Agreement of high-definition oscillometry at two cuff locations with invasively measured arterial blood pressures in anaesthetised cheetahs

Objectives To evaluate the agreement between high -definition oscillometry (HDO) used on the metatarsus or tail base with invasive arterial blood pressures measured in the dorsal pedal artery in anaesthetised cheetahs.Study Design Prospective clinical study. Animals A group of 13 captive adult cheetahs.Methods Cheetahs were immobilised with medetomidine (32-45 mg kg -1) and tiletamine/zolazepam (0.93-1.39 mg kg -1) administered intramuscularly, and anaesthesia was maintained with either isoflurane in oxygen or continuous propofol infusion. Invasive blood pressure was measured via a 20 gauge intra-arterial catheter in the dorsal pedal artery in the metatarsus and used as a refer-ence method for pressures simultaneously estimated using HDO on the contralateral metatarsus and tail base. Bland -Altman plots (for repeated measurements) and criteria defined by the American College of Veterinary In-ternal Medicine (ACVIM) were used to compare agreement according to the anatomical location of the cuff, the anaesthetic maintenance agent and magnitude of the blood pressure.Results A total of 147 paired measurements were obtained with HDO on the metatarsus and 135 on the tail. Agree-ment with invasive pressures was better when HDO was used on the tail (rather than on the metatarsus) with all ACVIM criteria being met. Mean bias (a positive bias meaning that HDO overestimated the invasively measured pressures) +/- standard deviation of differences for systolic, diastolic and mean arterial pressures were -7.0 +/- 13.9, 4.2 +/- 12.1 and 4.6 +/- 11.2 mmHg, respectively, for HDO on the tail, and -11.9 +/- 15.1, 2.8 +/- 16.5 and 2.1 +/- 13.2 mmHg, respectively, for HDO on the metatarsus. Agreement was better during isoflurane anaesthesia than propofol, and at lower blood pressures than at higher. Conclusions and clinical relevance When used on the tail base of anaesthetised cheetahs, HDO met the ACVIM vali-dation criteria for a noninvasive device, as compared to invasively measured pressures in the dorsal pedal artery.