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).
Copyright and/or publishing rights held by the Canadian Veterinary Medical Association.
Publication Date: 2021-09-04 PubMed ID: 34475586PubMed Central: PMC8360307
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- 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
- 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.
- 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
Researcher Affiliations
- 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).
- 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).
- 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).
- 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
References
This article includes 17 references
- Grandy JL, Steffey EP, Hodgson DS, Woliner MJ. Arterial hypotension and the development of postanesthetic myopathy in halothane-anesthetized horses.. Am J Vet Res 1987 Feb;48(2):192-7.
- Rioja E, Cernicchiaro N, Costa MC, Valverde A. Perioperative risk factors for mortality and length of hospitalization in mares with dystocia undergoing general anesthesia: a retrospective study.. Can Vet J 2012 May;53(5):502-10.
- Hatz LA, Hartnack S, Kümmerle J, Hässig M, Bettschart-Wolfensberger R. A study of measurement of noninvasive blood pressure with the oscillometric device, Sentinel, in isoflurane-anaesthetized horses.. Vet Anaesth Analg 2015 Jul;42(4):369-76.
- Heliczer N, Lorello O, Casoni D, Navas de Solis C. Accuracy and Precision of Noninvasive Blood Pressure in Normo-, Hyper-, and Hypotensive Standing and Anesthetized Adult Horses.. J Vet Intern Med 2016 May;30(3):866-72.
- Yamaoka TT, Flaherty D, Pawson P, Scott M, Auckburally A. Comparison of arterial blood pressure measurements obtained invasively or oscillometrically using a Datex S/5 Compact monitor in anaesthetised adult horses.. Vet Anaesth Analg 2017 May;44(3):492-501.
- Skelding A, Valverde A. Non-invasive blood pressure measurement in animals: Part 1 - Techniques for measurement and validation of non-invasive devices.. Can Vet J 2020 Apr;61(4):368-374.
- Skelding A, Valverde A. Review of non-invasive blood pressure measurement in animals: Part 2 - Evaluation of the performance of non-invasive devices.. Can Vet J 2020 May;61(5):481-498.
- Hartnack S. Issues and pitfalls in method comparison studies.. Vet Anaesth Analg 2014 May;41(3):227-32.
- Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement.. Lancet 1986 Feb 8;1(8476):307-10.
- Critchley LA, Critchley JA. A meta-analysis of studies using bias and precision statistics to compare cardiac output measurement techniques.. J Clin Monit Comput 1999 Feb;15(2):85-91.
- Mandrekar JN. Receiver operating characteristic curve in diagnostic test assessment.. J Thorac Oncol 2010 Sep;5(9):1315-6.
- White WB, Berson AS, Robbins C, Jamieson MJ, Prisant LM, Roccella E, Sheps SG. National standard for measurement of resting and ambulatory blood pressures with automated sphygmomanometers.. Hypertension 1993 Apr;21(4):504-9.
- Geddes LA, Voelz M, Combs C, Reiner D, Babbs CF. Characterization of the oscillometric method for measuring indirect blood pressure.. Ann Biomed Eng 1982;10(6):271-80.
- Kittleson MD, Olivier NB. Measurement of systemic arterial blood pressure.. Vet Clin North Am Small Anim Pract 1983 May;13(2):321-36.
- Duke T, Filzek U, Read MR, Read EK, Ferguson JG. Clinical observations surrounding an increased incidence of postanesthetic myopathy in halothane-anesthetized horses.. Vet Anaesth Analg 2006 Mar;33(2):122-7.
- Tearney CC, Guedes AG, Brosnan RJ. Equivalence between invasive and oscillometric blood pressures at different anatomic locations in healthy normotensive anaesthetised horses.. Equine Vet J 2016 May;48(3):357-61.
- Wilson KAT, Raisis AL, Drynan EA, Lester GD, Hosgood GL. Agreement between invasive blood pressures measured in three peripheral arteries in anaesthetized horses under clinical conditions.. Vet Anaesth Analg 2018 May;45(3):338-344.
Citations
This article has been cited 0 times.Use Nutrition Calculator
Check if your horse's diet meets their nutrition requirements with our easy-to-use tool Check your horse's diet with our easy-to-use tool
Talk to a Nutritionist
Discuss your horse's feeding plan with our experts over a free phone consultation Discuss your horse's diet over a phone consultation
Submit Diet Evaluation
Get a customized feeding plan for your horse formulated by our equine nutritionists Get a custom feeding plan formulated by our nutritionists
