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Comparison of thermodilution, lithium dilution, and pulse contour analysis for the measurement of cardiac output in 3 different hemodynamic states in dogs
Author(s) -
Morgaz Juan,
Granados María del Mar,
MuñozRascón Pilar,
Dominguez Juan Manuel,
FernándezSarmiento Jose Andrés,
GómezVillamandos Rafael J.,
Navarrete Rocío
Publication year - 2014
Publication title -
journal of veterinary emergency and critical care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.886
H-Index - 47
eISSN - 1476-4431
pISSN - 1479-3261
DOI - 10.1111/vec.12219
Subject(s) - hemodynamics , cardiac output , medicine , anesthesia , limits of agreement , mean arterial pressure , sevoflurane , cardiology , nuclear medicine , blood pressure , heart rate
Objective To (1) evaluate lithium dilution (LiDCO) and transpulmonary thermodilution (PiCCO TD ) in relation to traditional thermodilution (PAC‐TD) for determining cardiac output (CO) in 3 different hemodynamic states in dogs and to (2) compare the continuous CO values obtained using power analysis (PulseCO) with continuous PiCCO (PiCCOc). Design Prospective randomized study. Setting University research laboratory. Animals Fourteen healthy Beagles. Interventions CO was measured using PAC‐TD, LiDCO, and PiCCO TD in 3 different hemodynamic states induced in random order and defined on the basis of the mean arterial pressure (MAP). Normodynamic state was defined as the baseline MAP and 1 MAC sevoflurane. The hypodynamic state was induced with a deep level of sevoflurane anesthesia. The hyperdynamic state was induced with noradrenaline. After these measurements were obtained in each hemodynamic state, CO was monitored continuously for 30 min using PulseCO and PiCCOc. Agreement was assessed using Bland–Altman analysis and intraclass correlation coefficients, and a trend score was determined for the continuous CO measurements. Measurements and Main Results There was good agreement among the 3 modalities of CO measurement in each hemodynamic state. The mean CI PAC‐TD /CI PICCOTD bias was −0.04 ± 1.19 L/min/m 2 (limits of agreement, −2.37/1.93 L/min/m 2 ), and the mean CI PAC‐TD /CI LiDCO bias was −0.11 ± 1.55 L/min/m 2 (limits of agreement, −3.04/2.93 L/min/m 2 ). The mean CI PulseCO ‐CI PiCCOc bias was −0.04 ± 1.91 L/min/m 2 (limits of agreement, −1.95/1.87 L/min/m 2 ), which suggested good agreement. The CI PulseCO ‐CI PiCCOc trend score, calculated from 252 paired comparisons, was 93.3% positive after zone exclusion (∆CI < 15%). Conclusions Both LiDCO and PiCCO TD agreed well with PAC‐TD for the measurement of CO under different hemodynamic conditions. Moreover, PiCCOc appears to be an accurate method for monitoring continuous CO in dogs as its performance for measurement was similar to that of PulseCO.