Agreement of Bioreactance Cardiac Output Monitoring With Thermodilution in Healthy Standing Horses.
Abstract: Bioreactance is the continuous analysis of transthoracic voltage variation in response to an applied high frequency transthoracic current and was recently introduced for non-invasive cardiac output measurement (NICOM). We evaluated NICOM compared to thermodilution (TD) in adult horses. Six healthy horses were used for this prospective, blinded, experimental study. Cardiac output (CO) measurements were performed simultaneously using TD and the bioreactance method. Different cardiac output scenarios were established using xylazine (0.5 mg/kg IV) and dobutamine (1.5-3 mcg/kg/min). Statistical analysis was performed by calculating the concordance rate, performing a regression analysis, Pearson correlation, and Bland Altman. The TD-based CO and NICOM values were highly correlated for low, normal and high CO values with an overall correlation coefficient. A 4-quadrant plot showed an 89% rate of concordance. The linear regression calculated a relationship between NICOM and TDCO of Y = 0.4874 · X + 0.5936. For the corrected Bland Altman agreement, the mean bias and lower/upper limits of agreement were -0.26 and -3.88 to 3.41 L/min, respectively. Compared to TD, bioreactance- based NICOM showed good accuracy at induced low, normal, and high CO states in normal horses. Future studies performed under more clinical conditions will show if this monitor can help to assess hemodynamic status and guide therapy in horses in ICU settings and under general anesthesia.
Copyright © 2021 Hopster and Hurcombe.
Publication Date: 2021-08-03 PubMed ID: 34414227PubMed Central: PMC8369349DOI: 10.3389/fvets.2021.701339Google Scholar: Lookup
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- Journal Article
Summary
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This research article investigates the effectiveness of bioreactance for cardiac output measurement in healthy horses. It compares this new, non-invasive method to thermodilution, the standard technique, concluding that bioreactance displayed a good accuracy across different cardiac output scenarios.
Introduction
The study launched into a new field of cardiac output (CO) monitoring in adult horses, utilizing the modern technique of bioreactance. Bioreactance observes the changes in voltage across the chest in response to a high-frequency current. This method was tested against the traditional thermodilution (TD) approach.
- Bioreactance-based cardiac output monitoring, also known as NICOM, is a non-invasive method that provides continuous data.
- Thermodilution is an invasive technique that has been considered the standard practice for CO measurement.
Method
The researchers involved six healthy adult horses in a controlled, blinded, experimental study.
- CO measurements were simultaneously acquired using the new bioreactance method and the traditional thermodilution method.
- Different cardiac output scenarios were artificially induced using xylazine and dobutamine, driving low, normal, and high CO states.
Analysis
A range of statistical analyses were deployed to assess the relationship and concordance between the NICOM and TD measurements.
- Correlation between the NICOM and TD measurement was determined through Pearson correlation.
- Concordance of the two measurement techniques was assessed by calculating the concordance rate and viewing a 4-quadrant plot.
- Bland Altman agreement was used to understand the mean bias and the lower and upper limits of agreement between these two methods.
Results
The data revealed a high correlation between the TD and NICOM results, supporting the accuracy of the bioreactance technique.
- The correlation coefficient suggested sound agreement between the methods across low, normal, and high CO conditions.
- The 4-quadrant plot revealed an 89% rate of concordance, further validating the use of bioreactance for CO measurement.
- The regression analysis provided a relationship between NICOM and TD measurements, with a productive formula-yield.
- The Bland Altman agreement suggested a minimal average discrepancy and acceptable limits between the methods.
Conclusions
The study concluded that bioreactance-based NICOM provides accuracy comparable to TD in measuring CO at different levels in healthy horses. However, the authors also recommended further investigation under more clinical conditions to determine its utility and accuracy in more complex scenarios and settings, like intensive care units and during general anesthesia.
Cite This Article
APA
Hopster K, Hurcombe SDA.
(2021).
Agreement of Bioreactance Cardiac Output Monitoring With Thermodilution in Healthy Standing Horses.
Front Vet Sci, 8, 701339.
https://doi.org/10.3389/fvets.2021.701339 Publication
Researcher Affiliations
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States.
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States.
Conflict of Interest Statement
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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Citations
This article has been cited 1 times.- Gorenberg EB, Slack J, Stefanovski D, Theiss D, Hopster K. Dobutamine improves haemodynamics and oxygen delivery in standing and isoflurane-anaesthetised horses. Equine Vet J 2025 Nov;57(6):1677-1689.
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