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The Canadian veterinary journal = La revue veterinaire canadienne2021; 62(9); 994-998;

Evaluation of noninvasive blood pressure in anesthetized horses: Bias, limits of agreement, and comparative detection of a predetermined mean blood pressure warranting treatment.

Abstract: Oscillometric blood pressure monitoring may be a practical tool for short procedures or those performed outside of the operating room. Oscillometric and direct blood pressure values in 30 juvenile and adult horses in a clinical setting using mixed effect models were compared. The limits of agreement and percentage errors were also calculated. We evaluated the sensitivity and false positive rate for the oscillometric method to trigger an intervention for treating blood pressure [direct mean arterial pressure (MAP) < 70 mmHg]. Oscillometric MAP and diastolic arterial pressure (DAP) differed from direct values ( < 0.001); systolic arterial pressure (SAP) did not ( = 0.08). Wide limits of agreement were observed. Percentage errors were smaller for SAP (39%) than for MAP and DAP (48% and 72%). The oscillometric monitor indicated there was a requirement for blood pressure treatment with a true positive rate of 82%, consequently, it failed 18% of the times. The false positive rate (unnecessary treatment) was 55%. . La surveillance oscillométrique de la pression artérielle peut être un outil pratique pour les procédures courtes ou celles effectuées hors de la salle d’opération. Les valeurs oscillométriques et directes de la pression artérielle chez 30 chevaux juvéniles et adultes en milieu clinique ont été comparées à l’aide de modèles à effets mixtes. Les limites d’accord et les pourcentages d’erreurs furent également calculés. Nous avons évalué la sensibilité et le taux de faux positifs de la méthode oscillométrique pour déclencher une intervention pour le traitement de la pression artérielle [pression artérielle moyenne directe (PAM) < 70 mmHg]. La PAM oscillométrique et la pression artérielle diastolique (PAD) différaient des valeurs directes ( < 0,001); mais pas la pression artérielle systolique (PAS) ( = 0,08). De larges limites d’accord ont été observées. Les pourcentages d’erreurs étaient plus faibles pour PAS (39 %) que pour PAM et PAD (48 % et 72 %). Le moniteur oscillométrique a indiqué qu’il y avait une exigence pour un traitement de la pression artérielle avec un taux de vrais positifs de 82 %, par conséquent, il a échoué 18 % des fois. Le taux de faux positifs (traitement inutile) était de 55 %.(Traduit par D Serge Messier).
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Publication Date: 2021-09-04 PubMed ID: 34475586PubMed Central: PMC8360307
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  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research article investigates the accuracy and effectiveness of oscillometric blood pressure monitoring in anesthetized horses. The study found that this method, while practical for short procedures, has critical limitations when it comes to precision and the detection of low blood pressure conditions.

Research Methodology

  • The research was conducted using a sample of 30 juvenile and adult horses in a clinical setting.
  • Oscillometric and direct blood pressure measurements were compared using mixed-effect models.
  • The accuracy of the two measures was assessed by calculating their limits of agreement and percentage errors.

Research Findings

  • Statistical analysis revealed that oscillometric mean arterial pressure (MAP) and diastolic arterial pressure (DAP) differed significantly from direct measurements.
  • On the other hand, systolic arterial pressure (SAP) did not showcase significant difference.
  • Overall, wide limits of agreement were observed suggesting discrepancies between two methods.
  • Percentage errors were larger for MAP and DAP (48% and 72% respectively) than for the SAP (39%).

Implications for Treatment

  • The study also examined the effectiveness of the oscillometric method in triggering intervention for blood pressure treatment (defined as a condition where MAP falls below 70 mmHg).
  • On this aspect, the oscillometric method showed a true positive rate of 82%, meaning it correctly identified low-pressure conditions in 82% of cases.
  • However, the method also had a high false-positive rate of 55%, leading to unnecessary treatments.
  • These findings suggest that while the oscillometric method can be useful in some scenarios, it is prone to errors and may not always accurately detect when treatment for blood pressure is warranted.

Conclusion

  1. The research suggests that while oscillometric blood pressure monitoring can be a practical tool for short procedures, it has critical limitations in terms of accuracy.
  2. Given the high percentage errors and the substantial false-positive rates, further improvements and assessments would be crucial before integrating this method for routine use in anesthetized horses.

Cite This Article

APA
Radhakrishnan S, Lorenzutti AM, Araos JD, Martin-Flores M. (2021). Evaluation of noninvasive blood pressure in anesthetized horses: Bias, limits of agreement, and comparative detection of a predetermined mean blood pressure warranting treatment. Can Vet J, 62(9), 994-998.

Publication

The Canadian veterinary journal = La revue veterinaire canadienne
ISSN: 0008-5286
NlmUniqueID: 0004653
Country: Canada
Language: English
Volume: 62
Issue: 9
Pages: 994-998

Researcher Affiliations

Radhakrishnan, Shalini
  • Cornell University College of Veterinary Medicine, Equine Hospital, 930 Campus Road, Ithaca, New York 14853, USA (Radhakrishnan, Araos, Martin-Flores); Cátedra de Farmacología y Toxicología, Facultad de Ciencias Agropecuarias, Universidad Católica de Córdoba, Argentina (Lorenzutti).
Lorenzutti, Augusto M
  • Cornell University College of Veterinary Medicine, Equine Hospital, 930 Campus Road, Ithaca, New York 14853, USA (Radhakrishnan, Araos, Martin-Flores); Cátedra de Farmacología y Toxicología, Facultad de Ciencias Agropecuarias, Universidad Católica de Córdoba, Argentina (Lorenzutti).
Araos, Joaquin D
  • Cornell University College of Veterinary Medicine, Equine Hospital, 930 Campus Road, Ithaca, New York 14853, USA (Radhakrishnan, Araos, Martin-Flores); Cátedra de Farmacología y Toxicología, Facultad de Ciencias Agropecuarias, Universidad Católica de Córdoba, Argentina (Lorenzutti).
Martin-Flores, Manuel
  • Cornell University College of Veterinary Medicine, Equine Hospital, 930 Campus Road, Ithaca, New York 14853, USA (Radhakrishnan, Araos, Martin-Flores); Cátedra de Farmacología y Toxicología, Facultad de Ciencias Agropecuarias, Universidad Católica de Córdoba, Argentina (Lorenzutti).

MeSH Terms

  • Animals
  • Arterial Pressure
  • Blood Pressure
  • Blood Pressure Determination / veterinary
  • Blood Pressure Monitors / veterinary
  • Horses
  • Oscillometry / veterinary

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