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Evaluation of agreement and trending ability between transpulmonary thermodilution and calibrated pulse contour and pulse power cardiac output monitoring methods against pulmonary artery thermodilution in anesthetized dogs
Author(s) -
Kutter Annette P.N.,
BettschartWolfensberger Regula,
Romagnoli Noemi,
Bektas Rima N.
Publication year - 2016
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.12439
Subject(s) - medicine , pulmonary artery , anesthesia , cardiac output , beagle , bland–altman plot , pulse (music) , cardiology , limits of agreement , hemodynamics , nuclear medicine , engineering , detector , electrical engineering
Abstract Objective To assess agreement and trending ability of transpulmonary thermodilution (TPTD), calibrated pulse contour (PiCCO), and pulse power (PulseCO) methods compared to pulmonary artery thermodilution (PATD) for determination of cardiac output (CO) in anesthetized dogs. Design Experimental, prospective study. Setting University teaching hospital. Animals Six adult Beagle dogs. Interventions Dogs were anesthetized with sevoflurane and instrumented with pulmonary and femoral artery thermodilution catheters. CO was measured at baseline and at 5, 15, 30, 45, 60, 120, 180, and 240 minutes after IV administration of ketamine or s‐ketamine. Baseline PATD and TPTD calibrated PulseCO and PiCCO, respectively. Agreement and trending ability was analyzed with Bland–Altman, concordance, and polar plot methodology. Measurements and Main Results Median (range) CO values of 2.27 (0.98–3.4) L/min were measured with PATD, and 2.8 (1.9–4.04) L/min with TPTD, which resulted in a mean bias (± standard deviation) of −0.66 (± 0.36) L/min. Concordance rate was 91% and radial limits of agreement (RLOA) were ±35°. PATD against PiCCO resulted in a mean bias of −0.71 (± 0.62) L/min and PATD against PulseCO in a mean bias of 0.13 (± 0.46) L/min. The continuous techniques resulted in concordance rates of 77% for PATD‐PiCCO and 74% for PATD‐PulseCO and RLOA of ±57° and ±60°, respectively. Conclusions Intermittent TPTD showed marginal trending ability, while continuous pulse contour and pulse power methods showed poor trending ability over a 4‐hour period. The poor performance and possible side effects of the methods tested in this study suggest that they should not be recommended for use in critical patients.