Measurement of cardiac output by transoesophageal Doppler echocardiography in anaesthetized horses: comparison with thermodilution.

In order to determine if transoesophageal Doppler echocardiography could be used to estimate cardiac output in anaesthetized horses, we have compared the technique with estimations of cardiac output by thermodilution in eight healthy adult thoroughbreds. Measurements of aortic blood flow velocity were made by high pulse repetition frequency (HPRF) and continuous wave (CW) Doppler echocardiography from a 3.5-MHz transoesophageal probe. Cardiac output was increased during the study by administration of dobutamine, providing a range of cardiac output measurements by thermodilution from 15.0 to 64.4 liter min-1. Estimations derived from CW Doppler overestimated cardiac output compared with thermodilution (bias = 4.0 litre min-1). Estimations from HPRF Doppler echocardiography more closely reflected measurements obtained by thermodilution (bias = 0.7 litre min-1). Limits of agreement between the techniques were similar for both modes of insonation (HPRF = -7.7 to 9.1 litre min-1, CW = -4.9 to 12.8 litre min-1). There were significant differences in bias between both Doppler techniques and thermodilution for individual horses. As a result, for any individual horse, limits of agreement between the techniques were closer (HPRF = +/- 6.4 litre min-1, CW = +/- 7.6 litre min-1). We conclude that transoesophageal echocardiography provided an alternative, effective and non-invasive method for measurement of cardiac output in anaesthetized horses.