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Trending ability and limitations of transpulmonary thermodilution and pulse contour cardiac output measurement in cats as a model for pediatric patients

Kutter, Annette ; Bektas, Rima ; Hofer, Christoph ; Larenza Menzies, M. ; Bettschart-Wolfensberger, Regula

In: Journal of Clinical Monitoring and Computing, 2015, vol. 29, no. 3, p. 377-383

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    Title
    • Trending ability and limitations of transpulmonary thermodilution and pulse contour cardiac output measurement in cats as a model for pediatric patients
    Author
    • Kutter, Annette. Section of Anesthesiology, Equine Department, Vetsuisse Faculty, University of Zurich, Winterthurerstr. 260, 8057, Zurich, Switzerland
    • Bektas, Rima. Section of Anesthesiology, Equine Department, Vetsuisse Faculty, University of Zurich, Winterthurerstr. 260, 8057, Zurich, Switzerland
    • Hofer, Christoph. Institute of Anesthesiology and Intensive Care Medicine, Triemli City Hospital, Birmensdorferstrasse 497, 8063, Zurich, Switzerland
    • Larenza Menzies, M.. Section of Anesthesiology, Equine Department, Vetsuisse Faculty, University of Zurich, Winterthurerstr. 260, 8057, Zurich, Switzerland
    • Bettschart-Wolfensberger, Regula. Section of Anesthesiology, Equine Department, Vetsuisse Faculty, University of Zurich, Winterthurerstr. 260, 8057, Zurich, Switzerland
    Document Type
    • Postprint
    Language
    • English
    Published in
    • Journal of Clinical Monitoring and Computing, 2015, vol. 29, no. 3, p. 377-383. Springer Netherlands
    Other Version
    OAI-PMH Identifier
    • oai:doc.rero.ch:331722
    Summary
    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 3mL 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 224mL/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 73mL/kg/min and limits of agreement of 34-112mL/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.