Development and clinical application of non-invasive cardiac output measurement in dogs and cats

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Maintaining optimal cardiac output (CO) is an important goal of intraoperative hemodynamic management. The development of non-invasive methods for determining CO provides a potential solution to this goal. In this study, partial carbon dioxide rebreathing indirect Fick technique (NICO system) was evaluated for non-invasive CO measurementCO determined using NICO system (NICO) and thermodilution (TDCO) were compared in sevoflurane anesthetized 6 beagle dogs (body weight : 9.1-13.0kg). Thirty paired measurements of TDCO and NICO were collected during low, intermediate, and high values of CO achieved by varying the depth of anesthesia and the administration of dobutamine. The CO values ranged from 0.70-2.60L/min for NICO compared to 0.89-4.45L/min for TDCO. There was good correlation between TDCO and NICO (r=0.883, p<0.0001). The limits of agreement and relative bias were -1.04±0.54L/min (±56.2%) and -39.9±11.6%. In conclusion, NICO provided a low agreement to TDCO in beagle dogs.NICO system was evaluated in 89 large-breed dogs (body weight : 20.0-67.6kg) anesthetized for surgery. The dogs were classified into three groups : breathed spontaneously and maintained adequate arterial blood pressure (ABP) before skin incision (SB, n=23), required artificial ventilation to control respiratory depression and maintained adequate ABP (CV, n=52), or required artificial ventilation and showed hypotension (Hypo-CV, n=14). Cardiac index (CI) in Hypo-CV (62±13ml/min/kg) were significantly lower than SB (97±27ml/min/kg, p<0.001) and CV (84±26ml/min/kg, p=0.004). The CI in Hypo-CV increased significantly after the treatment for hypotension (79±19ml/min/kg, p<0.001). Changes in CI agreed with changes in ABP. In conclusion, NICO system is a useful method for non-invasive cardiac output monitoring during anesthesia in large-breed dogs. We recommend the value of 0.1 L/min/kg as a standard NICO value for adequate cardiac in anesthetized large-breed dogs.