Blood Pressure Measurement

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:

1. Usually measured using the metacarpal and metatarsal artery, although the tail can also be used.
2. Once a pulse has been detected, the doppler probe is placed over to check that it is audible and the probe is taped to the limb.
3. A cuff is selected and placed proximal to the doppler probe and attached to a manometer.
4. The cuff is inflated until the pulse is no longer audible on the doppler.
5. The cuff is the gently released and a reading is taken when the pulse becomes audible again.

• The measurement is systolic pressure.
• Cuff width should measure as 40% of the circumference of the limb being used.

Advantages

• Cheap and available in most practices.
• Useful in hypotensive patients.

Disadvantages

• Not very reliable in horses.

Oscillometric Method

Method:

1. The cuff is placed on a distal limb or tail.
2. The cuff automatically inflates.
3. 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:

1. Catheter is placed in a peripheral artery and attached to either a anaeroid manometer or electronic transducer.
2. An anaeroid manometer only gives a mean arterial blood pressure reading; an electronic transducer gives systolic, mean and diastolic arterial blood pressure readings.
3. In dogs, the dorsal pedal artery is commonly used.
4. 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