Comparison between lithium dilution and pulse contour analysis techniques for cardiac output measurement in isoflurane anaesthetized ponies: influence of different inotropic drugs.
Abstract: To compare cardiac output () measurements using lithium dilution (LiDCO) and pulse contour analysis (PulseCO) techniques in isoflurane-anaesthetized ponies before and during the administration of different inotropic/vasoactive drugs. Methods: Prospective randomized experimental cross-over trial. Methods: Six ponies aged 5.0 +/- 1.6 (4-6.5) years and weighing 286 +/- 53 (212-368) kg. Methods: After sedation (romifidine) and induction (midazolam + ketamine), anaesthesia was maintained with isoflurane in oxygen. After 90 minutes (= T0), one of four treatments was administered: saline 0.1 mL kg(-1) (S), enoximone 0.5 mg kg(-1) IV (E), enoximone followed by dobutamine (0.5 microg kg(-1) minute(-1) for 120 minutes) (ED) or enoximone followed by a calcium chloride infusion (0.5 mg kg(-1) minute(-1) for 10 minutes) (EC). Data were recorded for 120 minutes after T0. The PulseCO (recorded from carotid artery) was calibrated before T0, no further recalibrations were performed. was determined with LiDCO ((LiDCO)) and PulseCO ((PulseCO)) simultaneously at T5, T10, T20, T40, T60, T80, T100 and T120. Systemic vascular resistances (SVR(LiDCO) and SVR(PulseCO)) were calculated. Results: In the saline group, (PulseCO) was 4.9 +/- 12.3% lower than LiDCO (p < 0.01), whereas SVR(PulseCO) was 6.9 +/- 14.4% higher than SVR(LiDCO) (p < 0.01). These differences increased over time (mean +/- SEM), by 0.06 +/- 0.03% minute(-1) (p = 0.042) and SVR by 0.08 +/- 0.03% minute(-1) (p = 0.018). (PulseCO) was higher than (LiDCO) in the EC group (1.8 +/- 23.3%), but lower than (LiDCO) in groups E (-11.7 +/- 20.4%) and ED (-10.0 +/- 25.9%) (significant difference between treatments, p < 0.01). The differences in SVR in groups E (20.4 +/- 32.0%) and ED (20.7 +/- 35.3%) were significantly higher than in groups S (6.9 +/- 14.4%) and EC (3.1 +/- 22.2%) (p < 0.01). Conclusions: Pulse contour analysis values deviated significantly from LiDCO measurements in isoflurane-anaesthetized ponies. This difference was influenced by inotropic/vasoactive drugs.
Publication Date: 2009-04-29 PubMed ID: 19397771DOI: 10.1111/j.1467-2995.2009.00446.xGoogle Scholar: Lookup
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- Journal Article
- Randomized Controlled Trial
Summary
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This research compares two techniques, Lithium Dilution (LiDCO) and Pulse Contour Analysis (PulseCO), in measuring the cardiac output in ponies anesthetized with isoflurane, examining how different drugs influence the results.
Objective
The study aims to investigate the accuracy of two cardiac output () measurement techniques – lithium dilution (LiDCO) and pulse contour analysis (PulseCO) in ponies under isoflurane anaesthesia and being administered with various inotropic/vasoactive drugs.
Methodology
- The research is a prospective randomized experimental cross-over trial involving six ponies, aged between 4 and 6.5 years, and weighing between 212 to 368 kg.
- The ponies were sedated with romifidine and induced with a mix of midazolam and ketamine to maintain anesthesia, which was supplemented with isoflurane in oxygen.
- After 90 minutes (T0), the ponies were administered with one of four treatments, namely saline, enoximone, enoximone with dobutamine, and enoximone with calcium chloride infusion.
- Both LiDCO and PulseCO measurements of the cardiac output as well as systemic vascular resistances (SVR) were taken concurrently at several time points over the next 120 minutes.
Results
- Results in the saline administration (Group S) showed that PulseCO measurements were 4.9% lower than LiDCO measurements, while PulseCO measurements of SVR were 6.9% higher relative to SVR(LiDCO).
- Over time, these differences increased at the rate of 0.06% per minute for output and 0.08% per minute for SVR.
- Contrasting reactions were seen in other groups. For instance, in the Enoximone with Calcium intervention (Group EC), PulseCO rates were higher than LiDCO, while they were lower in the Enoximone (Group E) and Enoximone with Dobutamine (Group ED) treatments.
- Respective SVR differences in Group E (20.4%) and Group ED (20.7%) were significantly higher than in Group S (6.9%) and Group EC (3.1%).
Conclusions
This study found significant disparities between Pulse Contour Analysis and Lithium Dilution measurements in isoflurane-anesthetized ponies. Furthermore, these differences were found to be directly impacted by the choice of inotropic/vasoactive drugs administered.
Cite This Article
APA
Schauvliege S, Van den Eede A, Duchateau L, Pille F, Vlaminck L, Gasthuys F.
(2009).
Comparison between lithium dilution and pulse contour analysis techniques for cardiac output measurement in isoflurane anaesthetized ponies: influence of different inotropic drugs.
Vet Anaesth Analg, 36(3), 197-208.
https://doi.org/10.1111/j.1467-2995.2009.00446.x Publication
Researcher Affiliations
- Department of Surgery and Anaesthesia of Domestic Animals, University of Ghent, Merelbeke, Belgium. stijn.schauvliege@ugent.be
MeSH Terms
- Anesthetics, Inhalation / pharmacology
- Animals
- Calcium Chloride / pharmacology
- Cardiac Output / drug effects
- Cardiotonic Agents / pharmacology
- Cross-Over Studies
- Dobutamine / pharmacology
- Enoximone / pharmacology
- Female
- Horses / physiology
- Isoflurane / pharmacology
- Lithium
- Male
- Monitoring, Physiologic / veterinary
- Thermodilution / veterinary
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