Comparison of Fick and thermodilution cardiac output determinations in standing horses

Effect of thermodilution injectate volume and temperature on the accuracy and precision of cardiac output measurements for healthy anesthetized horses

OBJECTIVE

To compare the accuracy and precision of cardiac output (CO) measurements derived from 4 thermodilution protocols that used different injectate temperatures and volumes in healthy adult horses.

ANIMALS

8 healthy adult horses.

PROCEDURES

Horses were anesthetized and instrumented with Swan-Ganz catheters. The CO was derived from each of 4 thermodilution protocols (IV injection of physiologic saline [0.9% NaCl] solution chilled to < 5 °C at volumes of 1 mL/15 kg of body weight [protocol A; control], 1 mL/25 kg [protocol B], and 1 mL/35 kg [protocol C] or maintained at 17 °C at a volume of 1 mL/15 kg [protocol D]) 3 times during each of 5 measurement cycles, with a 30-minute interval between cycles. During each measurement cycle, protocol A was performed first, and protocols B, C, and D were performed in a randomized order. Mean CO and within-subject variance in CO were compared among the 4 protocols.

RESULTS

Mean CO did not differ significantly among the 4 protocols. The within-subject variance for CO measurements derived from protocols C and D, but not protocol B, was significantly greater than that for protocol A (control).

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that, in healthy adult horses, decreasing the thermodilution injectate volume to 1 mL/25 kg from the recommended volume of 1 mL/15 kg did not adversely affect the accuracy or precision of CO measurements. However, use of smaller injectate volumes or use of injectate at approximately room temperature is not recommended owing to a clinically unacceptable increase in CO measurement variability.