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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.

journal of veterinary internal medicine

Comparison of Transpulmonary Thermodilution and Calibrated Pulse Contour Analysis with Pulmonary Artery Thermodilution Cardiac Output Measurements in Anesthetized Dogs