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Mantovani, Matheus M; Fantoni, Denise T; Gimenes, André M; de Castro, Jacqueline R; Flor, Patrícia B; Ida, Keila K; Schwartz, Denise S
BMC veterinary research, 11/2017, Letnik: 13, Številka: 1Journal Article, Web Resource
Cardiac output (CO) is an important haemodynamic parameter to monitor in patients during surgery. However, the majority of the techniques for measuring CO have a limited application in veterinary practice due to their invasive approach and associated complexity and risks. Transoesophageal echocardiography (TEE) is a technique used to monitor cardiac function in human patients during surgical procedures and allows CO to be measured non-invasively. This prospective clinical study aimed to compare the transoesophageal echocardiography using a transgastric view of the left ventricular outflow tract (LVOT) and the thermodilution (TD) technique for the assessment of CO during mean arterial pressure of 65-80 mmHg (normotension) and <65 mmHg (hypotension) in dogs undergoing elective surgery. Eight dogs were pre-medicated with acepromazine (0.05 mg/kg, IM), tramadol (4 mg/kg, IM) and atropine (0.03 mg/kg, IM), followed by anaesthetic induction with propofol (3-5 mg/kg IV) and maintenance with isoflurane associated with a continuous infusion rate of fentanyl (bolus of 3 μg/kg followed by 0.3 μg/kg/min). The CO was measured by TEE (CO ) and TD (CO ) at the end of expiration during normotension and hypotension (induced by isoflurane). There was a strong positive correlation between CO and CO (r = 0.925; P < 0.0001). The bias between CO and CO was 0.14 ± 0.29 L/min (limits of agreement, -0.44 to 0.72 L/min). The percentage error of CO measured by the two methods was 12.32%. In addition, a strong positive correlation was found between CO and CO during normotension (r = 0.995; P < 0.0001) and hypotension (r = 0.78; P = 0.0223). The results of this study indicated that the transgastric view of the LVOT by TEE was a minimally invasive alternative to clinically monitoring CO in dogs during anaesthesia. However, during hypotension, the CO obtained by TEE was less reliable, although still acceptable.
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