Open AccessComparison of Transpulmonary Thermodilution and Calibrated Pulse Contour Analysis with Pulmonary Artery Thermodilution Cardiac Output Measurements in Anesthetized Dogs
Author(s) -
Garofalo N.A.,
TeixeiraNeto F.J.,
Rodrigues J.C.,
Cerejo S.A.,
Aguiar A.J.A.,
BecerraVelásquez D.R.
Publication year - 2016
Publication title -
journal of veterinary internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.356
H-Index - 103
eISSN - 1939-1676
pISSN - 0891-6640
DOI - 10.1111/jvim.13984
Subject(s) - medicine , dobutamine , cardiac output , isoflurane , vascular resistance , anesthesia , vasoconstriction , phenylephrine , hemodynamics , cardiology , blood pressure
Background Transpulmonary thermodilution (TPTD CO ) and calibrated pulse contour analysis (PCA CO ) are alternatives to pulmonary artery thermodilution cardiac output (PATD CO ) measurement. Hypothesis Ten mL of ice‐cold thermal indicator ( TI 10 ) would improve the agreement and trending ability between TPTD CO and PATD CO compared to 5 mL of indicator ( TI 5 ) (Phase‐1). The agreement and TA between PCA CO and PATD CO would be poor during changes in systemic vascular resistance ( SVR ) (Phase‐2). Animals Eight clinically normal dogs (20.8–31.5 kg). Methods Prospective, experimental study. Simultaneous TPTD CO and PATD CO (averaged from 3 repetitions) using TI 5 and TI 10 were obtained during isoflurane anesthesia combined or not with remifentanil or dobutamine (Phase‐1). Triplicate PCA CO and PATD CO measurements were recorded during phenylephrine‐induced vasoconstriction and nitroprusside‐induced vasodilation (Phase‐2). Results Mean bias (limits of agreement: LOA ) (L/min), percentage bias ( PB ), and percentage error ( PE ) were 0.62 (−0.11 to 1.35), 16%, and 19% for TI 5 ; and 0.33 (−0.25 to 0.91), 9%, and 16% for TI 10 . Mean bias ( LOA ), PB , and PE were 0.22 (−0.63 to 1.07), 6%, and 23% during phenylephrine; and 2.12 (0.70–3.55), 43%, and 29% during nitroprusside. Mean angular bias (radial LOA ) values were 2° (−10° to 14°) and −1° (−9° to 6°) for TI 5 and TI 10 , respectively (Phase‐1), and 38° (5°–71°) (Phase‐2). Conclusions and Clinical Importance Although TI 10 slightly improves the agreement and trending ability between TPTD CO and PATD CO in comparison to TI 5 , both volumes can be used for TPTD CO in replacement of PATD CO . Vasodilation worsens the agreement between PCA CO and PATD CO . Because of PCA CO 's poor agreement and trending ability with PATD CO during SVR changes, this method has limited clinical application.