Evaluation of the non-calibrated pulse contour cardiac output monitor FloTrac/Vigileo against thermodilution in standing horses.
Abstract: To evaluate the non-calibrated, minimally invasive cardiac output (CO) monitor FloTrac/Vigileo (FloTrac) against thermodilution (TD) CO in standing horses. Methods: Prospective, experimental trial. Methods: Nine adult horses weighing a median (range) of 535 (470-602) kg. Methods: Catheters were placed in the right atrium, pulmonary artery and carotid artery under local anaesthesia. CO was measured 147 times by TD and FloTrac and indexed to body weight. Changes in CO were achieved with romifidine or xylazine and dobutamine constant rate infusions. Bland-Altman analysis, concordance and polar plot analysis were used to assess agreement and ability to track changes in CO. Results: Mean ± standard deviation COTD of 48 ± 16 mL kg(-1) minute(-1) (range: 19-93 mL kg(-1) minute(-1) ) and mean COF loTrac of 9 ± 3 mL kg(-1) minute(-1) (range: 5-21 mL kg(-1) minute(-1) ) were measured. Low agreement with a large mean bias of 39 mL kg(-1) minute(-1) and wide limits of agreement of 8-70 mL kg(-1) minute(-1) were found. The percentage error of 108% and precision of TD of ± 18% resulted in an estimated precision of FloTrac of ± 106%. Comparison of changes in COF loTrac with changes in COTD gave a concordance rate of 52% in the four-quadrant plot, and a mean polar angle of -11° with radial limits of agreement of ± 61 ° in the polar plot. Mean arterial pressure (MAP) and COF loTrac were positively correlated (r = 0.5, p < 0.0001). No correlation of MAP with COTD was observed. Conclusions: The FloTrac system, originally designed for use in humans, neither measured absolute CO in standing horses accurately nor tracked relative changes in CO measured by TD correctly. The false dependence of COF loTrac on arterial blood pressure further discourages the use of this technique in horses.
© 2015 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.
Publication Date: 2015-06-11 PubMed ID: 26095722DOI: 10.1111/vaa.12281Google Scholar: Lookup
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- Evaluation Study
- Journal Article
- Research Support
- Non-U.S. Gov't
- Anesthesia
- Bioinformatics
- Biotechnology
- Cardiovascular Health
- Clinical Examination
- Clinical Findings
- Clinical Pathology
- Clinical Study
- Comparative Study
- Diagnostic Technique
- Equine Health
- Experimental Methods
- Hemodynamics
- Horses
- Minimally Invasive Surgery
- Pharmacodynamics
- Pharmacology
- Physiology
- Veterinary Medicine
- Veterinary Practice
Summary
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This research aimed to assess the effectiveness of a minimally invasive cardiac output (CO) monitor, FloTrac/Vigileo, in comparison with traditional thermodilution (TD) techniques for measuring CO in standing horses, and found that the former did not provide accurate or reliable results.
Research Methodology
- The research was designed as an experimental trial.
- Nine adult horses, with a median weight of 535 kg, participated in the study.
- The researchers placed catheters in the right atrium, pulmonary artery, and carotid artery of each horse while under local anesthesia.
- CO measurements were taken 147 times using both TD and FloTrac techniques and indexed according to body weight.
- The team manipulated CO levels with romifidine and xylazine and dobutamine constant rate infusions to observe the ability of both methods to accurately detect changes.
Results and Analysis
- The team used multiple methods of analysis: Bland-Altman analysis, concordance, and polar plot analysis to assess agreement between the two techniques and their ability to accurately track changes in CO.
- The data revealed a large disparity (low agreement) between the measurements of CO taken by FloTrac and TD techniques. FloTrac consistently produced lower readings than TD.
- The mean bias exhibited by the FloTrac system was substantial, and the range within which the system provided relatively precise measurements was wide, indicating a lack of accuracy.
- Furthermore, when changes in CO were compared between the two methods, only 52% concordance was found.
- The research also revealed a positive correlation between mean arterial pressure (MAP) and CO readings from FloTrac, but no similar correlation was observed with TD measurements, hinting the FloTrac system may be influenced by arterial blood pressure.
Conclusions
- Overall, the results indicate the FloTrac system, originally designed for use on humans, does not accurately measure absolute CO in standing horses or track relative changes in CO when compared with TD readings.
- The research discourages the use of the FloTrac system in horses due to inaccurate measurements and a potential false dependence on arterial blood pressure.
Cite This Article
APA
Kutter AP, Bettschart-Wolfensberger R, Schwarzwald CC, Portier KG, Ringer SK.
(2015).
Evaluation of the non-calibrated pulse contour cardiac output monitor FloTrac/Vigileo against thermodilution in standing horses.
Vet Anaesth Analg, 43(2), 153-162.
https://doi.org/10.1111/vaa.12281 Publication
Researcher Affiliations
- Section of Anaesthesiology, Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
- Section of Anaesthesiology, Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
- Clinic for Equine Internal Medicine, Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
- Section of Anaesthesiology, VetAgro Sup (Veterinary Campus), University of Lyon, Marcy L'Étoile, France.
- INSERM (Institut National de la Santé et de la Recherche Médicale), UMR-1060, CarMeN (Cardiovasculaire, Métabolisme, Diabétologie et Nutrition), Lyon, France.
- Section of Anaesthesiology, Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
MeSH Terms
- Adrenergic alpha-2 Receptor Agonists / administration & dosage
- Adrenergic beta-1 Receptor Agonists / administration & dosage
- Anesthesia / veterinary
- Anesthetics / administration & dosage
- Animals
- Blood Pressure
- Calibration
- Cardiac Output
- Dobutamine / administration & dosage
- Female
- Heart Function Tests / instrumentation
- Heart Function Tests / veterinary
- Horses
- Imidazoles / administration & dosage
- Male
- Monitoring, Physiologic / methods
- Monitoring, Physiologic / veterinary
- Thermodilution
- Xylazine / administration & dosage
Citations
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