Doppler ultrasonographic, oscillometric sphygmomanometric, and photoplethysmographic techniques for noninvasive blood pressure measurement in anesthetized cats

Abstract

Blood pressure (BP) measurements obtained using 3 indirect BP measuring instruments, a Doppler ultrasonic flowmeter, an oscillometric device, and a photoplethysmograph, were compared with direct arterial pressure measurements in 11 anesthetized cats. The standard deviation of the differences (SDD) between direct and indirect pressure measurements were not significantly different from each other (P < .01), and ranged from 10.82 to 24.32 mm Hg. The high SDD values indicate that indirect BP estimates obtained with all these devices must be interpreted cautiously in individual patients. The mean errors (calculated as the sum of the differences between direct and indirect pressure measurements divided by the number of observations) of the 3 indirect devices were significantly different for systolic (SAP), diastolic (DAP), and mean (MAP) arterial pressures (P < .05). The Doppler and photoplethysmographic devices had the highest overall accuracy, as indicated by mean error values of less than 10 mm Hg. Correlation coefficients varied from .88 to .96 for the Doppler flowmeter, and from .85 to .94 for the photoplethysmograph; for both devices, the regression line slopes were close to unity. The Doppler flowmeter detected a pulse under all experimental conditions. The photoplethysmograph was also efficient in obtaining BP measurements, obtaining over 90% of SAP, DAP, and MAP readings attempted. The oscillometric device was the least accurate, with mean error values varying from 10 to 22 mm Hg. Correlation coefficients were high (.90 to .94) for this device, but the slopes of the regression lines were 0.7 to 0.8, indicating a trend for increased error at higher BP. The oscillometric device tended to underestimate BP by increasing amounts as the BP increased. The oscillometric device was the least efficient device for obtaining BP measurements (P < .01).