Performance of four cardiac output monitoring techniques vs. intermittent pulmonary artery thermodilution during a modified passive leg raise maneuver in isoflurane-anesthetized dogs

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dc.contributor.authorParanjape, Vaidehi V.en
dc.contributor.authorHenao-Guerrero, Nataliaen
dc.contributor.authorMenciotti, Giulioen
dc.contributor.authorSaksena, Siddharthen
dc.date.accessioned2024-12-02T15:08:20Zen
dc.date.available2024-12-02T15:08:20Zen
dc.date.issued2023-09-14en
dc.description.abstractObjective: This study investigated the performance among four cardiac output (CO) monitoring techniques in comparison with the reference method intermittent pulmonary artery thermodilution (iPATD) and their ability to diagnose fluid responsiveness (FR) during a modified passive leg raise (PLRM) maneuver in isoflurane-anesthetized dogs undergoing acute blood volume manipulations. The study also examined the simultaneous effect of performing the PLRM on dynamic variables such as stroke distance variation (SDV), peak velocity variation (PVV), and stroke volume variation (SVV). Study design: Prospective, nonrandomized, crossover design. Study animals: Six healthy male Beagle dogs. Methods: The dogs were anesthetized with propofol and isoflurane and mechanically ventilated under neuromuscular blockade. After instrumentation, they underwent a series of sequential, nonrandomized steps: Step 1: baseline data collection; Step 2: removal of 33 mL kg−1 of circulating blood volume; Step 3: blood re-transfusion; and Step 4: infusion of 20 mL kg−1 colloid solution. Following a 10-min stabilization period after each step, CO measurements were recorded using esophageal Doppler (EDCO), transesophageal echocardiography (TEECO), arterial pressure waveform analysis (APWACO), and electrical cardiometry (ECCO). Additionally, SDV, PVV, and SVV were recorded. Intermittent pulmonary artery thermodilution (iPATDCO) measurements were also recorded before, during, and after the PLRM maneuver. A successful FR diagnosis made using a specific test indicated that CO increased by more than 15% during the PLRM maneuver. Statistical analysis was performed using one-way analysis of variance for repeated measures with post hoc Tukey test, linear regression, Lin’s concordance correlation coefficient (ρc), and Bland–Altman analysis. Statistical significance was set at p < 0.05. Results: All techniques detected a reduction in CO (p < 0.001) during hemorrhage and an increase in CO after blood re-transfusion and colloid infusion (p < 0.001) compared with baseline. During hemorrhage, CO increases with the PLRM maneuver were as follows: 33% for iPATD (p < 0.001), 19% for EC (p = 0.03), 7% for APWA (p = 0.97), 39% for TEE (p < 0.001), and 17% for ED (p = 0.02). Concurrently, decreases in SVV, SDV, and PVV values (p < 0.001) were also observed. The percentage error for TEE, ED, and EC was less than 30% but exceeded 55% for APWA. While TEECO and ECCO slightly underestimated iPATDCO values, EDCO and APWACO significantly overestimated iPATDCO values. TEE and EC exhibited good and acceptable agreement with iPATD. However, CO measurements using all four techniques and iPATD did not differ before, during, and after PLRM at baseline, blood re-transfusion, and colloid infusion. Conclusion and clinical relevance: iPATD, EC, TEE, and ED effectively assessed FR in hypovolemic dogs during the PLRM maneuver, while the performance of APWA was unacceptable and not recommended. SVV, SDV, and PVV could be used to monitor CO changes during PLRM and acute blood volume manipulations, suggesting their potential clinical utility.en
dc.description.versionPublished versionen
dc.format.extent16 page(s)en
dc.format.mimetypeapplication/pdfen
dc.identifierARTN 1238549 (Article number)en
dc.identifier.doihttps://doi.org/10.3389/fvets.2023.1238549en
dc.identifier.eissn2297-1769en
dc.identifier.issn2297-1769en
dc.identifier.orcidHenao Guerrero, Piedad [0000-0003-1525-9317]en
dc.identifier.orcidSaksena, Siddharth [0000-0003-3746-6368]en
dc.identifier.orcidMenciotti, Giulio [0000-0001-7483-062X]en
dc.identifier.otherPMC10538972en
dc.identifier.pmid37781276en
dc.identifier.urihttps://hdl.handle.net/10919/123670en
dc.identifier.volume10en
dc.language.isoenen
dc.publisherFrontiersen
dc.relation.urihttps://www.ncbi.nlm.nih.gov/pubmed/37781276en
dc.rightsCreative Commons Attribution 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectarterial pressure waveform analysisen
dc.subjectcanineen
dc.subjectelectrical cardiometryen
dc.subjectesophageal doppleren
dc.subjectgeneral anesthesiaen
dc.subjectfluid responsivenessen
dc.subjecthypovolemiaen
dc.subjecttransesophagealen
dc.subjectechocardiographyen
dc.titlePerformance of four cardiac output monitoring techniques vs. intermittent pulmonary artery thermodilution during a modified passive leg raise maneuver in isoflurane-anesthetized dogsen
dc.title.serialFrontiers in Veterinary Scienceen
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten
dc.type.otherArticleen
dc.type.otherJournalen
dcterms.dateAccepted2023-08-21en
pubs.organisational-groupVirginia Techen
pubs.organisational-groupVirginia Tech/Engineeringen
pubs.organisational-groupVirginia Tech/Engineering/Civil & Environmental Engineeringen
pubs.organisational-groupVirginia Tech/Veterinary Medicineen
pubs.organisational-groupVirginia Tech/Veterinary Medicine/Small Animal Clinical Sciencesen
pubs.organisational-groupVirginia Tech/All T&R Facultyen
pubs.organisational-groupVirginia Tech/Engineering/COE T&R Facultyen
pubs.organisational-groupVirginia Tech/Veterinary Medicine/CVM T&R Facultyen

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