Comparison of Transpulmonary Thermodilution and Calibrated Pulse Contour Analysis with Pulmonary Artery Thermodilution Cardiac Output Measurements in Anesthetized Dogs

Author(s)

Garofalo, N. A. ; Teixeira-Neto, F. J. ; Rodrigues, J. C. ; Cerejo, S. A. ; Aguiar, A. J. A. ; Becerra-Velasquez, D. R.

• Document type: Journal article
• Source: JOURNAL OF VETERINARY INTERNAL MEDICINE; v. 30, n. 4, p. 941-950, JUL-AUG 2016.
• Web of Science Citations: 4

Abstract

BackgroundTranspulmonary thermodilution (TPTDCO) and calibrated pulse contour analysis (PCA(CO)) are alternatives to pulmonary artery thermodilution cardiac output (PATD(CO)) measurement. HypothesisTen mL of ice-cold thermal indicator (TI10) would improve the agreement and trending ability between TPTDCO and PATD(CO) compared to 5 mL of indicator (TI5) (Phase-1). The agreement and TA between PCA(CO) and PATD(CO) would be poor during changes in systemic vascular resistance (SVR) (Phase-2). AnimalsEight clinically normal dogs (20.8-31.5 kg). MethodsProspective, experimental study. Simultaneous TPTDCO and PATD(CO) (averaged from 3 repetitions) using TI5 and TI10 were obtained during isoflurane anesthesia combined or not with remifentanil or dobutamine (Phase-1). Triplicate PCA(CO) and PATD(CO) measurements were recorded during phenylephrine-induced vasoconstriction and nitroprusside-induced vasodilation (Phase-2). ResultsMean bias (limits of agreement: LOA) (L/min), percentage bias (PB), and percentage error (PE) were 0.62 (-0.11 to 1.35), 16%, and 19% for TI5; and 0.33 (-0.25 to 0.91), 9%, and 16% for TI10. Mean bias (LOA), PB, and PE were 0.22 (-0.63 to 1.07), 6%, and 23% during phenylephrine; and 2.12 (0.70-3.55), 43%, and 29% during nitroprusside. Mean angular bias (radial LOA) values were 2 degrees (-10 degrees to 14 degrees) and -1 degrees (-9 degrees to 6 degrees) for TI5 and TI10, respectively (Phase-1), and 38 degrees (5 degrees-71 degrees) (Phase-2). Conclusions and Clinical ImportanceAlthough TI10 slightly improves the agreement and trending ability between TPTDCO and PATD(CO) in comparison to TI5, both volumes can be used for TPTDCO in replacement of PATD(CO). Vasodilation worsens the agreement between PCA(CO) and PATD(CO). Because of PCA(CO)'s poor agreement and trending ability with PATD(CO) during SVR changes, this method has limited clinical application. (AU)

• FAPESP's process: 12/03207-2 - Effects of dexmedetomidine on dynamic preload indices, and on global and regional perfusion indices in dogs undergoing acute hipovolemia followed by volume replacement
• Grantee: Francisco José Teixeira Neto
• Support Opportunities: Regular Research Grants