for both systolic and diastolic BP (P=.01 and P=.001, respectively). The mean systolic and diastolic BP differences between the oscillometric vs first mercury reading were 4.2/10.2mmHg, respectively. A large difference was observed between the BP measurement methods. The ICC showed regular to moderate reliability for the systolic BP (.595), but poor for the diastolic BP (.330). Screening using the first of three mercury measurements showed that 10.4% of the children and adolescents had BPs within the pre-hypertension/hypertension range. This was reduced to 5.2% when the mean of three mercury readings was used. CONCLUSIONS: Large discrepancies were observed in both the systolic and diastolic BP. These differences are not clinically acceptable as to consider the two instruments interchangeable. The electronic device readings were higher, and they overestimated the diagnosis of hypertension.

Evaluation of the accuracy and precision of the GE Dash 4000 oscillometric monitor for blood pressure measurement in anesthetized female dogs / Determinação da acurácia do monitor oscilométrico GE Dash 4000 na mensuração da pressão arterial em cadelas anestesiadas

Background: Indirect measurement of arterial blood pressure, such as the oscillometric method, is the most commonly used in clinical practice of dogs and cats. This method measures blood pressure values that are estimates of direct (invasive) arterial blood pressure values. Oscillometric devices are easy to use even for non-experienced personnel. However, there is considerable variation in accuracy and precision of blood pressure values measured by different oscillometric monitors. The present study aimed to determine the accuracy and precision of the GE Dash 4000 oscillometric monitor for arterial blood pressure measurement in anesthetized female dogs.Materials, Methods & Results:Sixteen healthy adult female dogs received 0.3 mg/kg morphine as premedication and were anesthetized with propofol and isoflurane. A 22-gauge catheter was introduced into the dorsal pedal artery and connected to a rigid tubular system and a pressure transducer filled with heparinized solution to allow direct (invasive) measurement of systolic (SAP), mean (MAP) and diastolic arterial pressure (DAP). A blood pressure cuff was positioned proximal to the carpus and connected to the oscillometric device (GE-DASH 4000 monitor) in order to obtain indirect measurements of SAP, MAP and DAP. Cuff width was 40% of limb circumference. During anesthesia, invasive arterial blood pressure values were measured and recorded simultaneously with the oscillometric method. The Bland Altman method was used to evaluate agreement between the methods by calculating the bias (invasive - oscillometric) and limits of agreement. Percentages of differences between the methods with an error ≤ 10 mmHg and ≤ 20 mmHg were calculated. Results were compared with the criteria from the American College of Veterinary Internal Medicine (ACVIM) for validation of noninvasive blood pressure methods.[...]

Evaluation of the accuracy and precision of the GE Dash 4000 oscillometric monitor for blood pressure measurement in anesthetized female dogs / Determinação da acurácia do monitor oscilométrico GE Dash 4000 na mensuração da pressão arterial em cadelas anestesiadas

Background: Indirect measurement of arterial blood pressure, such as the oscillometric method, is the most commonly used in clinical practice of dogs and cats. This method measures blood pressure values that are estimates of direct (invasive) arterial blood pressure values. Oscillometric devices are easy to use even for non-experienced personnel. However, there is considerable variation in accuracy and precision of blood pressure values measured by different oscillometric monitors. The present study aimed to determine the accuracy and precision of the GE Dash 4000 oscillometric monitor for arterial blood pressure measurement in anesthetized female dogs.Materials, Methods & Results:Sixteen healthy adult female dogs received 0.3 mg/kg morphine as premedication and were anesthetized with propofol and isoflurane. A 22-gauge catheter was introduced into the dorsal pedal artery and connected to a rigid tubular system and a pressure transducer filled with heparinized solution to allow direct (invasive) measurement of systolic (SAP), mean (MAP) and diastolic arterial pressure (DAP). A blood pressure cuff was positioned proximal to the carpus and connected to the oscillometric device (GE-DASH 4000 monitor) in order to obtain indirect measurements of SAP, MAP and DAP. Cuff width was 40% of limb circumference. During anesthesia, invasive arterial blood pressure values were measured and recorded simultaneously with the oscillometric method. The Bland Altman method was used to evaluate agreement between the methods by calculating the bias (invasive - oscillometric) and limits of agreement. Percentages of differences between the methods with an error ≤ 10 mmHg and ≤ 20 mmHg were calculated. Results were compared with the criteria from the American College of Veterinary Internal Medicine (ACVIM) for validation of noninvasive blood pressure methods.[...](AU)

Office blood pressure measurements with oscillometric devices in adolescents: a comparison with home blood pressure.

PURPOSE: Compare multiple in office BP measurements in adolescents using an oscillometric device with out-of-office blood pressure measurements (home blood pressure monitoring - HBPM). MATERIALS AND METHODS: Office measurements were performed with validated semi-automatic devices twice (3 minutes interval) in two different moments (1 week apart), with a total of four readings. These BP readings were named R1, R2, R3 and R4 (following the sequence they were performed), FDM (mean of two readings on first day) and SDM (mean of two readings on second day) and SRM (R2-R4 means). The HBPM protocol included two day-time and two evening-time measurements over 6 days. RESULTS: A total of 1024 students between 12 and 17 years were included (mean age 14.68 years; 52.4% females). The mean systolic blood pressure (SBP) values of R2, SDM and SRM were similar to HBPM values. Regarding diastolic blood pressure (DBP) HBPM value was different than R4. High SBP and DBP correlation coefficients with HBPM values were found for R2, SDM and SRM values. CONCLUSION: The second office BP measurement performed with an oscilometric device in adolescents was comparable to HBPM values, suggesting that two office readings might be suitable to rule out hypertension in this age group.

Acurácia dos métodos oscilométrico (PETMAP®) e doppler para aferição indireta da pressão arterial em cordeiros / Accuracy of oscillometric (PETMAP) and doppler methods to indirect measurement of blood pressure in lambs

Neonatal physiology has peculiarities inherent to the age group. The objective of this study was to monitor the systemic arterial pressure in lambs during neonatal period. We used 20 Ile de France lambs, from birth and at 7, 14, 21, 28 and 35 days of life. The following parameters were analyzed: heart rate (HR), systolic (SBP), diastolic (DBP), and average blood pressure (ABP) by oscillometric method petMAP, and SBP with Doppler. Invasive pressure validated indirect methods with the average 101.52 ± 12.04 mmHg. The averages with petMAP were as follows: HR (156.38 ± 37.46 bpm); DBP (63.80 ± 11.14 mmHg); ABP (81.58 ± 11.83 mmHg); SBP (112.48 ± 15.68 mmHg) and SBP by Dobler (90.27 ± 12.11 mmHg). There was significant difference in HR and blood pressure among the moments. Indirect methods differ between each other in 12.30 mmHg (overestimation   of 11%). Comparing with the invasive methods, both overestimated values of 4% and 16% in   PAS, respectively, for Doppler and petMAP. The results showed that the Doppler method has established a good relationship with the invasive one being useful for gauging the SBP. The oscillometric method requires larger studies to be used in small ruminants.

A fisiologia neonatal possui peculiaridades inerentes à faixa etária. O objetivo do estudo foi monitorar a pressão arterial sistêmica de cordeiros durante o período neonatal. Foram usados 20 cordeiros da raça Ile de France, a partir do nascimento e aos sete, 14, 21, 28 e 35 dias de vida. Os parâmetros analisados foram: frequência cardíaca (FC), pressão arterial sistólica (PAS), diastólica (PAD) e média (PAM) pelo método oscilométrico petMAP®, e PAS com Doppler. Também foi realizada a pressão invasiva para validar os métodos indiretos obtendo a média de 101,52 ± 12,04 mmHg. As médias utilizando o petMAP® foram: FC (156,38 ± 37,46 bpm); PAD (63,80 ± 11,14 mmHg); PAM   (81,58± 11,83 mmHg); PAS (112,48 ±15,68 mmHg) e PAS (90,27 ± 12,11 mmHg) com Doppler. Houve diferença significativa na FC e pressão arterial entre os momentos analisados. Os métodos indiretos diferiram entre si em 12,30 mmHg (superestimação de 11%). Comparando com a invasiva, os dois métodos superestimaram os valores da PAS em 4% e 16%, respectivamente, para Doppler e petMAP®. Os resultados mostraram que o método Doppler estabeleceu boa relação com a invasiva, sendo útil para aferição da PAS. O método oscilométrico necessita de maiores estudos para sua utilização em pequenos ruminantes.

Avaliação e comparação entre métodos de mensuração de pressão arterial sistólica em gatos hígidos conscientes / Evaluation and comparison between methods of measurement of systolic blood pressure in healthy conscious cats

Após validação de dois diferentes métodos de mensuração de pressão arterial sistólica (PAS) não invasivos ou indiretos (oscilométrico e Doppler vascular) com o invasivo ou direto (cateterização arterial - padrão ouro) em 12 gatos hígidos anestesiados de mesma faixa etária, os métodos não invasivos foram avaliados e comparados em 24 gatos hígidos e conscientes, divididos em quatro grupos de idade. Em cada animal, procedeu-se à mensuração da pressão pelos métodos Doppler e oscilométrico. O método oscilométrico foi o primeiro a ser realizado, e, logo em seguida, o método Doppler. Os valores considerados foram obtidos das médias de sete medidas consecutivas para cada método, com intervalo de 30 segundos entre elas. A primeira medida e as medidas discrepantes (variação ˃ 20% PAS), obtidas com sinais óbvios de estresse e/ou com movimentação do animal, foram descartadas. Os métodos de mensuração oscilométrico e Doppler, embora tenham apresentado médias estatisticamente diferentes em todos os grupos, quando comparados em cada grupo, apresentaram uma correlação significativa, alta e positiva. Ou seja, sempre que for obtido um valor elevado por um método, o mesmo fato ocorrerá com o outro método e vice-versa. Clinicamente, a diferença observada não é relevante, uma vez que a diferença média dos valores obtida pelos dois métodos, em cada grupo, foi menor que 1,1%.(AU)

After two different validation systolic blood pressure measurement methods (PAS), not invasive or indirect (oscillometric and doppler vascular) with invasive or direct (arterial catheterization - Gold Standard) in 12 anesthetized healthy cats of the same age group, not invasive methods were evaluated and compared in 24 healthy conscious cats, divided into four age groups. In each animal, we proceeded to measure the pressure by Doppler and oscillometric methods. The oscillometric method was the first to be performed, and, shortly thereafter, the doppler method. The values considered were obtained from averages from seven consecutive measurements for each method with an interval of thirty seconds between them. The first measurement and disparate measurements (range ˃ 20% PAS) obtained with obvious signs of stress and / or animal movement were discarded. Methods of oscillometric and doppler measurement, although statistically different averages were shown in all groups when compared, each group showed a significant high positive correlation, meaning that when a high value is obtained by a method, the same occurs with the other method, and vice versa. Clinically, the observed difference is not relevant since the mean difference values obtained by the two methods, in each group was lower than 1.1%.(AU)

Avaliação e comparação entre métodos de mensuração de pressão arterial sistólica em gatos hígidos conscientes / Evaluation and comparison between methods of measurement of systolic blood pressure in healthy conscious cats

Após validação de dois diferentes métodos de mensuração de pressão arterial sistólica (PAS) não invasivos ou indiretos (oscilométrico e Doppler vascular) com o invasivo ou direto (cateterização arterial - padrão ouro) em 12 gatos hígidos anestesiados de mesma faixa etária, os métodos não invasivos foram avaliados e comparados em 24 gatos hígidos e conscientes, divididos em quatro grupos de idade. Em cada animal, procedeu-se à mensuração da pressão pelos métodos Doppler e oscilométrico. O método oscilométrico foi o primeiro a ser realizado, e, logo em seguida, o método Doppler. Os valores considerados foram obtidos das médias de sete medidas consecutivas para cada método, com intervalo de 30 segundos entre elas. A primeira medida e as medidas discrepantes (variação ˃ 20% PAS), obtidas com sinais óbvios de estresse e/ou com movimentação do animal, foram descartadas. Os métodos de mensuração oscilométrico e Doppler, embora tenham apresentado médias estatisticamente diferentes em todos os grupos, quando comparados em cada grupo, apresentaram uma correlação significativa, alta e positiva. Ou seja, sempre que for obtido um valor elevado por um método, o mesmo fato ocorrerá com o outro método e vice-versa. Clinicamente, a diferença observada não é relevante, uma vez que a diferença média dos valores obtida pelos dois métodos, em cada grupo, foi menor que 1,1%.(AU)

After two different validation systolic blood pressure measurement methods (PAS), not invasive or indirect (oscillometric and doppler vascular) with invasive or direct (arterial catheterization - Gold Standard) in 12 anesthetized healthy cats of the same age group, not invasive methods were evaluated and compared in 24 healthy conscious cats, divided into four age groups. In each animal, we proceeded to measure the pressure by Doppler and oscillometric methods. The oscillometric method was the first to be performed, and, shortly thereafter, the doppler method. The values considered were obtained from averages from seven consecutive measurements for each method with an interval of thirty seconds between them. The first measurement and disparate measurements (range ˃ 20% PAS) obtained with obvious signs of stress and / or animal movement were discarded. Methods of oscillometric and doppler measurement, although statistically different averages were shown in all groups when compared, each group showed a significant high positive correlation, meaning that when a high value is obtained by a method, the same occurs with the other method, and vice versa. Clinically, the observed difference is not relevant since the mean difference values obtained by the two methods, in each group was lower than 1.1%.(AU)

Acurácia dos métodos oscilométrico (PETMAP®) e doppler para aferição indireta da pressão arterial em cordeiros / Accuracy of oscillometric (PETMAP) and doppler methods to indirect measurement of blood pressure in lambs

Neonatal physiology has peculiarities inherent to the age group. The objective of this study was to monitor the systemic arterial pressure in lambs during neonatal period. We used 20 Ile de France lambs, from birth and at 7, 14, 21, 28 and 35 days of life. The following parameters were analyzed: heart rate (HR), systolic (SBP), diastolic (DBP), and average blood pressure (ABP) by oscillometric method petMAP, and SBP with Doppler. Invasive pressure validated indirect methods with the average 101.52 ± 12.04 mmHg. The averages with petMAP were as follows: HR (156.38 ± 37.46 bpm); DBP (63.80 ± 11.14 mmHg); ABP (81.58 ± 11.83 mmHg); SBP (112.48 ± 15.68 mmHg) and SBP by Dobler (90.27 ± 12.11 mmHg). There was significant difference in HR and blood pressure among the moments. Indirect methods differ between each other in 12.30 mmHg (overestimation   of 11%). Comparing with the invasive methods, both overestimated values of 4% and 16% in   PAS, respectively, for Doppler and petMAP. The results showed that the Doppler method has established a good relationship with the invasive one being useful for gauging the SBP. The oscillometric method requires larger studies to be used in small ruminants.(AU)

A fisiologia neonatal possui peculiaridades inerentes à faixa etária. O objetivo do estudo foi monitorar a pressão arterial sistêmica de cordeiros durante o período neonatal. Foram usados 20 cordeiros da raça Ile de France, a partir do nascimento e aos sete, 14, 21, 28 e 35 dias de vida. Os parâmetros analisados foram: frequência cardíaca (FC), pressão arterial sistólica (PAS), diastólica (PAD) e média (PAM) pelo método oscilométrico petMAP®, e PAS com Doppler. Também foi realizada a pressão invasiva para validar os métodos indiretos obtendo a média de 101,52 ± 12,04 mmHg. As médias utilizando o petMAP® foram: FC (156,38 ± 37,46 bpm); PAD (63,80 ± 11,14 mmHg); PAM   (81,58± 11,83 mmHg); PAS (112,48 ±15,68 mmHg) e PAS (90,27 ± 12,11 mmHg) com Doppler. Houve diferença significativa na FC e pressão arterial entre os momentos analisados. Os métodos indiretos diferiram entre si em 12,30 mmHg (superestimação de 11%). Comparando com a invasiva, os dois métodos superestimaram os valores da PAS em 4% e 16%, respectivamente, para Doppler e petMAP®. Os resultados mostraram que o método Doppler estabeleceu boa relação com a invasiva, sendo útil para aferição da PAS. O método oscilométrico necessita de maiores estudos para sua utilização em pequenos ruminantes.(AU)

ACURÁCIA DOS MÉTODOS OSCILOMÉTRICO (PETMAP®) E DOPPLER PARA AFERIÇÃO INDIRETA DA PRESSÃO ARTERIAL EM CORDEIROS

Abstract Neonatal physiology has peculiarities inherent to the age group. The objective of this study was to monitor the systemic arterial pressure in lambs during neonatal period. We used 20 Ile de France lambs, from birth and at 7, 14, 21, 28 and 35 days of life. The following parameters were analyzed: heart rate (HR), systolic (SBP), diastolic (DBP), and average blood pressure (ABP) by oscillometric method petMAPTM, and SBP with Doppler. Invasive pressure validated indirect methods with the average 101.52 ± 12.04 mmHg. The averages with petMAPTM were as follows: HR (156.38 ± 37.46 bpm); DBP (63.80 ± 11.14 mmHg); ABP (81.58 ± 11.83 mmHg); SBP (112.48 ± 15.68 mmHg) and SBP by Dobler (90.27 ± 12.11 mmHg). There was significant difference in HR and blood pressure among the moments. Indirect methods differ between each other in 12.30 mmHg (overestimation of 11%). Comparing with the invasive methods, both overestimated values of 4% and 16% in PAS, respectively, for Doppler and petMAPTM. The results showed that the Doppler method has established a good relationship with the invasive one being useful for gauging the SBP. The oscillometric method requires larger studies to be used in small ruminants.

Resumo A fisiologia neonatal possui peculiaridades inerentes à faixa etária. O objetivo do estudo foi monitorar a pressão arterial sistêmica de cordeiros durante o período neonatal. Foram usados 20 cordeiros da raça Ile de France, a partir do nascimento e aos sete, 14, 21, 28 e 35 dias de vida. Os parâmetros analisados foram: frequência cardíaca (FC), pressão arterial sistólica (PAS), diastólica (PAD) e média (PAM) pelo método oscilométrico petMAP®, e PAS com Doppler. Também foi realizada a pressão invasiva para validar os métodos indiretos obtendo a média de 101,52 ± 12,04 mmHg. As médias utilizando o petMAP® foram: FC (156,38 ± 37,46 bpm); PAD (63,80 ± 11,14 mmHg); PAM (81,58 ± 11,83 mmHg); PAS (112,48 ±15,68 mmHg) e PAS (90,27 ± 12,11 mmHg) com Doppler. Houve diferença significativa na FC e pressão arterial entre os momentos analisados. Os métodos indiretos diferiram entre si em 12,30 mmHg (superestimação de 11%). Comparando com a invasiva, os dois métodos superestimaram os valores da PAS em 4% e 16%, respectivamente, para Doppler e petMAP®. Os resultados mostraram que o método Doppler estabeleceu boa relação com a invasiva, sendo útil para aferição da PAS. O método oscilométrico necessita de maiores estudos para sua utilização em pequenos ruminantes.

Evaluation of blood pressure in feline night monkeys (Aotus azarae infulatus) under different restraint protocols.

BACKGROUND: Feline night monkeys are very susceptible to stress when handled, and because of that, the use of anesthetic and physical restraint methods should be carefully evaluated. To ensure a safer anesthesia to the animals the present study aimed to observe the influence of four restraint protocols in the blood pressure of Aotus azarae infulatus. METHODS: Blood pressure was obtained from 10 animals subjected to restraining protocols using tiletamine and zolazepam, isoflurane, ketamine and midazolam, and physical restraint and results were evaluated to determine their effect on this exam. RESULTS: Among the restraint protocols tested, the anesthetic isoflurane promoted lower blood pressure values and no differences were observed between values measured in both arms in all groups. CONCLUSION: The results of our study suggest that all restraint protocols tested significantly alter blood pressure in this species of primates.

Comparative evaluation of blood pressure monitoring devices / Avaliação comparativa dos equipamentos de aferição da pressão arterial

Objective: This study evaluated the agreement of blood pressure measurements obtained through different auscultatory and oscillometric automated/ semi-automated monitors. Material and Methods: The blood pressure of 30 participants was evaluated by a single calibrated examiner. The measurements were carried out through either auscultatory monitor (mercury column or aneroid) or automated/semiautomated oscillometric pulse monitors. For each participant, 5 min rest was established by sitting on dental chair and the measurements were always carried out on the left arm, at the heart level. Three consecutive measurements were performed with the four monitors in each participant with a minimum time interval of five minutes between each measurement. All monitors were properly calibrated and certified by INMETRO. The results were submitted to intraclass correlation coefficient and Friedman’s analysis of variance. Results: The measurements of systolic blood pressure for both auscultatory and oscillometric methods were similar. The measurements of diastolic blood pressure for auscultatory monitors were similar (p > 0.05); as well as for oscillometric monitors (p > 0.05). However, when auscultatory and oscillometric monitors were compared, there were statistically significant differences in diastolic blood pressure (p < 0.05). Conclusion: It was verified a difference in the results between the auscultatory and oscillometric blood pressure monitors. The systolic blood pressure measurements exhibited similar correlations, while diastolic blood pressure measurements showed different correlations...

Objetivo: Esse estudo avaliou a concordância da aferição da pressão arterial (PA) obtidas em diferentes equipamentos auscultatório e equipamentos digitais oscilométrico. Material e Métodos: A PA de 30 participantes foi avaliada por um único examinador calibrado. As aferições foram realizadas por meio de aparelhos auscultatório de coluna de mercúrio e aneróide e com equipamentos digital oscilométrico, semi automático e automático de pulso. Foi estabelecido para cada participante, repouso mínimo de cinco minutos permanecendo sentados na cadeira odontológica e as mensurações foram realizadas sempre no braço esquerdo, estando o mesmo apoiado ao nível do coração. Foram realizas 3 mensurações consecutivas com os 4 aparelhos em cada participante com tempo mínimo de 5 minutos entre as aferições. Todos os aparelhos estavam devidamente calibrados e certificados pelo INMETRO. Com os resultados foi realizado coeficiente de correlação intraclasses e a análise de variância de Friedman. Resultados: As medidas da pressão arterial sistólica (PAS) para o método auscultatório e para o oscilométrico foram semelhantes entre si. Para as medidas da pressão arterial diastólica (PAD), aparelhos auscultatórios foram semelhantes (p> 0,05); aparelhos oscilométricos foram semelhantes entre si (p > 0,05), porém quando comparados os modelos auscultatório com o oscilométrico ocorreu diferença estatisticamente significante (p < 0,05). Conclusão: Verificou-se diferença nos resultados entre os métodos auscultatórios e oscilométricos de medida da pressão arterial. Ocorreu uma correlação semelhante nas aferições obtidas para PAS e diferentes para PAD...

Correlation between systemic blood pressure measured by oscillometry and age and serum sodium level in healthy dogs / Correlação entre a pressão arterial sistêmica aferida por método oscilométrico com a idade e o nível sérico de sódio em cães hígidos

Blood pressure has received attention in current veterinary clinic and can be measured in a non-invasive way by the oscillometric method, among others. Factors such as age have already been related to disorders on blood pressure. Sodium, vital element in cell physiology of animals, has been reported to increase blood pressure. Thus, this work correlates age, the values of blood pressure, both systolic and diastolic, with the serum levels of sodium in healthy adult dogs. We studied 23 adult healthy dogs of both sexes and varying age fed with commercial feed (standard). The arterial pressure, systolic (SBP) and diastolic (DBP), and pulse were measured by digital human sphygmomanometer. The level of serum sodium was obtained by the method of enzyme reagent in kinetic mode, using a commercial kit. We performed Pearson correlation between variables. The values of SBP, DBP, pulse and serum sodium varied respectively from 96 184mmHg, 53 137mmHg, 64 135bpm and 120-157mEq/L. We observed a positive correlation between the variables age and SBP, age and DBP, SBP and sodium, and sodium and DBP, while the values of serum sodium and age showed a negative correlation. Regarding this study conditions, we conclude that there is little interference in the values of blood pressure, both systolic and diastolic, regarding age and serum sodium in healthy adult dogs.

A pressão arterial vem recebendo destaque na clínica veterinária atual, podendo ser mensurada de forma não-invasiva, pelo método oscilométrico, entre outros. Fatores como a idade já foram relacionados com distúrbios na pressão arterial. O sódio, elemento vital na fisiologia celular de animais, já foi relacionado com o aumento da pressão arterial. Desta forma, este trabalho correlaciona a idade, os valores da pressão arterial sistêmica, sistólica e diastólica, com os níveis séricos de sódio em cães adultos hígidos. Foram estudados 23 cães adultos, hígidos, de ambos os sexos e idade variável, alimentados com ração comercial (standard). As pressões arteriais, sistólica (PAS) e diastólica (PAD), e pulso foram aferidas por esfigmomanômetro digital humano. O nível sérico de sódio foi obtido pelo método de reagente enzimático em modo cinético, utilizando kit comercial. Foi realizada a Correlação de Pearson entre as variáveis. Os valores da PAS, PAD, pulso e sódio sérico, variaram respectivamente de 96 184mmHg, 53- 137mmHg, 64 135bpm e 120 157mEq/L. Foi observada uma correlação positiva entre as variáveis idade e PAS, idade e PAD, sódio e PAS, e sódio e PAD, enquanto os valores de idade e sódio sérico, demonstraram uma correlação negativa. Nas condições deste estudo conclui-se que há pouca interferência nos valores de pressão arterial, sistólica e diastólica, pela idade e o nível

Correlation between systemic blood pressure measured by oscillometry and age and serum sodium level in healthy dogs / Correlação entre a pressão arterial sistêmica aferida por método oscilométrico com a idade e o nível sérico de sódio em cães hígidos

Blood pressure has received attention in current veterinary clinic and can be measured in a non-invasive way by the oscillometric method, among others. Factors such as age have already been related to disorders on blood pressure. Sodium, vital element in cell physiology of animals, has been reported to increase blood pressure. Thus, this work correlates age, the values of blood pressure, both systolic and diastolic, with the serum levels of sodium in healthy adult dogs. We studied 23 adult healthy dogs of both sexes and varying age fed with commercial feed (standard). The arterial pressure, systolic (SBP) and diastolic (DBP), and pulse were measured by digital human sphygmomanometer. The level of serum sodium was obtained by the method of enzyme reagent in kinetic mode, using a commercial kit. We performed Pearson correlation between variables. The values of SBP, DBP, pulse and serum sodium varied respectively from 96 184mmHg, 53 137mmHg, 64 135bpm and 120-157mEq/L. We observed a positive correlation between the variables age and SBP, age and DBP, SBP and sodium, and sodium and DBP, while the values of serum sodium and age showed a negative correlation. Regarding this study conditions, we conclude that there is little interference in the values of blood pressure, both systolic and diastolic, regarding age and serum sodium in healthy adult dogs. 

A pressão arterial vem recebendo destaque na clínica veterinária atual, podendo ser mensurada de forma não-invasiva, pelo método oscilométrico, entre outros. Fatores como a idade já foram relacionados com distúrbios na pressão arterial. O sódio, elemento vital na fisiologia celular de animais, já foi relacionado com o aumento da pressão arterial. Desta forma, este trabalho correlaciona a idade, os valores da pressão arterial sistêmica, sistólica e diastólica, com os níveis séricos de sódio em cães adultos hígidos. Foram estudados 23 cães adultos, hígidos, de ambos os sexos e idade variável, alimentados com ração comercial (standard). As pressões arteriais, sistólica (PAS) e diastólica (PAD), e pulso foram aferidas por esfigmomanômetro digital humano. O nível sérico de sódio foi obtido pelo método de reagente enzimático em modo cinético, utilizando kit comercial. Foi realizada a Correlação de Pearson entre as variáveis. Os valores da PAS, PAD, pulso e sódio sérico, variaram respectivamente de 96 184mmHg, 53- 137mmHg, 64 135bpm e 120 157mEq/L. Foi observada uma correlação positiva entre as variáveis idade e PAS, idade e PAD, sódio e PAS, e sódio e PAD, enquanto os valores de idade e sódio sérico, demonstraram uma correlação negativa. Nas condições deste estudo conclui-se que há pouca interferência nos valores de pressão arterial, sistólica e diastólica, pela idade e o nível