Abstract
Objective
To evaluate the non-calibrated, minimally invasive cardiac output (CO) monitor FloTrac/Vigileo
(FloTrac) against thermodilution (TD) CO in standing horses.
Study design
Prospective, experimental trial.
Animals
Nine adult horses weighing a median (range) of 535 (470–602) kg.
Methods
Catheters were placed in the right atrium, pulmonary artery and carotid artery under
local anaesthesia. CO was measured 147 times by TD and FloTrac and indexed to body
weight. Changes in CO were achieved with romifidine or xylazine and dobutamine constant
rate infusions. Bland–Altman analysis, concordance and polar plot analysis were used
to assess agreement and ability to track changes in CO.
Results
Mean ± standard deviation COTD of 48 ± 16 mL kg−1 minute−1 (range: 19–93 mLkg−1 minute−1) and mean COFloTrac of 9 ± 3 mLkg−1 minute−1 (range: 5–21 mL kg−1 minute−1) were measured. Low agreement with a large mean bias of 39 mL kg−1 minute−1 and wide limits of agreement of 8–70 mL kg−1 minute−1 were found. The percentage error of 108% and precision of TD of ±18% resulted in
an estimated precision of FloTrac of ±106%. Comparison of changes in COFloTrac with changes in COTD gave a concordance rate of 52% in the four-quadrant plot, and a mean polar angle
of -11° with radial limits of agreement of ±61 ° in the polar plot. Mean arterial
pressure (MAP) and COFloTrac were positively correlated (r = 0.5, p < 0.0001). No correlation of MAP with COTD was observed.
Conclusions and clinical relevance
The FloTrac system, originally designed for use in humans, neither measured absolute
CO in standing horses accurately nor tracked relative changes in CO measured by TD
correctly. The false dependence of COFloTrac on arterial blood pressure further discourages the use of this technique in horses.
Keywords
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Article info
Publication history
Accepted:
February 10,
2015
Received:
October 8,
2014
Identification
Copyright
© 2016 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Inc. All rights reserved.
