Trending ability and limitations of transpulmonary thermodilution and pulse contour cardiac output measurement in cats as a model for pediatric patients
| Autor: | Christoph K. Hofer, Rima N Bektas, M. Paula Larenza Menzies, Regula Bettschart-Wolfensberger, Annette P N Kutter |
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| Přispěvatelé: | University of Zurich, Kutter, Annette P N |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Cardiac output Dopamine Thermodilution Hemodynamics Health Informatics Pulmonary Artery Critical Care and Intensive Care Medicine Pediatrics Cardiac output measurement Phenylephrine Bolus (medicine) Internal medicine Dobutamine medicine Animals Anesthesia Cardiac Output 2718 Health Informatics Monitoring Physiologic CATS 630 Agriculture Isoflurane business.industry Reproducibility of Results Medetomidine Anesthesiology and Pain Medicine Glucose Models Animal 11404 Department of Clinical Diagnostics and Services Cardiology Cats 570 Life sciences biology 2703 Anesthesiology and Pain Medicine 2706 Critical Care and Intensive Care Medicine business medicine.drug |
| Popis: | The present study evaluated transpulmonary thermodilution (TPTD) and pulse contour cardiac output (PCCO) both measured by the PiCCO Plus™ monitor (Pulsion Medical Systems, Munich, Germany) against pulmonary artery thermodilution (PATD) in cats as a hemodynamic model for small children. A wide range of cardiac outputs (CO) was simultaneously measured. Accuracy and trending abilities were critically evaluated. Three cats were studied under isoflurane anesthesia and 160 CO measurements were performed with 3 mL ice-cold 5 % dextrose with PATD and TPTD. The results were compared with the PCCO measurement before the bolus measurement. Cardiac output was manipulated from 32 to 224 mL/kg/min by dobutamine, dopamine, phenylephrine, medetomidine and increased concentrations of isoflurane. Bland–Altman analysis, concordance and polar plot analysis were performed to assess accuracy and trending ability. TPTD was measuring constantly higher than PATD with a mean bias of 73 mL/kg/min and limits of agreement of 34–112 mL/kg/min, a concordance rate of 94 % and a mean polar angle of −5° with radial limits of agreement (RLOA) of 33°. Concordance rate of the PCCO versus PATD was 82 % with a mean polar angle of −10° and RLOA of 46° and versus TPTD 90 % with a mean polar angle of −6° and RLOA of 46°. Both tested methods constantly overestimated simultaneous PATD measurements. The small size, low flows and the relative short catheter not reaching the abdominal aorta may explain that. However TPTD tracked changes accurately opposed to a poor trending ability of the PCCO measurement. |
| Databáze: | OpenAIRE |
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