Bruno H Pypendop, Victor N Rivas, Melissa Couto Bueno, Amandeep S Chohan, Linda S Barter, Joshua A Stern
{"title":"麻醉猫经胸超声和经食道多普勒估测的心输出量与肺动脉热稀释的相关性、一致性和协调性。","authors":"Bruno H Pypendop, Victor N Rivas, Melissa Couto Bueno, Amandeep S Chohan, Linda S Barter, Joshua A Stern","doi":"10.1016/j.vaa.2024.08.006","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To characterize the correlation, agreement and concordance of cardiac output (CO) measured with transthoracic ultrasound and the correlation and concordance of aortic blood flow (ABF) minute distance (MD) measured by transesophageal Doppler with CO measured by pulmonary artery thermodilution (PATD) in cats.</p><p><strong>Study design: </strong>Experimental study.</p><p><strong>Animals: </strong>A group of six healthy male neutered cats, aged 2-8 years and weighing 5.3 ± 0.3 kg.</p><p><strong>Methods: </strong>Cats were anesthetized with isoflurane in oxygen. CO was measured by PATD (CO<sub>PATD</sub>) and transthoracic echocardiography (CO<sub>ECHO</sub>). ABF MD was measured using an esophageal Doppler flow probe aligned with descending ABF. All measurements were made under three conditions: dexmedetomidine (20 μg kg<sup>-1</sup>) intravenously; atipamezole (200 μg kg<sup>-1</sup>) intramuscularly and atropine (20 μg kg<sup>-1</sup>) intravenously as needed to achieve a minimum heart rate of 140 beats minute<sup>-1</sup>; and dopamine (20 μg kg<sup>-1</sup> minute<sup>-1</sup>) intravenously in that order. Correlation between CO<sub>PATD</sub> and CO<sub>ECHO</sub>, and CO<sub>PATD</sub> and Doppler MD was evaluated using repeated measures correlation. Agreement between CO<sub>PATD</sub> and CO<sub>ECHO</sub> was evaluated using Bland-Altman method. Differences between consecutive pairs of CO measurements were calculated for concordance analysis.</p><p><strong>Results: </strong>Correlation between CO<sub>PATD</sub> and CO<sub>ECHO</sub> and between CO<sub>PATD</sub> and MD was significant (p < 0.001), with correlation coefficients greater than 0.92. A bias of > 27% and upper limits of agreement of 66% were found between CO<sub>PATD</sub> and CO<sub>ECHO</sub>. Concordance rate with CO<sub>PATD</sub> was 76-80% for CO<sub>ECHO</sub> and 72% for MD.</p><p><strong>Conclusions and clinical relevance: </strong>Echocardiographic methods for the measurement of CO showed poor agreement and concordance with PATD. MD showed poor concordance with PATD. As such, these methods cannot be used as an alternative to PATD nor can they appropriately track changes in CO in anesthetized cats.</p>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Correlation, agreement and concordance of cardiac output estimated by transthoracic ultrasound and transesophageal Doppler with pulmonary artery thermodilution in anesthetized cats.\",\"authors\":\"Bruno H Pypendop, Victor N Rivas, Melissa Couto Bueno, Amandeep S Chohan, Linda S Barter, Joshua A Stern\",\"doi\":\"10.1016/j.vaa.2024.08.006\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To characterize the correlation, agreement and concordance of cardiac output (CO) measured with transthoracic ultrasound and the correlation and concordance of aortic blood flow (ABF) minute distance (MD) measured by transesophageal Doppler with CO measured by pulmonary artery thermodilution (PATD) in cats.</p><p><strong>Study design: </strong>Experimental study.</p><p><strong>Animals: </strong>A group of six healthy male neutered cats, aged 2-8 years and weighing 5.3 ± 0.3 kg.</p><p><strong>Methods: </strong>Cats were anesthetized with isoflurane in oxygen. CO was measured by PATD (CO<sub>PATD</sub>) and transthoracic echocardiography (CO<sub>ECHO</sub>). ABF MD was measured using an esophageal Doppler flow probe aligned with descending ABF. All measurements were made under three conditions: dexmedetomidine (20 μg kg<sup>-1</sup>) intravenously; atipamezole (200 μg kg<sup>-1</sup>) intramuscularly and atropine (20 μg kg<sup>-1</sup>) intravenously as needed to achieve a minimum heart rate of 140 beats minute<sup>-1</sup>; and dopamine (20 μg kg<sup>-1</sup> minute<sup>-1</sup>) intravenously in that order. Correlation between CO<sub>PATD</sub> and CO<sub>ECHO</sub>, and CO<sub>PATD</sub> and Doppler MD was evaluated using repeated measures correlation. Agreement between CO<sub>PATD</sub> and CO<sub>ECHO</sub> was evaluated using Bland-Altman method. Differences between consecutive pairs of CO measurements were calculated for concordance analysis.</p><p><strong>Results: </strong>Correlation between CO<sub>PATD</sub> and CO<sub>ECHO</sub> and between CO<sub>PATD</sub> and MD was significant (p < 0.001), with correlation coefficients greater than 0.92. A bias of > 27% and upper limits of agreement of 66% were found between CO<sub>PATD</sub> and CO<sub>ECHO</sub>. Concordance rate with CO<sub>PATD</sub> was 76-80% for CO<sub>ECHO</sub> and 72% for MD.</p><p><strong>Conclusions and clinical relevance: </strong>Echocardiographic methods for the measurement of CO showed poor agreement and concordance with PATD. MD showed poor concordance with PATD. As such, these methods cannot be used as an alternative to PATD nor can they appropriately track changes in CO in anesthetized cats.</p>\",\"PeriodicalId\":23626,\"journal\":{\"name\":\"Veterinary anaesthesia and analgesia\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2024-08-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Veterinary anaesthesia and analgesia\",\"FirstCategoryId\":\"97\",\"ListUrlMain\":\"https://doi.org/10.1016/j.vaa.2024.08.006\",\"RegionNum\":2,\"RegionCategory\":\"农林科学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"VETERINARY SCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Veterinary anaesthesia and analgesia","FirstCategoryId":"97","ListUrlMain":"https://doi.org/10.1016/j.vaa.2024.08.006","RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"VETERINARY SCIENCES","Score":null,"Total":0}
Correlation, agreement and concordance of cardiac output estimated by transthoracic ultrasound and transesophageal Doppler with pulmonary artery thermodilution in anesthetized cats.
Objective: To characterize the correlation, agreement and concordance of cardiac output (CO) measured with transthoracic ultrasound and the correlation and concordance of aortic blood flow (ABF) minute distance (MD) measured by transesophageal Doppler with CO measured by pulmonary artery thermodilution (PATD) in cats.
Study design: Experimental study.
Animals: A group of six healthy male neutered cats, aged 2-8 years and weighing 5.3 ± 0.3 kg.
Methods: Cats were anesthetized with isoflurane in oxygen. CO was measured by PATD (COPATD) and transthoracic echocardiography (COECHO). ABF MD was measured using an esophageal Doppler flow probe aligned with descending ABF. All measurements were made under three conditions: dexmedetomidine (20 μg kg-1) intravenously; atipamezole (200 μg kg-1) intramuscularly and atropine (20 μg kg-1) intravenously as needed to achieve a minimum heart rate of 140 beats minute-1; and dopamine (20 μg kg-1 minute-1) intravenously in that order. Correlation between COPATD and COECHO, and COPATD and Doppler MD was evaluated using repeated measures correlation. Agreement between COPATD and COECHO was evaluated using Bland-Altman method. Differences between consecutive pairs of CO measurements were calculated for concordance analysis.
Results: Correlation between COPATD and COECHO and between COPATD and MD was significant (p < 0.001), with correlation coefficients greater than 0.92. A bias of > 27% and upper limits of agreement of 66% were found between COPATD and COECHO. Concordance rate with COPATD was 76-80% for COECHO and 72% for MD.
Conclusions and clinical relevance: Echocardiographic methods for the measurement of CO showed poor agreement and concordance with PATD. MD showed poor concordance with PATD. As such, these methods cannot be used as an alternative to PATD nor can they appropriately track changes in CO in anesthetized cats.
期刊介绍：
Veterinary Anaesthesia and Analgesia is the official journal of the Association of Veterinary Anaesthetists, the American College of Veterinary Anesthesia and Analgesia and the European College of Veterinary Anaesthesia and Analgesia. Its purpose is the publication of original, peer reviewed articles covering all branches of anaesthesia and the relief of pain in animals. Articles concerned with the following subjects related to anaesthesia and analgesia are also welcome:
the basic sciences;
pathophysiology of disease as it relates to anaesthetic management
equipment
intensive care
chemical restraint of animals including laboratory animals, wildlife and exotic animals
welfare issues associated with pain and distress
education in veterinary anaesthesia and analgesia.
Review articles, special articles, and historical notes will also be published, along with editorials, case reports in the form of letters to the editor, and book reviews. There is also an active correspondence section.
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