Introduction Cardiac output monitoring in intensive care unit can reduce complications and mortality of critical patient. Non-invasive methods for cardiac output (CO) evaluation include ultrasonography and pulse contour techniques. The Most Care ®/Pram monitor permits cardiac output evaluation from a peripheral artery and can provide continuous measurements. The aim of this study was to evaluate the agreement between cardiac output measurements obtained with Most Care versus transthoracic echocardiography in dogs. Methods Ten healthy Labrador Retrievers of 8-12 month age, anaesthetized for diagnostic procedures were enrolled in the study. A written consensus was signed from the owners. Complete echocardiographic, hematological and biochemical analysis were performed before enrolling the animals in the study. An arterial catheter (20 G) was positioned in the right dorsal pedal artery of each dog after a local anesthetic cream (EMLA) was placed on for 20 minutes. Serial cardiac output measurements were done simultaneously with echocardiography and with Most Care, for each dog, before anesthesia (T0) and 5 minutes after induction of anesthesia (T5). During measurement dogs were positioned in right lateral recumbency and a pressure transducer was positioned at right atrium level on a specific support, which was isolated form the dog. The pressure transducer was connected to the monitor and to the patient with a three-way stopcock. Anesthesia was provided using 10 mg/kg of propofol IV. A Pearson parametrical correlation test was performed and r2 values were considered significant when P <0.05. Results Two measurements were recorded in each dog for each time point. Mean weight of the dogs was 30.4 ± 4.1 kg. Recorded echocardiographic and Most Care CO values are listed in the table. The values registered showed a good correlation between the two employed methods with a r2 of 0.52 for T0 values and of 0.68 for T5 values (P<0.0001 in both time points). Movements of the patient can alter the recorded values of Most Care and before anesthesia dogs had to be physically restrained in order to have correct values. Discussion - Conclusion This study confirmed a good correlation between the two employed methods for cardiac output evaluation. Those preliminary results are promising but need to be confirmed with larger population study. The possibility to have a validated pulse contour method for continuous cardiac output monitoring in intensive care unit or during anesthesia could be very important for the management of cardiovascular complication of critical patients. Further studies are needed to evaluate the effectiveness of this technique in the clinical setting and in patients of various weights.
EVALUATION OF MOST CARE® /PRAM VERSUS ECHOCARDIOGRAPHY FOR CARDIAC OUTPUT ESTIMATION IN DOGS: PRELIMINARY STUDY
BRIGANTI, ANGELA;BREGHI, GLORIA
2014-01-01
Abstract
Introduction Cardiac output monitoring in intensive care unit can reduce complications and mortality of critical patient. Non-invasive methods for cardiac output (CO) evaluation include ultrasonography and pulse contour techniques. The Most Care ®/Pram monitor permits cardiac output evaluation from a peripheral artery and can provide continuous measurements. The aim of this study was to evaluate the agreement between cardiac output measurements obtained with Most Care versus transthoracic echocardiography in dogs. Methods Ten healthy Labrador Retrievers of 8-12 month age, anaesthetized for diagnostic procedures were enrolled in the study. A written consensus was signed from the owners. Complete echocardiographic, hematological and biochemical analysis were performed before enrolling the animals in the study. An arterial catheter (20 G) was positioned in the right dorsal pedal artery of each dog after a local anesthetic cream (EMLA) was placed on for 20 minutes. Serial cardiac output measurements were done simultaneously with echocardiography and with Most Care, for each dog, before anesthesia (T0) and 5 minutes after induction of anesthesia (T5). During measurement dogs were positioned in right lateral recumbency and a pressure transducer was positioned at right atrium level on a specific support, which was isolated form the dog. The pressure transducer was connected to the monitor and to the patient with a three-way stopcock. Anesthesia was provided using 10 mg/kg of propofol IV. A Pearson parametrical correlation test was performed and r2 values were considered significant when P <0.05. Results Two measurements were recorded in each dog for each time point. Mean weight of the dogs was 30.4 ± 4.1 kg. Recorded echocardiographic and Most Care CO values are listed in the table. The values registered showed a good correlation between the two employed methods with a r2 of 0.52 for T0 values and of 0.68 for T5 values (P<0.0001 in both time points). Movements of the patient can alter the recorded values of Most Care and before anesthesia dogs had to be physically restrained in order to have correct values. Discussion - Conclusion This study confirmed a good correlation between the two employed methods for cardiac output evaluation. Those preliminary results are promising but need to be confirmed with larger population study. The possibility to have a validated pulse contour method for continuous cardiac output monitoring in intensive care unit or during anesthesia could be very important for the management of cardiovascular complication of critical patients. Further studies are needed to evaluate the effectiveness of this technique in the clinical setting and in patients of various weights.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
