Accuracy of indirect measurement of blood pressure in neonatal foals.
Authors: Giguère Steeve, Knowles Harvey A, Valverde Alexander, Bucki Eric, Young Linda
Journal: Journal of veterinary internal medicine
Summary
# Editorial Summary: Blood Pressure Measurement in Neonatal Foals Accurate haemodynamic monitoring of critically ill neonatal foals remains challenging, yet indirect blood pressure measurement via oscillometric monitors is increasingly available in equine practice; this 2005 study sought to validate two commonly used devices and identify optimal cuff placement sites in anaesthetised foals. Ten neonates were fitted with direct arterial catheters in the metatarsal artery whilst simultaneous indirect measurements were taken using Cardell and Dinamap monitors with cuffs positioned over the coccygeal, metatarsal, and median arteries, with blood pressure deliberately varied through anaesthetic depth and pharmacological manipulation. The Cardell monitor demonstrated significantly lower measurement bias when the cuff was placed over the coccygeal artery compared with median or dorsal metatarsal placement, whereas cuff position made no significant difference with the Dinamap device. A weak correlation (r = 0.47) emerged between mean arterial pressure and cardiac output—an important distinction suggesting that acceptable blood pressure readings do not necessarily indicate adequate tissue perfusion in anaesthetised foals. For practitioners managing critically ill foals, these findings support oscillometric monitoring as a practical, non-invasive tool when cuff placement is carefully selected (coccygeal preferred with Cardell units), though clinicians must recognise that blood pressure alone is insufficient to assess haemodynamic status and should be interpreted alongside other indicators of cardiac output and perfusion.
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Practical Takeaways
- •When using Cardell oscillometric monitors to measure blood pressure in anesthetized neonatal foals, place the cuff over the coccygeal artery rather than the median or dorsal metatarsal artery for most accurate readings
- •Dinamap monitors perform consistently regardless of cuff placement site, providing more flexibility in monitoring location
- •Blood pressure measurements alone should not be relied upon to assess cardiac output in anesthetized foals—additional monitoring methods are necessary
Key Findings
- •Coccygeal artery cuff placement with Cardell monitor showed significantly lower bias than median or dorsal metatarsal artery placement (P < 0.0001 and P = 0.0149)
- •Dinamap monitor showed no significant difference in bias across the three cuff placement sites tested
- •Correlation coefficient between mean arterial pressure and cardiac output was 0.47, indicating poor correlation in anesthetized foals
- •Indirect oscillometry with cuff placed over coccygeal or dorsal metatarsal artery is an acceptable method for MAP measurement in foals