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Evaluation of the tongue for oscillometric measurement of arterial pressure in anesthetized Beagle dogs

Published:November 23, 2021DOI:https://doi.org/10.1016/j.vaa.2021.11.003

      Abstract

      Objective

      To evaluate the agreement between oscillometric blood pressure (OBP) measured from the tongue and invasive blood pressure (IBP), and to compare OBPs measured from the tongue with OBPs measured from the pelvic limb and tail.

      Study design

      Prospective experimental study.

      Animals

      A total of eight adult Beagle dogs weighing 11.1 ± 1.2 kg.

      Methods

      Animals were premedicated with intravenous (IV) acepromazine (0.005 mg kg–1). Anesthesia was induced with alfaxalone (3 mg kg–1) IV and maintained with isoflurane. The dorsal pedal artery was catheterized for IBP measurements. Systolic (SAP), diastolic (DAP) and mean (MAP) arterial pressure were simultaneously measured from the tongue, pelvic limb and tail. Based on invasive SAP, hypertension (>140 mmHg), normotension (90–140 mmHg) and hypotension (<90 mmHg) were induced by controlling end-tidal isoflurane concentrations and/or dobutamine/dopamine administration. Agreement between paired IBP and OBP measurements was analyzed with reference standards for noninvasive blood pressure devices used in small animals and humans.

      Results

      Regardless of cuff placement, the mean bias ± standard deviation between IBP and OBP met veterinary (≤10 ± 15 mmHg) and human (<5 ± 8 mmHg) standards for MAP and DAP. SAP measurements provided by the OBP device showed unacceptable agreement with IBP, and the bias between methods increased at higher blood pressures, regardless of cuff site. During hypotension, tongue OBP showed the largest percentage of absolute difference <10 mmHg in relation to IBP for SAP (90%), MAP (97%), and DAP (93%), compared with pelvic limb (60%, 97% and 82%, respectively) and tail OBP (54%, 92% and 77%, respectively).

      Conclusions and clinical relevance

      The tongue is a clinically useful site for measuring OBP in anesthetized Beagle dogs, providing reliable estimates of MAP and DAP. The tongue could replace other cuff placement sites and may be a relatively suitable site for assessing hypotension.

      Keywords

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      References

        • Alpert B.S.
        • Quinn D.
        • Gallick D.
        Oscillometric blood pressure: a review for clinicians.
        J Am Soc Hypertens. 2014; 8: 930-938
        • ANSI/AAMI/SP10:2002/(R)
        Manual, electronic, or automated sphygmomanometers.
        BJM. 2008; (Association for the Advancement of Medical Instruments, USA) (Available from)
        • Binns S.H.
        • Sisson D.D.
        • Buoscio D.A.
        • Schaeffer D.J.
        Doppler ultrasonographic, oscillometric sphygmomanometric, and photoplethysmographic techniques for noninvasive blood pressure measurement in anesthetized cats.
        J Vet Intern Med. 1995; 9: 405-414
        • Bland J.M.
        • Altman D.G.
        Agreement between methods of measurement with multiple observations per individual.
        J Biopharm Stat. 2007; 17: 571-582
        • Bodey A.R.
        • Young L.E.
        • Bartram D.H.
        • et al.
        A comparison of direct and indirect (oscillometric) measurements of arterial blood pressure in anaesthetised dogs, using tail and limb cuffs.
        Res Vet Sci. 1994; 57: 265-269
        • Branson K.R.
        • Wagner-Mann C.C.
        • Mann F.A.
        Evaluation of an oscillometric blood pressure monitor on anesthetized cats and the effect of cuff placement and fur on accuracy.
        Vet Surg. 1997; 26: 347-353
        • Brown S.
        • Atkins C.
        • Bagley R.
        • et al.
        Guidelines for the identification, evaluation, and management of systemic hypertension in dogs and cats.
        J Vet Intern Med. 2007; 21: 542-558
        • Clarke K.W.
        • Trim C.M.
        • Hall L.W.
        Veterinary Anesthesia.
        11th edn. Saunders Elsevier, UK2014: 634-638
        • Cremer J.
        • da Cunha A.F.
        • Paul L.J.
        • et al.
        Assessment of a commercially available veterinary blood pressure device used on awake and anesthetized dogs.
        Am J Vet Res. 2019; 80: 1067-1073
        • da Cunha A.F.
        • Ramos S.J.
        • Domingues M.
        • et al.
        Agreement between two oscillometric blood pressure technologies and invasively measured arterial pressure in the dog.
        Vet Anaesth Analg. 2016; 43: 199-203
        • Deflandre C.J.A.
        • Hellebrekers L.J.
        Clinical evaluation of the Surgivet V60046, a non invasive blood pressure monitor in anaesthetized dogs.
        Vet Anaesth Analg. 2008; 35: 13-21
        • Drynan E.A.
        • Raisis A.L.
        Comparison of invasive versus noninvasive blood pressure measurements before and after hemorrhage in anesthetized greyhounds using the Surgivet V9203.
        J Vet Emerg Crit Care (San Antonio). 2013; 23: 523-531
        • Eubanks D.L.
        Anatomy and clinical examination of the tongue in the dog.
        J Vet Dent. 2007; 24: 271-273
        • Garofalo N.A.
        • Teixeira Neto F.J.
        • Alvaides R.K.
        • et al.
        Agreement between direct, oscillometric and Doppler ultrasound blood pressures using three different cuff positions in anesthetized dogs.
        Vet Anaesth Analg. 2012; 39: 324-334
        • Haberman C.E.
        • Kang C.W.
        • Morgan J.D.
        • Brown S.A.
        Evaluation of oscillometric and Doppler ultrasonic methods of indirect blood pressure estimation in conscious dogs.
        Can J Vet Res. 2006; 70: 211-217
        • Hermanson J.W.
        • de Lahunta A.
        Miller’s Anatomy of the Dog.
        5th edn. Saunders, USA2019: 202
        • McMurphy R.M.
        • Stoll M.R.
        • McCubrey R.
        Accuracy of an oscillometric blood pressure monitor during phenylephrine-induced hypertension in dogs.
        Am J Vet Res. 2006; 67: 1541-1545
        • Pascoe P.J.
        Perioperative management of fluid therapy.
        in: DiBartola S.P. Fluid, Electrolyte, and Acid–Base Disorders in Small Animal Practice. 4th edn. Elsevier Saunders, USA2011: 405-435
        • Ramos S.J.
        • da Cunha A.F.
        • Domingues M.
        • et al.
        Comparison of blood pressure measurements of anesthetized dogs obtained noninvasively with a cylindrical blood pressure cuff and an anatomically modified conical blood pressure cuff.
        Am J Vet Res. 2016; 77: 59-64
        • Sawyer D.C.
        • Guikema A.H.
        • Siegel E.M.
        Evaluation of a new oscillometric blood pressure monitor in isoflurane-anesthetized dogs.
        Vet Anaesth Analg. 2004; 31: 27-39
        • Sawyer D.C.
        • Brown M.
        • Striler E.L.
        • et al.
        Comparison of direct and indirect blood pressure measurement in anesthetized dogs.
        Lab Anim Sci. 1991; 41: 134-138
        • Schauvliege S.
        Patient monitoring and monitoring equipment.
        in: Duke-Novakovski T. de Vries M. Seymour C. BSAVA Manual of Canine and Feline Anaesthesia and Analgesia. 3rd edn. British Small Animal Veterinary Association, UK. 2016: 77-80
        • Séguin B.
        Surgical treatment of tongue, lip and cheek tumors.
        in: Verstraete F.J.M. Lommer M.J. Oral and Maxillofacial Surgery in Dogs and Cats. Saunders Elsevier, USA2012: 431-449
        • Vachon C.
        • Belanger M.C.
        • Burns P.M.
        Evaluation of oscillometric and Doppler ultrasonic devices for blood pressure measurements in anesthetized and conscious dogs.
        Res Vet Sci. 2014; 97: 111-117
        • Wernick M.
        • Doherr M.
        • Howard J.
        • Francey T.
        Evaluation of high-definition and conventional oscillometric blood pressure measurement in anaesthetised dogs using ACVIM guidelines.
        J Small Anim Pract. 2010; 51: 318-324