Cuff size, cuff placement, blood pressure state, and monitoring technique can influence indirect arterial blood pressure monitoring in anesthetized bats (Pteropus vampyrus)

OBJECTIVE Evaluate agreement between 2 non-invasive blood pressure (NIBP) techniques and invasive arterial blood pressure (IBP) in anesthetized bats using various cuff sizes and cuff positioning while also evaluating its performance during hypertension and hypotension. ANIMALS 8 bats (1.1 +/- 0.2 kg). PROCEDURES Bats were anesthetized with isoflurane in oxygen. NIBP was measured using oscillometric (NIBP-O) and Doppler (NIBP-D) techniques in the pectoral limb (PEC) and pelvic limbs (PEL) using 3 cuff sizes (1, 2, and 3). NIBP mea- surements were compared with IBP; systolic (SAPinvasive), mean (MAPinvasive), and diastolic arterial blood pres-sure (DAPinvasive) during normotension, hypertension, and hypotension. Hypotension was induced with isoflurane (3.8 +/- 1.2%) and hypertension with norepinephrine (3 +/- 0.5 mu g/kg/min). Data analysis included Bland-Altman analy-ses and 3-way ANOVA. Results were reported as mean bias (95% CI). RESULTS NIBP-O monitor reported 29% errors, and experienced more failures with hypertension, cuff placement on PEC, and using a size 1 cuff. Across states, an agreement between NIBP-D and MAPinvasive with cuff 2 on PEL (-3 mmHg [-8, 1]), and NIBP-D and SAPinvasive with cuff 3 on PEC (2 mmHg [-5, 9 mmHg]) was achieved. NIBP-D over-estimated SAPinvasive and MAPinvasive during hypertension in both limbs with cuffs 1 and 2. Except during hypotension, NIBP-O underestimated MAPinvasive and DAPinvasive using a size 2 cuff on PEL. CLINICAL RELEVANCE In anesthetized bats, NIBP-O is unreliable for estimating IBP. NIBP-D shows acceptable agreement with MAPinvasive with cuff size 2 on PEL, and with SAPinvasive with cuff size 3 on PEC across a wide range of IBP values.