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Agreement between invasive blood pressures measured in three peripheral arteries in anaesthetized horses under clinical conditions
Authors:Keely A.T. Wilson  Anthea L. Raisis  Eleanor A. Drynan  Guy D. Lester  Giselle L. Hosgood
Affiliation:1. Department of Veterinary Anaesthesia and Analgesia, College of Veterinary Medicine, School of Veterinary and Life sciences, Murdoch University Veterinary Hospital, Murdoch, Australia;2. Department of Large Animal Surgery and Internal Medicine, College of Veterinary Medicine, School of Veterinary and Life sciences, Murdoch University Veterinary Hospital, Murdoch, Australia;3. Department of Small Animal Surgery, College of Veterinary Medicine, School of Veterinary and Life Sciences, Murdoch University Veterinary Hospital, Murdoch, Australia
Abstract:

Objective

To determine agreement between invasive blood pressures measured in three peripheral arteries in anaesthetized horses undergoing elective surgery.

Study design

Prospective balanced incomplete block design.

Animals

A total of 18 client-owned horses.

Methods

Invasive blood pressure (IBP) was measured simultaneously in one of the following three combinations: 1) transverse facial and facial artery; 2) transverse facial and metatarsal artery; and 3) facial and metatarsal artery. The agreement in blood pressure measured for each combination was performed in six horses. At each sample time, systolic (SAP), mean (MAP) and diastolic (DAP) arterial pressures were measured concurrently in each artery, and the mean of three consecutive measurements was recorded. The position of horse, heart rate and use of dobutamine were also recorded. Bland–Altman analysis was used to assess agreement between sites.

Results

A total of 54 paired measurements were obtained, with 18 paired measurements from each combination. All paired measurements showed poor and haphazard (nonsystematic) agreement. The widest limit of agreement was 51 mmHg for SAP measured in the facial artery and metatarsal artery, with a bias of –11 mmHg. The smallest limit of agreement was 16 mmHg for MAP measured in the transverse facial and metatarsal artery, with a bias of 1 mmHg.

Conclusions and clinical relevance

There was poor and haphazard agreement for SAP, MAP and DAP measured in each pair of peripheral arteries in this study. These results show that blood pressure measured in different peripheral arteries cannot be used interchangeably. This has implications for studies that use IBP as an outcome variable and studies determining agreement between noninvasive blood pressure and IBP measurements in horses under general anaesthesia.
Keywords:agreement  anaesthesia  blood pressure  cardiovascular monitoring  horses
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