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can be cost prohibitive, especially when not used
frequently.
• Arterial catheters are invasive, and arterial
access can be technically difficult to obtain and
maintain.
• Complications that can result from arterial
catheterization include bleeding from the
catheter insertion site, hematoma formation,
significant hemorrhage if the system becomes
disconnected, infection, and arterial thrombosis
with possibility of necrosis of the tissues distal to
the catheter.

FIGURE 5. Simultaneous electrocardiography Blood Pressure Measurement: Step by Step
and direct arterial blood pressure readings Table 3 lists the supplies needed for DABP
demonstrated on a different monitor (PM-9000 measurement (Figure 6).
Vet Monitor, mindray.com). 1. Place and secure an arterial catheter; common
sites for arterial catheterization include the
• Presenting in hypovolemic or septic shock dorsal pedal artery, coccygeal artery (Figures 7
• In congestive heart failure, especially when and 8), and medial auricular artery.
1,2
receiving powerful vasodilator medication for 2. Once the arterial catheter is placed and secured,
purpose of afterload reduction connect it to the DABP monitoring system.
• Requiring vasopressors or mechanical ventilation 3. At one end of the system—the end farthest away
• Receiving medication for severe hypertension from the patient—a fl uid administration set is
• Demonstrating a high anesthetic risk. connected to a heparinized bag of 0.9% sodium
DABP monitoring is NOT indicated in healthy, chloride (Table 3).
ambulatory patients because these patients are 4. Pressurize the fl uid bag to a range between 250
more likely to disconnect an arterial line, or and 300 mm Hg: the goal is to achieve a pressure
remove the arterial catheter, increasing the risk for
arterial hemorrhage.

Advantages
DABP has many advantages over other methods
of blood pressure monitoring. Two of the most
important advantages include:
• “Real-time” monitoring of blood pressure
and blood pressure trends, even in extremely
hypotensive patients; this up-to-the-minute
information about a patient’s hemodynamic
status enables clinicians to gauge whether a
specific therapy is working or if additional,
immediate intervention is necessary.
• Handling and restraint of the patient is usually
limited to the initial arterial catheter placement;
therefore, DABP values are less prone to falsely
elevated readings related to stress of restraint and
handling.
FIGURE 6. DABP supplies: Transpac disposable
Disadvantages pressure transducer (icumed.com), heparinized
However, DABP monitoring is not used saline bag inside pressurized air bag, electronic
extensively because it has several drawbacks: cable to connect Transpac to monitor,
transducer board (white), arterial catheter
• The equipment necessary to monitor DABP (eg, (dorsal metatarsal).
pressure transducers, hemodynamic monitors)

96 TODAY’S VETERINARY PRACTICE | March/April 2015 | tvpjournal.com