Difference between revisions of "Blood Pressure Measurement"
Line 12: | Line 12: | ||
Method: | Method: | ||
#Usually measured using the metacarpal and metatarsal artery, although the tail can also be used. | #Usually measured using the metacarpal and metatarsal artery, although the tail can also be used. | ||
− | #Once a pulse has been detected, the doppler probe is placed | + | #Once a pulse has been detected, the doppler probe is placed in that position on the limb to check that it is audible and the probe canthen be taped to the limb. |
#A cuff is selected and placed proximal to the doppler probe and attached to a manometer. | #A cuff is selected and placed proximal to the doppler probe and attached to a manometer. | ||
#The cuff is inflated until the pulse is no longer audible on the doppler. | #The cuff is inflated until the pulse is no longer audible on the doppler. | ||
− | #The cuff is | + | #The cuff is gently released and a reading is taken when the pulse becomes audible again. |
− | * | + | *This measures systolic pressure only. |
− | *Cuff width should | + | *Cuff width should ideally be 40% of the circumference of the limb chosen for this method. |
'''Advantages''' | '''Advantages''' | ||
*Cheap and available in most practices. | *Cheap and available in most practices. | ||
*Useful in hypotensive patients. | *Useful in hypotensive patients. | ||
'''Disadvantages''' | '''Disadvantages''' | ||
− | *Not | + | *Not a reliable method in horses. |
===Oscillometric Method=== | ===Oscillometric Method=== |
Revision as of 17:27, 25 October 2010
Introduction
Blood pressure (BP) is an useful measurement to help assess the cardiovascular status of a patient during an anaesthetic, or as a diagnostic test for an underlying cause of ocular changes in cats as a result of high blood pressure. Many agents used during anaesthesia have an affect on the cardiovascular system, and blood pressure in particular so it is important to monitor and correct this if necessary. Some surgical procedures such as portosystemic shunt surgery, for example may have a direct effect on blood pressure and BP must be closely monitored throughout the procedure. There are various methods, both invasive and non invasive of measuring blood pressure.
Normal Arterial Blood Pressures
- Dogs – Systolic 140, Mean 100, Diastolic 75 mm Hg
- Cats - Systolic 180, Mean 135, Diastolic 100 mm Hg
- Horses - Systolic 110, Mean 90, Diastolic 70 mm Hg
Dogs are subject to breed specific variations in blood pressure reference ranges.
Non Invasive Methods
Doppler Flow Detection
Method:
- Usually measured using the metacarpal and metatarsal artery, although the tail can also be used.
- Once a pulse has been detected, the doppler probe is placed in that position on the limb to check that it is audible and the probe canthen be taped to the limb.
- A cuff is selected and placed proximal to the doppler probe and attached to a manometer.
- The cuff is inflated until the pulse is no longer audible on the doppler.
- The cuff is gently released and a reading is taken when the pulse becomes audible again.
- This measures systolic pressure only.
- Cuff width should ideally be 40% of the circumference of the limb chosen for this method.
Advantages
- Cheap and available in most practices.
- Useful in hypotensive patients.
Disadvantages
- Not a reliable method in horses.
Oscillometric Method
Method:
- The cuff is placed on a distal limb or tail.
- The cuff automatically inflates.
- As it deflates, oscillation in the cuff is detected.
- Measures systolic, diastolic and mean arterial blood pressure as well as pulse rate.
Advantages
- Good in dogs.
- Automatic.
Disadvantages
- Less reliable in cats and hypotensive patients.
- Expensive.
Invasive Methods
Arterial Catheterisation
Method:
- Catheter is placed in a peripheral artery and attached to either a anaeroid manometer or electronic transducer.
- An anaeroid manometer only gives a mean arterial blood pressure reading; an electronic transducer gives systolic, mean and diastolic arterial blood pressure readings.
- In dogs, the dorsal pedal artery is commonly used.
- In horses, the facial, transverse facial or metatarsal arteries used.
Advantages
- Continuous measurement.
- Catheterisation allows for blood gas analysis sampling.
Disadvantages
- Invasive
- Requires the correct equipment, which can be expensive.
Central Venous Pressure
Central venous pressure (CVP) is an indicator of blood return to the heart. It indicates adequacy of fluid therapy, heart performance and volume loading of the heart. It is measured by the placement of a central line, usually via the jugular vein. The method used is that described above for invasive arterial blood pressure measurements.
- Low or falling CVP suggests hypovolemia.
- High or rising CVP suggests volume overload or a failing heart.
Literature Search
Use these links to find recent scientific publications via CAB Abstracts (log in required unless accessing from a subscribing organisation).
Blood Pressure Measurement publications