Validation of a new method of determining cardiac output in neonatal foals

Abstract

Hypotension is a common finding in hospitalized, critically ill neonatal foals. Hypotension may be a function of low cardiac output or increased cardiac output and decreased systemic vascular resistance. In the first instance, treatment would include fluids and/or inotropes and in the second, fluids and/or vasopressors. Therefore, cardiac output measurements are expected to help guide the treatment of hypotension associated with critical illness and/or anesthesia in neonatal foals. However, a practical and safe method of measuring cardiac output has not been described for the foal.

Lithium dilution, a new method of cardiac output determination not requiring cardiac catheterization, has recently been reported in adult horses. We compared this method to thermodilution in isoflurane anesthetized, 30 to 42 hour old foals and found good agreement (mean bias 0.0474L/min; limits of agreement -3.03 to 3.12) between the two methods in a range of cardiac outputs from 5.4 to 20.4 liters/min. The lithium dilution technique is a practical and reliable method of measuring cardiac output in anesthetized neonatal foals, and warrants investigation in critically ill conscious foals.