Bias, sensitivity, and specificity of Doppler ultrasonic flow detector measurement of blood pressure for detecting and monitoring hypotension in anesthetized dogs. 2018

Lisa A Bourazak, and Erik H Hofmeister

OBJECTIVE To determine the bias, sensitivity, and specificity of Doppler ultrasonic flow detector measurement of blood pressure (DBPM) to detect hypotension in dogs with various disease states and to determine whether patient characteristics could affect accuracy of DBPM in dogs. DESIGN Prospective cross-sectional study. ANIMALS 146 client-owned dogs undergoing general anesthesia at a veterinary teaching hospital between April 2007 and August 2010. PROCEDURES Data collected for each dog were breed, limb conformation, sex, American Society of Anesthesiologists physical status classification, anesthetic protocol, surgical procedure, arterial catheter size and location, and DBPM location. Doppler and invasive blood pressure measurements (IBPMs; criterion standard) were simultaneously recorded every 5 minutes throughout anesthesia. Hypotension was defined as mean arterial blood pressure < 60 mm Hg or DBPM < 90 mm Hg. Repeated-measures Bland-Altman analysis was performed to determine bias between DBPMs and IBPMs. Overall sensitivity and specificity of DBPM to detect hypotension were calculated with 2 methods, and values were recalculated for specific patient groups and compared. RESULTS Bias of DBPM was 2.8 mm Hg with wide 95% limits of agreement (-46.4 to 51.9 mm Hg). For the 2 calculation methods, sensitivity of DBPM to detect hypotension was 69.2% and 66.7% and specificity was 82.2% and 86.8%. No significant differences in sensitivity or specificity were identified regarding limb conformation, gauge of catheter (20 vs 22) used for IBPM, or side (ipsilateral or contralateral) of paired measurements. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that in dogs of the present study, DBPM was unreliable for detecting hypotension.

UI MeSH Term Description Entries
D008297 Male Males
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D001795 Blood Pressure Determination Techniques used for measuring BLOOD PRESSURE. Blood Pressure Determinations,Determination, Blood Pressure
D003430 Cross-Sectional Studies Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time. Disease Frequency Surveys,Prevalence Studies,Analysis, Cross-Sectional,Cross Sectional Analysis,Cross-Sectional Survey,Surveys, Disease Frequency,Analyses, Cross Sectional,Analyses, Cross-Sectional,Analysis, Cross Sectional,Cross Sectional Analyses,Cross Sectional Studies,Cross Sectional Survey,Cross-Sectional Analyses,Cross-Sectional Analysis,Cross-Sectional Study,Cross-Sectional Surveys,Disease Frequency Survey,Prevalence Study,Studies, Cross-Sectional,Studies, Prevalence,Study, Cross-Sectional,Study, Prevalence,Survey, Cross-Sectional,Survey, Disease Frequency,Surveys, Cross-Sectional
D004285 Dogs The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065) Canis familiaris,Dog
D005260 Female Females
D006762 Hospitals, Animal Facility for in-house medical care of animals. Animal Hospitals,Hospitals, Veterinary,Veterinary Clinics,Veterinary Hospitals,Clinics, Veterinary,Animal Hospital,Clinic, Veterinary,Hospital, Animal,Hospital, Veterinary,Veterinary Clinic,Veterinary Hospital
D000768 Anesthesia, General Procedure in which patients are induced into an unconscious state through use of various medications so that they do not feel pain during surgery. Anesthesias, General,General Anesthesia,General Anesthesias
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D012680 Sensitivity and Specificity Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed) Specificity,Sensitivity,Specificity and Sensitivity

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