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How I Treat...Hypotension
F. Laredo
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BACKGROUND
Intraoperative hypotension is a common anaesthetic complication in small animals, which incidence is 7 for dogs and 8.5% for cats, respectively1. There is quite a lot of agreement regarding the values that define intraoperative hypotension scenarios in dogs, as well as the limits that require immediate corrective measures2. Classically, hypotension has been treated after detection of systolic blood pressure (SBP) below 80 mmHg or mean blood pressure (MBP) below 60 mmHg1,2,3. Additionally, the coronary perfusion pressure is largely determined by the systolic blood pressure (SBP), and it is estimated that SBP values below 45 mmHg may give rise to ischemia at this level. In a recent study, ACVAA and ECVAA specialists have defined the limits for intraoperative hypotension as SBP < 87 ± 8 mm Hg or MBP < 62 ± 4 mm Hg, considering the limits for intervention as values close to these ones: SBP < 85 ± 13mm Hg or MBP < 61 ± 4 mm Hg2. As it can be observed, these reference ranges are not different from what has been classically described. It is not possible to determine the blood pressure by pulse palpation, since its wideness correlates with the difference between systolic and diastolic pressures, and does not provide an absolute blood pressure value. This is why it is advisable to monitor the blood pressure instrumentally, by means of invasive or non-invasive methods during the anaesthesia. In a previous study conducted on dogs, 40% of anesthetized patients were monitored at this level by means of2automatized oscillometry (non-invasive) systems, 40% by direct invasive records and 9.4% by Doppler . In cats, on the contrary, monitoring the blood pressure by Doppler methods is a precise and effective system although it may be tedious for repeated intraoperative use. […]
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About
Affiliation of the authors at the time of publication
Hospital Clínico Veterinario, Universidad de Murcia, Departamento de Medicina y Cirugía Animal Campus de Espinardo, Murcia, España.
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