Paranjape Vaidehi V, Henao-Guerrero Natalia, Menciotti Giulio, Saksena Siddharth, Agostinho Manuela
Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, 205 Duck Pond Dr, Blacksburg, VA 24061, USA.
Department of Civil and Environmental Engineering, Virginia Polytechnic Institute and State University, 750 Drillfield Dr, Blacksburg, VA 24061, USA.
Animals (Basel). 2023 Apr 21;13(8):1420. doi: 10.3390/ani13081420.
In animals, invasive pulmonary artery thermodilution (PATD) is a gold standard for cardiac output (CO) monitoring, but it is impractical in clinical settings. This study evaluates the agreement between PATD and noninvasive electrical cardiometry (EC) for measuring CO and analyzes the other EC-derived hemodynamic variables in six healthy anesthetized dogs subjected to four different hemodynamic events in a sequential order: (1) euvolemia (baseline); (2) hemorrhage (33% blood volume loss); (3) autologous blood transfusion; and (4) 20 mL/kg colloid bolus. The CO measurements obtained using PATD and EC are compared using Bland-Altman analysis, Lin's concordance correlation (LCC), and polar plot analysis. Values of < 0.05 are considered significant. The EC measurements consistently underpredict the CO values as compared with PATD, and the LCC is 0.65. The EC's performance is better during hemorrhage, thus indicating its capability in detecting absolute hypovolemia in clinical settings. Even though the percentage error exhibited by EC is 49.4%, which is higher than the standard (<30%), EC displays a good trending ability. Additionally, the EC-derived variables display a significant correlation with the CO measured using PATD. Noninvasive EC may have a potential in monitoring trends in hemodynamics in clinical settings.
在动物中,有创肺动脉热稀释法(PATD)是心输出量(CO)监测的金标准,但在临床环境中并不实用。本研究评估了PATD与无创心电描记法(EC)在测量CO方面的一致性,并分析了六只健康麻醉犬在依次经历四种不同血流动力学事件时,其他源自EC的血流动力学变量:(1)血容量正常(基线);(2)出血(失血33%血容量);(3)自体输血;(4)20 mL/kg胶体推注。使用Bland-Altman分析、Lin一致性相关性(LCC)和极坐标图分析比较了使用PATD和EC获得的CO测量值。P < 0.05的值被认为具有显著性。与PATD相比,EC测量值始终低估CO值,LCC为0.65。EC在出血期间的性能更好,因此表明其在临床环境中检测绝对血容量不足的能力。尽管EC表现出的百分比误差为49.4%,高于标准值(<30%),但EC显示出良好的趋势跟踪能力。此外,源自EC的变量与使用PATD测量的CO显示出显著相关性。无创EC在临床环境中监测血流动力学趋势方面可能具有潜力。