Agreement of High-Definition Oscillometry (HDO) and Invasive Blood Pressure Measurements at a Metatarsal Artery in Isoflurane-Anaesthetised Horses.
Authors: Twele Lara, Neudeck Stephan, Delarocque Julien, Verhaar Nicole, Reiners Julia, Noll Mike, Tünsmeyer Julia, Kästner Sabine B R
Journal: Animals : an open access journal from MDPI
Summary
# Editorial Summary Oscillometric blood pressure monitoring offers a non-invasive alternative to arterial catheterisation, but its reliability during anaesthesia—particularly under haemodynamic stress—remains poorly characterised in equine practice. Twele and colleagues evaluated high-definition oscillometry (HDO) applied over the metatarsal artery against invasive blood pressure measurement in 11 anaesthetised horses, simultaneously recording systolic, mean and diastolic pressures whilst manipulating systemic blood pressure across normal (MAP 61–119 mmHg), hypotensive (≤60 mmHg) and hypertensive (≥120 mmHg) ranges. During normotension, HDO and invasive readings showed acceptable agreement; however, the oscillometric device systematically overestimated pressures during induced hypotension and underestimated them during hypertension, failing to meet most American College of Veterinary Internal Medicine validation criteria. For routine perioperative monitoring in clinically stable horses, metatarsal HDO may provide useful trending data, but when haemodynamic instability is likely or rapid pressure changes anticipated—particularly in critical cases—direct arterial measurement remains the gold standard and should not be replaced by oscillometric devices in such scenarios.
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Practical Takeaways
- •Do not rely on HDO over the metatarsal artery as a substitute for invasive monitoring during equine anaesthesia if hypotension or hypertension is likely; the device shows systematic measurement errors in these states
- •HDO may be acceptable for basic normotensive monitoring in routine anaesthesia cases but cannot replace invasive techniques when critical haemodynamic changes are expected
- •Until further validation, consider HDO as a screening tool only and use invasive catheters when precise blood pressure data is clinically important
Key Findings
- •HDO agreement with invasive blood pressure at the metatarsal artery was acceptable during normotension (MAP 61-119 mmHg) but not during induced hypotension or hypertension
- •During hypotension, IBP measurements were overestimated by HDO; during hypertension, IBP was underestimated by HDO
- •The HDO monitor failed to meet most ACVIM validation criteria for blood pressure measurement accuracy
- •Invasive blood pressure monitoring remains preferable when haemodynamic compromise or rapid blood pressure changes are anticipated in anaesthetised horses