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Use of lithium dilution and pulse contour analysis cardiac output determination in anaesthetized horses: a clinical evaluation.
Abstract: To assess the suitability of a human algorithm for calculation of continuous cardiac output from the arterial pulse waveform, in anaesthetized horses. Methods: Prospective clinical study. Methods: Twenty-four clinical cases undergoing anaesthesia for various conditions. Methods: Cardiac output (Qt), measured by lithium dilution (QtLiDCO), was compared with a preceding, calibrated Qt measured from the pulse waveform (QtPulse). These comparisons were repeated every 20-30 minutes. Positive inotropes or vasopressors were administered when clinically indicated. Cardiac indices from 30.7 to 114.9 mL kg(-1) minute(-1) were recorded. Unusually shaped QtLiDCO curves were rejected and the measurement was repeated immediately. Results: Eighty-nine comparisons were made between QtLiDCO and QtPulse. The bias between the mean (+/-SD) of the two methods (QtLiDCO - QtPulse) was -0.07 L minute(-1)(+/-3.08) (0.24 +/- 6.48 mL kg(-1) minute(-1)). The limits of agreement were -12.72 and 13.2 mL kg(-1) minute(-1) (Bland & Altman 1986; Mantha et al. 2000). Linear regression analysis demonstrated a correlation coefficient (r2) of 0.89. Cardiac output in individual patients varied from 49.1 to 183% of the initial measurement at the time of calibration. Linear regression of log-transformed Qt variation for each method found a mean difference of 9% with limits of agreement of -4.1 to 22.1%. Conclusions: This method of pulse contour analysis is a relatively noninvasive and reliable way of monitoring continuous Qt in the horse under anaesthesia. The ability to easily monitor Qt might decrease morbidity and mortality in the anaesthetized horse.
Publication Date: 2005-07-13 PubMed ID: 16008717DOI: 10.1111/j.1467-2995.2005.00249.xGoogle Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Clinical Trial
- Journal Article
Summary
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The study was conducted to evaluate the appropriateness of a human algorithm for determining continuous cardiac output in anaesthetized horses using an arterial pulse waveform. The results showed that the method is relatively non-invasive and reliable for monitoring continuous cardiac output, potentially reducing morbidity and mortality rates in anaesthetized horses.
Research Methodology
- The study was a prospective clinical investigation involving twenty-four clinical cases where horses were anaesthetized for various conditions.
- Cardiac output (Qt) was measured by lithium dilution (QtLiDCO), and compared to a previous, calibrated Qt measured from the pulse waveform (QtPulse).
- Comparisons were performed every 20-30 minutes and medications like vasopressors or positive inotropes were provided when necessary.
- If there were strangely shaped QtLiDCO curves, the measurements were discarded and instantly repeated.
Key Findings
- The study involved eighty-nine comparisons between QtLiDCO and QtPulse.
- A negligible bias was found between the mean of the two methods (QtLiDCO – QtPulse) of -0.07 L minute(-1)(+/-3.08) (0.24 +/- 6.48 mL kg(-1) minute(-1)).
- The limits of agreement were found to be -12.72 and 13.2 mL kg(-1) minute(-1).
- The linear regression analysis disclosed a correlation coefficient (r2) of 0.89, showing a strong correlation between the two measurement methods.
- The cardiac output in individual patients varied from 49.1% to 183% of the initial measurement at calibration time.
- Log transformation of Qt variation for each method found a mean difference of 9% and limits of agreement ranging from -4.1 to 22.1%.
Conclusions
- The method of pulse contour analysis is reliable and relatively noninvasive when monitoring continuous Qt in anaesthetized horses.
- The ease of monitoring Qt using this method may help reduce morbidity and mortality rates among anaesthetized horses.
Cite This Article
APA
Hallowell GD, Corley KT.
(2005).
Use of lithium dilution and pulse contour analysis cardiac output determination in anaesthetized horses: a clinical evaluation.
Vet Anaesth Analg, 32(4), 201-211.
https://doi.org/10.1111/j.1467-2995.2005.00249.x Publication
Researcher Affiliations
- Equine Referral Hospital, Royal Veterinary College, Hertfordshire, UK.
MeSH Terms
- Anesthesia, General / veterinary
- Animals
- Cardiac Output / physiology
- Horses / physiology
- Horses / surgery
- Indicator Dilution Techniques / veterinary
- Lithium Chloride
- Monitoring, Intraoperative / methods
- Monitoring, Intraoperative / veterinary
- Predictive Value of Tests
- Prospective Studies
- Pulse
Citations
This article has been cited 3 times.- Tapio H, Raekallio MR, Mykkänen A, Männikkö S, Scheinin M, Bennett RC, Vainio O. Effects of vatinoxan on cardiorespiratory function and gastrointestinal motility during constant-rate medetomidine infusion in standing horses. Equine Vet J 2019 Sep;51(5):646-652.
- Dane DM, Cao K, Lu H, Yilmaz C, Dolan J, Thaler CD, Ravikumar P, Hammond KA, Hsia CCW. Acclimatization of low altitude-bred deer mice ( Peromyscus maniculatus) to high altitude. J Appl Physiol (1985) 2018 Nov 1;125(5):1411-1423.
- Yilmaz C, Ravikumar P, Bellotto DJ, Unger RH, Hsia CC. Fatty diabetic lung: functional impairment in a model of metabolic syndrome. J Appl Physiol (1985) 2010 Dec;109(6):1913-9.
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