Agreement and Diagnostic Accuracy of New Linear Deflection Oscillometry and Doppler Devices for Hypotension Detection Compared to Invasive Blood Pressure in Anesthetized Dogs.

Abstract

Blood pressure (BP) monitoring is essential during anesthesia to maintain cardiovascular stability and detect hypotension. This study evaluated the agreement and diagnostic accuracy of linear deflection oscillometry (LDO) and Doppler compared to invasive blood pressure (IBP) in anesthetized dogs. Eleven healthy dogs were anesthetized, and BP measurements were taken using LDO, Doppler, and IBP methods under normotensive and hypotensive conditions. The LDO device demonstrated superior agreement, assessed using Bland-Altman analysis, with IBP, especially in hypotensive conditions, compared to the Doppler method. LDO showed bias and standard deviation in the hypotensive state, with a mean and systolic arterial pressure (MAP and SAP) of -5.1 ± 7.9 and -5.6 ± 12.5 mmHg, respectively. Conversely, Doppler measurements tended to overestimate SAP during hypotension, presenting a bias of -13 ± 15.45 mmHg. The LDO achieved an area under the curve (AUC) of 0.809 for hypotension detection, with an MAP cutoff of ≤72 mmHg (sensitivity: 90%, specificity: 63%). Meanwhile, the best threshold for Doppler measurements was an AUC of 0.798, SAP ≤ 100 mmHg (sensitivity: 77.8%, specificity: 81.8%). These results indicate that LDO is a reliable method for hypotension detection in anesthetized dogs, with potential applications for real-time monitoring. In contrast, the Doppler method may help confirm hypotension diagnoses.