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Topic:Halothane

Halothane is an inhalation anesthetic agent commonly used in veterinary medicine, including equine practice, for the induction and maintenance of general anesthesia. It acts on the central nervous system to produce a reversible loss of consciousness and sensation in horses. The use of halothane in horses requires careful monitoring due to its effects on cardiovascular and respiratory systems. It is known for its relatively rapid onset and recovery times, making it a practical choice for various surgical procedures. This page compiles peer-reviewed research studies and scholarly articles that explore the pharmacokinetics, effects, and safety considerations of halothane use in equine anesthesia.
The effects of halothane and isoflurane on cardiovascular function in laterally recumbent horses.
British journal of anaesthesia    June 24, 2005   Volume 95, Issue 3 317-325 doi: 10.1093/bja/aei180
Raisis AL, Blissitt KJ, Henley W, Rogers K, Adams V, Young LE.Experimental studies in adult horses have shown that general anaesthesia maintained with isoflurane is associated with less depression of cardiovascular function compared with halothane anaesthesia. Adverse effects of intermittent positive-pressure ventilation (IPPV) have also been demonstrated. Nevertheless, the haemodynamic effects of these agents and the effects of differing modes of ventilation have not been assessed during clinical anaesthesia in horses undergoing surgery. Methods: The haemodynamic effects of isoflurane or halothane anaesthesia during spontaneous or IPPV were studied non-...
Malignant hyperthermia in a horse anesthetized with halothane.
Journal of veterinary internal medicine    June 16, 2005   Volume 19, Issue 3 363-366 doi: 10.1892/0891-6640(2005)19[363:mhiaha]2.0.co;2
Aleman M, Brosnan RJ, Williams DC, LeCouteur RA, Imai A, Tharp BR, Steffey EP.No abstract available
Post-anaesthetic myelomalacia in a horse.
Journal of the South African Veterinary Association    May 20, 2005   Volume 76, Issue 1 36-39 doi: 10.4102/jsava.v76i1.392
Jouber KE, Duncan N, Murray SE.This article describes a rare neurological complication of anaesthesia in a 2 year-old Clydesdale colt undergoing castration. Anaesthesia was induced with glyceryl guaiacol ether and ketamine and maintained with halothane. Following an uneventful anaesthetic of 40 minutes, the horse recovered from anaesthesia in a padded recovery stall. After approximately 70 minutes in the recovery stall, the horse attempted to stand and adopted a dog sitting position. One hundred and fifty minutes later, the horse became distressed and was sedated with xylazine. Clinical examination of the horse did not reve...
In vivo interaction of pulmonary intravascular macrophages with activated platelets in microvessels of equine lung after multiple exposures to halothane, isoflurane, and thiamylal: a comparative ultrastructural and cytochemical study.
The anatomical record. Part A, Discoveries in molecular, cellular, and evolutionary biology    May 10, 2005   Volume 284, Issue 2 574-584 doi: 10.1002/ar.a.20196
Atwal OS, McDonell W.The pulmonary intravascular macrophages (PIMs) of equines contain a unique electron-dense surface coat that is predominantly composed of lipoproteins. A single exposure of inhalatory halothane causes mobilization of the surface coat into the endocytotic system of the PIMs, followed by expansion of the Golgi apparatus and its enrichment with acid phosphatase. Simultaneously, the cells of the lymphocytic series show hyperplasia in the form of mitotic changes inside the microvascular compartment of the lung. Halothane is known to cause acute and chronic hepatotoxicity because of its biotransforma...
Muscle metabolic changes associated with long-term inhalation anaesthesia in the horse analysed by muscle biopsy and microdialysis techniques.
Journal of veterinary medicine. A, Physiology, pathology, clinical medicine    March 2, 2005   Volume 52, Issue 2 99-107 doi: 10.1111/j.1439-0442.2004.00685.x
Edner A, Essén-Gustavsson B, Nyman G.During anaesthesia in the horse, muscle blood flow has been found to be reduced, possibly leading to hypoxia or ischaemia in the muscle. The aim of this study was to use the muscle biopsy and microdialysis techniques to determine whether long-term inhalation anaesthesia in laterally recumbent horses induces metabolic changes in gluteal muscle indicative of anaerobic metabolism. Muscle biopsies and plasma samples were taken from seven horses at the start and end of halothane anaesthesia. In six isoflurane-anaesthetised horses, given three pharmacological provocations (dobutamine, detomidine, ac...
Effects of peri-operative morphine administration during halothane anaesthesia in horses.
Veterinary anaesthesia and analgesia    January 25, 2005   Volume 32, Issue 1 10-15 doi: 10.1111/j.1467-2995.2004.00174.x
Clark L, Clutton RE, Blissitt KJ, Chase-Topping ME.To study the effects of morphine on haemodynamic variables, blood gas values and the requirement for additional anaesthetic drugs in horses undergoing surgery. Methods: Prospective randomized study. Methods: Thirty-eight client-owned horses, ASA(American Society of Anesthesiologists) category I or II, undergoing elective surgical procedures, were studied. Horses were divided between two groups, and were paired according to operation, anaesthetist, body position during surgery, mass and breed. Group M+ received morphine by intravenous (IV) injection (0.15 mg kg(-1)) before induction of anaesthe...
Malignant hyperthermia: a syndrome not a disease.
The Veterinary clinics of North America. Small animal practice    October 12, 2004   Volume 34, Issue 6 1419-1433 doi: 10.1016/j.cvsm.2004.05.010
Brunson DB, Hogan KJ.No abstract available
Effects of intravenous administration of dimethyl sulfoxide on cardiopulmonary and clinicopathologic variables in awake or halothane-anesthetized horses.
Journal of the American Veterinary Medical Association    September 4, 2004   Volume 225, Issue 4 560-566 doi: 10.2460/javma.2004.225.560
Lin HC, Johnson CR, Duran SH, Waldridge BM.To evaluate the cardiopulmonary and clinicopathologic effects of rapid IV administration of dimethyl sulfoxide (DMSO) in awake and halothane-anesthetized horses. Methods: Prospective study. Methods: 6 adult horses. Methods: Horses received IV infusion of 5 L of a balanced electrolyte solution with and without 1 g/kg (0.45 g/lb) of 10% DMSO solution when they were awake and anesthetized with halothane (4 treatments/horse). Arterial and venous blood samples were collected immediately before and at intervals during or after fluid administration and analyzed for blood gases and hematologic and ser...
Association of a mutation in the ryanodine receptor 1 gene with equine malignant hyperthermia.
Muscle & nerve    August 20, 2004   Volume 30, Issue 3 356-365 doi: 10.1002/mus.20084
Aleman M, Riehl J, Aldridge BM, Lecouteur RA, Stott JL, Pessah IN.Equine malignant hyperthermia MH has been suspected but never genetically confirmed. In this study, we investigated whether mutations in a candidate gene, RyR1, were associated with MH in two clinically affected horses. RyR1 gene sequences revealed polymorphisms in exons 15, 17, and 46 in WTRyR1 and MHRyR1 horses with one derived amino acid change in MHRyR1 exon 46, R2454G. The MHRyR1 horses were genetically heterozygous for this mutation, but presented an MH phenotype with halothane challenge. Skeletal sarcoplasmic reticulum from a R2454G heterozygote collected during a fulminant MH episode s...
Effects of a muscarinic type-2 antagonist on cardiorespiratory function and intestinal transit in horses anesthetized with halothane and xylazine.
American journal of veterinary research    April 14, 2004   Volume 65, Issue 4 464-472 doi: 10.2460/ajvr.2004.65.464
Teixeira Neto FJ, McDonell WN, Black WD, Moraes AN, Duronghphongtorn S.To evaluate the cardiorespiratory and intestinal effects of the muscarinic type-2 (M2) antagonist, methoctramine, in anesthetized horses. Methods: 6 horses. Methods: Horses were allocated to 2 treatments in a randomized complete block design. Anesthesia was maintained with halothane (1% end-tidal concentration) combined with a constant-rate infusion of xylazine hydrochloride (1 mg/kg/h, i.v.) and mechanical ventilation. Hemodynamic variables were monitored after induction of anesthesia and for 120 minutes after administration of methoctramine or saline (0.9% NaCl) solution (control treatment)....
Effects of glycopyrrolate on cardiorespiratory function in horses anesthetized with halothane and xylazine.
American journal of veterinary research    April 14, 2004   Volume 65, Issue 4 456-463 doi: 10.2460/ajvr.2004.65.456
Teixeira Neto FJ, McDonell WN, Black WD, Duronghphongtorn S.To evaluate cardiopulmonary effects of glycopyrrolate in horses anesthetized with halothane and xylazine. Methods: 6 horses. Methods: Horses were allocated to 2 treatment groups in a randomized complete block design. Anesthesia was maintained in mechanically ventilated horses by administration of halothane (1% end-tidal concentration) combined with a constant-rate infusion of xylazine hydrochloride (1 mg/kg/h, i.v.). Hemodynamic variables were monitored after induction of anesthesia and for 120 minutes after administration of glycopyrrolate or saline (0.9% NaCl) solution. Glycopyrrolate (2.5 m...
Influence of morphine sulfate on the halothane sparing effect of xylazine hydrochloride in horses.
American journal of veterinary research    April 14, 2004   Volume 65, Issue 4 519-526 doi: 10.2460/ajvr.2004.65.519
Bennett RC, Steffey EP, Kollias-Baker C, Sams R.To quantitate the dose and time-related effects of morphine sulfate on the anesthetic sparing effect of xylazine hydrochloride in halothane-anesthetized horses and determine the associated plasma xylazine and morphine concentration-time profiles. Methods: 6 healthy adult horses. Methods: Horses were anesthetized 3 times to determine the minimum alveolar concentration (MAC) of halothane in O2 and characterize the anesthetic sparing effect (ie, decrease in MAC of halothane) by xylazine (0.5 mg/kg, i.v.) administration followed immediately by i.v. administration of saline (0.9% NaCI) solution, lo...
The effect of general anesthesia and abdominal surgery upon plasma thromboxane B concentrations in horses.
Veterinary anaesthesia and analgesia    April 1, 2004   Volume 31, Issue 2 146-149 doi: 10.1111/j.1467-2987.2004.00129.x
Dinev D, Andonova M.To compare the effect of anesthesia alone with anesthesia and abdominal surgery on plasma thromboxane B(2) concentrations in horses. Methods: Non-randomized experimental study. Methods: Six male mixed-bred horses (5-12 years, 350 +/- 18 kg). Methods: All horses were anesthetized for 2.5 hours using halothane, and a month later abdominal surgery was performed using the same anesthetic technique with a similar duration. The schedule of anesthesia included pre-medication with diazepam (0.1 mg kg(-1) IM), followed by xylazine (2.2 mg kg(-1) IV), and 10 minutes later anesthesia was induced with ket...
Is isoflurane safer than halothane in equine anaesthesia? Results from a prospective multicentre randomised controlled trial.
Equine veterinary journal    February 6, 2004   Volume 36, Issue 1 64-71 doi: 10.2746/0425164044864723
Johnston GM, Eastment JK, Taylor PM, Wood JL.Approximately 1 in 100 horses suffer unexpectedly from anaesthetic-related death. Identification and use of the safest anaesthetic drugs should support this aim. Experimental evidence has suggested that isoflurane should be a safer maintenance agent in equine anaesthesia than halothane. Objective: The death rate would be reduced in horses being maintained with isoflurane compared to halothane. Methods: A multicentre randomised controlled trial was undertaken to compare the effects of isoflurane and halothane for maintenance of equine anaesthesia for all types of operation. Data were analysed f...
Problems associated with perioperative morphine in horses: a retrospective case analysis.
Veterinary anaesthesia and analgesia    September 23, 2003   Volume 30, Issue 3 147-155 doi: 10.1046/j.1467-2995.2003.00092.x
Mircica E, Clutton RE, Kyles KW, Blissitt KJ.To identify the incidence of adverse effects caused by morphine 100-170 micro g kg-1 administration during surgery in horses. Methods: Retrospective case record analysis (1996-2000). Methods: Eighty-four healthy (ASA 1 or 2) horses, mean age 5.5 +/- 3.1 (SD) years (2 months to 16 years), mean weight 524 +/- 14 kg (100-950). Methods: Physiological data and evidence of complications were collected from the anaesthetic records of all animals anaesthetized with romifidine, ketamine, diazepam and halothane and undergoing laryngeal surgery or orchiectomy at the Royal (Dick) School of Veterinary Stud...
Changes in the EEG during castration in horses and ponies anaesthetized with halothane.
Veterinary anaesthesia and analgesia    September 23, 2003   Volume 30, Issue 3 138-146 doi: 10.1046/j.1467-2995.2003.00138.x
Murrell JC, Johnson CB, White KL, Taylor PM, Haberham ZL, Waterman-Pearson AE.To identify changes in the amplitude spectrum of the electroencephalogram (EEG) during a standardized surgical model of nociception in horses. Methods: Thirteen entire male horses and ponies referred to Division of Clinical Veterinary Science, Bristol (n = 9) and Department of Clinical Veterinary Medicine (n = 4) for castration. Methods: Following pre-anaesthetic medication with acepromazine, anaesthesia was induced with guaiphenesin and thiopental and maintained with halothane in oxygen. The EEG was recorded continuously using subcutaneous needle electrodes. Additional monitoring comprised EC...
Blood/gas partition coefficients of halothane, isoflurane and sevoflurane in horse blood.
British journal of anaesthesia    July 25, 2003   Volume 91, Issue 2 276-278 doi: 10.1093/bja/aeg151
Bergadano A, Lauber R, Zbinden A, Schatzmann U, Moens Y.Blood/gas partition coefficients (lambda(b/g)) for volatile agents in horse blood are reported for halothane but not for isoflurane and sevoflurane. We measured the lambda(b/g) of halothane, isoflurane and sevoflurane in the blood of fasted horses. The correlation with age, weight and some haematological and biochemical variables was studied. The temperature correction factor for isoflurane solubility was calculated. Methods: Twenty-four horses were randomly allocated to halothane (n=8), isoflurane (n=8) or sevoflurane (n=8). Blood samples were taken after 10 h' fasting. Calculation of lambda(...
Effects of midazolam and sarmazenil on the equine electroencephalogram during anaesthesia with halothane in oxygen.
Journal of veterinary pharmacology and therapeutics    April 2, 2003   Volume 26, Issue 2 105-112 doi: 10.1046/j.1365-2885.2003.00459.x
Johnson CB, Bloomfield M, Taylor PM.The electroencephalographic (EEG) effects of a rapid infusion of midazolam and sarmazenil following a bolus of midazolam were investigated in eight Welsh mountain ponies anaesthetized with 0.8% halothane in oxygen. The peak plasma concentration of midazolam was 2.13 +/- 0.34 ng/mL (mean +/- SD) occurring 5 min after the start of the infusion. Sarmazenil concentrations were not measured. The 95% spectral edge frequency of the EEG decreased by a maximum of 39.8 +/- 15.8%, 10 min after the start of the midazolam infusion. No changes were seen in median frequency of the EEG or the second different...
Effects of halothane anaesthesia on the cryopreservation of epididymal spermatozoa in pony stallions.
Equine veterinary journal    January 30, 2003   Volume 35, Issue 1 93-95 doi: 10.2746/042516403775467333
Schulman ML, Gerber D, Nurton J, Guthrie AJ, Joubert K, Volkmann DH.No abstract available
Comparison of the cardiopulmonary effects of anesthesia maintained by continuous infusion of romifidine, guaifenesin, and ketamine with anesthesia maintained by inhalation of halothane in horses.
American journal of veterinary research    December 21, 2002   Volume 63, Issue 12 1655-1661 doi: 10.2460/ajvr.2002.63.1655
McMurphy RM, Young LE, Marlin DJ, Walsh K.To compare cardiopulmonary responses during anesthesia maintained with halothane and responses during anesthesia maintained by use of a total intravenous anesthetic (TIVA) regimen in horses. Methods: 7 healthy adult horses (1 female, 6 geldings). Methods: Each horse was anesthetized twice. Romifidine was administered IV, and anesthesia was induced by IV administration of ketamine. Anesthesia was maintained for 75 minutes by administration of halothane (HA) or IV infusion of romifidine, guaifenesin, and ketamine (TIVA). The order for TIVA or HA was randomized. Cardiopulmonary variables were mea...
Clinical comparison of xylazine and medetomidine for premedication of horses.
Journal of the American Veterinary Medical Association    October 22, 2002   Volume 221, Issue 8 1144-1149 doi: 10.2460/javma.2002.221.1144
Yamashita K, Muir WW, Tsubakishita S, Abrahamsen E, Lerch P, Hubbell JA, Bednarski RM, Skarda RT, Izumisawa Y, Kotani T.To compare the analgesic and cardiopulmonary effects of medetomidine and xylazine when used for premedication of horses undergoing general anesthesia. Methods: Randomized clinical trial. Methods: 40 horses. Methods: Twenty horses were premedicated with medetomidine (10 microg/kg [4.5 microg/lb], i.m.) and the other 20 were premedicated with xylazine (2 mg/kg [0.9 mg/kg], i.m.). Horses were then anesthetized with a combination of guaifenesin and ketamine; anesthesia was maintained with halothane. Additional doses of medetomidine or xylazine were given if horses were not sufficiently sedated at ...
Cardiopulmonary function in horses during anesthetic recovery in a hydropool.
American journal of veterinary research    January 5, 2002   Volume 62, Issue 12 1903-1910 doi: 10.2460/ajvr.2001.62.1903
Richter MC, Bayly WM, Keegan RD, Schneider RK, Weil AB, Ragle CA.To determine the cardiovascular and respiratory effects of water immersion in horses recovering from general anesthesia. Methods: 6 healthy adult horses. Methods: Horses were anesthetized 3 times with halothane and recovered from anesthesia while positioned in lateral or sternal recumbency in a padded recovery stall or while immersed in a hydropool. Cardiovascular and pulmonary functions were monitored before and during anesthesia and during recovery until horses were standing. Measurements and calculated variables included carotid and pulmonary arterial blood pressures (ABP and PAP respective...
Effect of two anaesthetic regimens on airway nitric oxide production in horses.
British journal of anaesthesia    September 29, 2001   Volume 86, Issue 1 127-130 doi: 10.1093/bja/86.1.127
Marlin DJ, Young LE, McMurphy R, Walsh K, Dixon P.There is evidence that halothane inhibits nitric oxide synthase in vitro, but the effect of intravenous anaesthetic agents is less clear. This study was undertaken to compare the rate of exhaled nitric oxide production (VNO) in spontaneously breathing horses anaesthetized with halothane or an intravenous regimen. Seven adult horses were studied twice in random order. After premedication with romifidine 100 microg kg(-1), anaesthesia was induced with ketamine 2.2 mg kg(-1) and maintained with halothane in oxygen (HA) or by an intravenous infusion of ketamine, guaiphenesin and romifidine (IV). I...
Cardiorespiratory and endocrine effects of endogenous opioid antagonism by naloxone in ponies anaesthetised with halothane.
Research in veterinary science    May 18, 2001   Volume 70, Issue 2 95-100 doi: 10.1053/rvsc.2000.0444
Luna SP, Taylor PM.Halothane depresses cardiorespiratory function and activates the pituitary-adrenal axis, increasing beta endorphin. In horses, beta endorphin may enhance the anaesthetic-associated cardiorespiratory depression and mortality risk. The authors studied endogenous opioid effects on cardiorespiratory function and pituitary-adrenal activity in halothane-anaesthetised ponies by investigating opioid antagonism by naloxone. Six ponies were anaesthetised three times (crossover design). Anaesthesia was induced with thiopentone and maintained with 1.2 per cent halothane for 2 hours. Immediately after indu...
Effect of venous strangulation obstruction on length of equine jejunum and relevance to small-intestinal resection.
Veterinary surgery : VS    May 8, 2001   Volume 30, Issue 3 218-222 doi: 10.1053/jvet.2001.23349
Freeman DE, Kilgallon EG.To determine if venous strangulation obstruction (VSO) of the distal half of the equine small intestine would increase length of that segment. Methods: Halothane-anesthetized horses were assigned randomly to 3 groups of 5 horses: Group 1 (controls)--the entire small intestine was measured and rubber-shod clamps were applied to mark each end of the most distal 50% of the small intestine; Group 2--same procedure, except that VSO was induced in the distal 50% of the small intestine for 180 minutes; and Group 3--same initial procedure, except that VSO was induced for 90 minutes and followed by rep...
Comparison of detomidine and romifidine as premedicants before ketamine and halothane anesthesia in horses undergoing elective surgery.
American journal of veterinary research    March 30, 2001   Volume 62, Issue 3 359-363 doi: 10.2460/ajvr.2001.62.359
Taylor PM, Bennett RC, Brearley JC, Luna SP, Johnson CB.To compare detomidine hydrochloride and romifidine as premedicants in horses undergoing elective surgery. Methods: 100 client-owned horses. Methods: After administration of acepromazine (0.03 mg/kg, IV), 50 horses received detomidine hydrochloride (0.02 mg/kg of body weight, IV) and 50 received romifidine (0.1 mg/kg, IV) before induction and maintenance of anesthesia with ketamine hydrochloride (2 mg/kg) and halothane, respectively. Arterial blood pressure and blood gases, ECG, and heart and respiratory rates were recorded. Induction and recovery were timed and graded. Results: Mean (+/- SD) d...
Cardiopulmonary effects of romifidine and detomidine used as premedicants for ketamine/halothane anaesthesia in ponies.
The Veterinary record    November 30, 2000   Volume 147, Issue 19 535-539 doi: 10.1136/vr.147.19.535
Freeman SL, Bowen IM, Bettschart-Wolfensberger R, England GC.The cardiopulmonary effects of romifidine at 80 microg/kg (R80) or 120 pg/kg (R120), and detomidine at 20 pg/kg (D20) when used as premedicants for ketamine/halothane anaesthesia were investigated in six ponies. Using a blinded crossover design, acepromazine (0-04 mg/kg) was administered followed by the alpha-2 agonist. Anaesthesia was induced with ketamine at 2.2 mg/kg and maintained with halothane (expired concentration 1.0 per cent) in oxygen for three hours. During anaesthesia, arterial blood pressure, cardiac index, PaO2 and PmvO2 decreased, and systemic vascular resistance and PaCO2 incr...
Effect of a 30-minute infusion of dobutamine hydrochloride on hind limb blood flow and hemodynamics in halothane-anesthetized horses.
American journal of veterinary research    October 20, 2000   Volume 61, Issue 10 1282-1288 doi: 10.2460/ajvr.2000.61.1282
Raisis AL, Young LE, Blissitt KJ, Walsh K, Meire HB, Taylor PM, Lekeux P.To evaluate the hemodynamic effects of dobutamine hydrochloride (0.5 microg/kg of body weight/min) in halothane-anesthetized horses. Methods: 6 adult Thoroughbred horses. Methods: Anesthesia was induced by use of romifidine (100 microg/kg) and ketamine (2.2 mg/kg), IV. Anesthesia was maintained by halothane (end-tidal concentration 0.9 to 1.0%). Aortic, left ventricular, and right atrial pressures were measured, using catheter-mounted strain gauge transducers. Cardiac output (CO), velocity time integral, maximal aortic blood flow velocity and acceleration, and left ventricular preejection peri...
A comparison of the haemodynamic effects of isoflurane and halothane anaesthesia in horses.
Equine veterinary journal    August 22, 2000   Volume 32, Issue 4 318-326 doi: 10.2746/042516400777032282
Raisis AL, Young LE, Blissitt KJ, Brearley JC, Meire HB, Taylor PM, Lekeux P.The purpose of this study was to compare the haemodynamic effects of equipotent isoflurane and halothane anaesthesia. Six adult horses were investigated on two separate occasions at least 4 weeks apart. On both occasions anaesthesia was induced by ketamine 2.2 mg/kg bwt given 5 min after i.v. administration 100 microg/kg bwt romifidine. Anaesthesia was maintained either by halothane or isoflurane (end-tidal concentrations 0.9-1.0% and 1.3-1.4%, respectively). Horses were ventilated by intermittent positive pressure to maintain PaCO2 between 40-50 mmHg. Haemodynamic variables were measured usin...
Repeatability of Doppler ultrasound measurements of hindlimb blood flow in halothane anaesthetised horses.
Equine veterinary journal    June 3, 2000   Volume 32, Issue 3 239-246 doi: 10.2746/042516400776563662
Raisis AL, Young LE, Meire H, Walsh K, Taylor PM, Lekeux P.The purpose of this study was to determine the repeatability of femoral blood flow recorded using Doppler ultrasound in anaesthetised horses. Doppler ultrasound of the femoral artery and vein was performed in 6 horses anaesthetised with halothane and positioned in left lateral recumbency. Velocity spectra, recorded using low pulse repetition frequency, were used to calculate time-averaged mean velocity (TAV), velocity of component a (TaVa), velocity of component b (TaVb), volumetric flow, early diastolic deceleration slope (EDDS) and pulsatility index (PI). Within-patient variability was deter...