Reliability of cardiac output measured by thermodilution method in small animals

Effects of intravenous butorphanol on cardiopulmonary function in isoflurane-anesthetized alpacas

OBJECTIVE

To determine the effects of intravenous (IV) butorphanol on the cardiopulmonary system and on the bispectral index (BIS) in isoflurane-anesthetized alpacas.

STUDY DESIGN

Randomized, blinded cross-over experimental trial.

ANIMALS

Eight healthy, young (3 +/- 1 SD years) adult female alpacas weighing 64 +/- 9 SD kg.

METHODS

Alpacas were anesthetized with isoflurane by mask followed by tracheal intubation and maintenance of anesthesia with isoflurane in oxygen and intermittent positive pressure ventilation. Animals were assigned to two treatments, butorphanol (0.1 mg kg(-1), IV) and saline (0.01 mL kg(-1), IV) in a randomized manner allowing a 2-week interval between treatments. Cardiovascular variables included systolic, diastolic, and mean arterial blood pressure, heart rate, pulmonary arterial pressure, pulmonary arterial occlusion pressure (PAOP), central venous pressure, cardiac output, and pulmonary temperature (TEMP). Cardiac index, systemic vascular resistance (SVR), and pulmonary vascular resistance (PVR) were calculated. Bispectral index was also measured. Arterial and mixed venous blood samples were collected for blood gas analysis. All variables were recorded at baseline (time 0) and at 5, 10, 15, 30, 45 and 60 minutes following injection and were analyzed by using repeated-measures ANOVA (p < 0.05). PAOP, PVR, and BIS were analyzed by paired t-tests.

RESULTS

Butorphanol decreased SVR at all times when compared with the baseline, but no difference was detected between treatments. TEMP decreased with time in both treatments, but they were not different from each other. Other cardiovascular, BIS, and blood gas variables were not different between groups.

CONCLUSION AND CLINICAL RELEVANCE

We conclude that butorphanol had minimal effects on the cardiovascular system of the alpacas, causing a mild decrease in SVR.

Dietary-sodium-induced cardiac remodeling in spontaneously hypertensive rat versus Wistar-Kyoto rat

OBJECTIVE

To study the effects of short-term and long-term high sodium intake on cardiac mass and design in sodium-sensitive spontaneously hypertensive rats versus sodium-resistant Wistar-Kyoto rats.

METHODS

Young spontaneously hypertensive rats and Wistar-Kyoto rats were randomly allocated to control diet, 2 or 8% dietary sodium for 2-12 weeks and changes in resting hemodynamics, cardiac angiotensin II level, sympathetic activity and cardiac structure evaluated. Sympathetic activity was assessed by measuring levels of plasma catecholamines, responses of blood pressure to ganglionic blockade, and rates of cardiac turnover of norepinephrine.

RESULTS

High sodium intake for 4 weeks increased left ventricle weight of Wistar-Kyoto rats aged 4 weeks (by 11 and 25% for 2 and 8% NaCl diets, respectively). This hypertrophic response was temporary, however, had already diminished after 6 weeks, and was absent after 12 weeks of a high sodium intake. However, after prolonged exposure concentric remodeling occurred (i.e. left ventricle wall thickness : radius ratio increased with no change in left ventricle mass). High sodium intake did not affect resting blood pressure, cardiac index, cardiac angiotensin II level, and general sympathetic activity of Wistar-Kyoto rats. Short-term high sodium intake did not increase left ventricle mass of young spontaneously hypertensive rats, unless sodium intake was so high (8% NaCl) that blood pressure and general sympathetic activity increased, too. However, a prolonged moderate (2%) increase in sodium intake also caused concentric remodeling in spontaneously hypertensive rats without increasing left ventricle mass, blood pressure, cardiac index, and general and cardiac sympathetic activities.

CONCLUSIONS

The blood pressure in young Wistar-Kyoto rats is sodium-insensitive but the heart structure is sodium-sensitive and high dietary sodium intake causes an early hypertrophic response, and then concentric remodeling. In contrast, hypertrophic response appears to occur after the response of blood pressure in spontaneously hypertensive rats, whereas the remodeling is similar to that in Wistar-Kyoto rats.

Measurement of cardiac output in small laboratory animals using recordings of blood conductivity

No method exists which enables easy, frequent, and, at the same time, reliable cardiac output (CO) measurements in mice. To validate a simple indicator-dilution method suitable for frequent measurements of CO in small laboratory animals, a 5% glucose solution was injected as a bolus into femoral veins of mice and rats. The corresponding blood conductivity was measured continuously between an intra-aortic and a rectal electrode. The resulting conductivity-dilution curves were used to calculate CO in mice during hypervolemia and hypovolemia and in conscious as well as halothane-anesthetized mice and rats. In rats, conductivity-dilution curves and time courses of plasma glucose concentration were recorded simultaneously. Compared with CO in awake animals, CO in both species was slightly, but not significantly, reduced during halothane anesthesia. CO was significantly and gradually reduced in hypovolemic mice (up to 58 ml blood/kg body wt), whereas hypervolemia (23 ml saline/kg body wt) had no significant effect. Simultaneous recordings of conductivity-dilution curves and time courses of plasma glucose concentration yielded corresponding values of CO (P < 0.001). Measurement of blood conductivity appears to be a reliable, simple, and convenient method for quantification of CO in small animals.

Cardiac output and regional hemodynamics during recurrent seizures in rats

Altered cardiovascular function in status epilepticus may contribute to mortality and morbidity in patients. We investigated changes in cardiac output and regional hemodynamics during 2 h of recurrent PTZ-induced seizures in anesthetized, paralyzed rats using radioactive microspheres, thermodilution methods, and the pulsed Doppler technique. Cardiac output fell 30-60% during recurrent seizures in 17 of 27 animals. The fall in cardiac output was sudden in onset and occurred primarily in association with seizures accompanied by prolonged increases in MABP but no change in central venous pressure. Total peripheral resistance (TPR) rose during early seizures in association with vasoconstriction of renal and certain splanchnic vascular beds. Ictal increases in TPR became attenuated during late seizures, due to failure of renal and splanchnic beds to constrict. Therefore, derangements in both cardiac and vascular function occur during late seizures. These derangements may contribute to both cerebral hypoperfusion and sudden death in status epilepticus.

Errors in the measurement of cardiac output by thermodilution

Cardiac output (CO) determination by thermodilution, which was introduced by Fegler in 1954, has gained wide acceptance in clinical medicine and animal experiments because it has several advantages over other methods with respect to simplicity, accuracy, reproducibility, repeated measurements at short intervals, and because there is no need for blood withdrawal. However, errors in determination of CO by thermodilution may be introduced by technical factors and the patients' pathological conditions. The current review summarizes these issues and provides our recommendations, based on the medical literature published between 1954-1992. To obtain more reproducible and accurate CO values by thermodilution, one should make several determinations (1) by using 10 ml injectate at room temperature for adults and 0.15 ml.kg-1 injectate for infants and children; (2) at evenly spaced intervals of the ventilation cycle; (3) when rapid intravenous fluid administration is discontinued; (4) by observing thermodilution curves so that baseline pulmonary artery temperature drift or the existence of intra- and extracardiac shunts are noticed. Finally, CO determination by thermodilution may be unreliable or impossible in patients with low CO states and tricuspid or pulmonary regurgitation. Since non-invasive CO monitoring has not replaced CO determination by thermodilution, intimate knowledge of this method is crucial for anaesthetists to prevent errors in the management of patients.

Hemodynamic effects of calcitonin in the normal rat

Calcitonin (CT) was administered acutely (IV 4-8 U/kg) and chronically (SC 2 U/kg/day x 150 day) to normal male rats. Measurements included heart rate (HR), mean blood pressure (MBP), cardiac index (CI), peripheral vascular resistance (PVR), and stroke volume index (SVI). The MBP was higher in CT rats examined under pentobarbital anesthesia. Upon awakening from anesthesia, rats chronically on CT exhibited impaired recovery of CI and SVI. Hemodynamic effects were not seen in rats acutely treated with CT. Heart weight was unchanged in chronic treatment with CT. Therefore, CT had minimal hemodynamic effects in the normal male rat.

Right heart catheterization in rats with pulmonary hypertension and right ventricular hypertrophy

Using a special Millar ultraminiature catheter pressure transducer, right ventricular functional parameters were measured in anesthetized, closed-chest rats under control conditions, during acute pulmonary hypertension and after induction of right ventricular hypertrophy. Acute i.v. infusion of noradrenaline and a brief period of hypoxia in female Sprague-Dawley rats elicited a marked increase in right ventricular systolic pressure (RVSP) and in the maximal rate of rise in right ventricular pressure (RV dp/dtmax). After 3 and 16 days of daily administrations of triiodothyronine in female Sprague-Dawley rats, all right ventricular hemodynamic parameters were enhanced along with the increase in left ventricular function. The right and left ventricles were hypertrophied, and cardiac output was increased. After 40 and 45 days subsequent to bilateral thorax irradiation of male Brown-Norway rats, RVSP and RV dp/dtmax were increased, the right ventricle was hypertrophied, while the left ventricle did not exhibit appreciable hemodynamic or morphologic alterations. Cardiac output was depressed. Thus, these two experimental models differ considerably as to the mechanism and time course of the development of right ventricular hypertrophy as well as to the participation of the left ventricle and the involvement of volume overload.

The cardiovascular effects of vasopressin after haemorrhage in anaesthetized rats

The cardiovascular effects of an acute haemorrhage (2% of the body weight) were studied over a 60 min period in three groups of rats: (a) Brattleboro rats with hereditary hypothalamic diabetes insipidus (b.d.i.) lacking circulating vasopressin, (b) control rats of the parent Long Evans (l.e.) strain, and (c) l.e. rats treated with an antagonist of the vascular action of vasopressin. Prior to the haemorrhage there were no significant differences between the three groups of rats with respect to mean arterial blood pressure, cardiac output, stroke volume or total peripheral resistance. Following the haemorrhage cardiac output and stroke volume were severely reduced in all three groups of rats. Total peripheral resistance was relatively unaffected in antagonist-treated l.e. rats and b.d.i. rats, but rose substantially in response to the loss of blood in the control l.e. group. Both total peripheral resistance and mean arterial blood pressure were markedly greater in the untreated l.e. control rats than in the other two groups of animals during the first 20 min after haemorrhage. The mean heart rate measured in Brattleboro rats was elevated compared with that of control l.e. rats throughout the experiment and, in addition, significantly greater than that of antagonist-treated l.e. rats during the first 40 min after the haemorrhage. Survival rate for the b.d.i. rats following the 2% haemorrhage was lower than that for l.e. control rats and antagonist-treated l.e. rats. The results indicate that the recovery of the blood pressure following an acute arterial haemorrhage is significantly influenced by vasopressin, particularly during the first 20 min, and that the predominant effect of the hormone is to increase the total peripheral resistance. The higher mortality associated with volume depletion in the b.d.i. rats is unlikely to be directly related to the absence of the vascular action of vasopressin, since administration of the vasopressin antagonist to normal l.e. rats does not reduce their survival rate.

Cardiac output and tissue blood flow in the abalone, Haliotis cracherodii (Mollusca, Gastropoda)

Little is known about the characteristics of hemolymph (blood) flow in animals with open circulatory systems. We measured cardiac output and blood flow to specific tissues in the black abalone, Haliotis cracherodii, a gastropod mollusk. The use of thermodilution allowed us to make repeated measurements of cardiac output and cardiac stroke volume over relatively short time intervals (5-10 heart beats) in resting, unrestrained abalone while disturbing the animals minimally. Anatomical studies of the abalone circulation showed that the arterial system terminated in small diameter (approaching 10-20 micron in some cases) lacunar tissue spaces. Because of this, we used radioactive microspheres (which must be trapped in the tissue vasculature) to measure blood flow rates to selected tissues. The major findings of our study were that 1) cardiac output in the black abalone ranged from about 100 to 150 ml X kg-1 X min-1, and was highly correlated with body size; 2) weight-specific cardiac stroke volume was about 5 ml X kg-1, considerably larger than that of a mammal; 3) tissue blood flow rates ranged from 10 ml X 100 g-1 X min-1 (foot muscle) to 80 ml X 100 g-1 X min-1 (nephridial tissue), similar to typical tissue blood flow rates in mammals. Our data suggest that the blood in the abalone is directed to the tissues not in proportion to percent total body weight the tissues represent (as might be expected in an open vascular system), but apparently in proportion to tissue metabolic rate.

Local thermodilution: a reliable technique for estimating renal blood flow in the rabbit

1. A thermistor probe designed for determination of renal blood flow in rabbits, consisted of a fast-responding bead thermistor and an injection port which was also used to measure renal venous pressure between injections. 2. By an in vitro calibration system, actual measured flow (Qa) correlates well with the thermodilution calculated flow (Qc), where Qc = 0.99 Qa + 4.9 (r = 0.97, n = 42). 3. The renal blood flow (RBF) as determined by the thermodilution technique in 3 control groups was 53 +/- 3 (8), 60 +/- 6 (8), and 62 +/- 3 (3) ml/min/kidney or about 9% of the cardiac output. 4. Hypovolemia (-10%) reduced RBF by 19% from the control value, whereas, hypervolemia (+10%) did not alter RBF. 5. Smoke-induced apnea resulted in hypertension (+30%) and bradycardia (-39%), and was associated with changes in RBF (-55%) and renal vascular resistance (+183%). 6. We conclude that the local thermodilution technique is a relatively easy and reliable method for estimating RBF in rabbits.

Measurement of cardiac output by the thermodilution method in rats. II. Simultaneous measurement of cardiac output and blood pressure in conscious rats

A method is described for the simultaneous measurement of cardiac output (CO), using the thermodilution method, and arterial blood pressure in conscious unrestrained rats. For the injection of the indicator solution (ice-cold, 0.9% saline) and for the measurement of systolic and diastolic blood pressure, chronically-implanted polyethylene cathethers were used, while CO was measured transpulmonarily with a commercially available CO computer and an acutely-implanted (via caudal artery) arterial thermistor catheter. The following were observed in 10 rats at rest: a CO of 40.2 +/- 1.9 ml/min/100 g, a mean arterial blood pressure of 106 +/- 5 mmHg, a heart rate of 417 +/- 20 beats/min and a peripheral vascular resistance of 2.68 +/- 0.13 mmHG/(ml/min/100 g). After injection of the beta-adrenergic agonist isoprenaline, there was a rise in CO and heart rate, while peripheral resistance and blood pressure were lowered. Injection of the beta-receptor-blocked propranolol caused decreases in CO and heart rate, while peripheral resistance and blood pressure rose. It is concluded, that the method described here for the simultaneous measurement of CO and arterial blood pressure is suitable for the investigation of drug-induced cardiovascular effects in conscious rats.

Determination of catheter wall heat transfer in cardiac output measurement by thermodilution

1. A model system of the thermal dilution technique was used to determine in vitro the loss of thermal indicator across different sizes of polyethylene catheters. 2. Thermal indicator loss (caloric gain by the indicator fluid or caloric loss by the catheter) per unit length of catheters (H/L) increased as a function of the outer radius (OR) of the catheters. Linear regression analysis gave the following equation: H/L=0.337OR+0.073 (r=0.88, P<0.05). 3. Thermal indicator loss per unit surface area (H/SA) decreased almost linearly with the following regression equation: H/SA=-1.860 OR+0.364 (r=0.97, P<0.97, P<0.01). 4. Thermal indicator loss per unit volume contained in the catheter (H/vol) decreased exponentially according to the following equation: H/vol =89.le-25.4(OR) (r=0.97, P<0.01). 5. This study indicates that there is a measurable loss of thermal indicator during injection corresponding to a loss between 9 and 16% (for a 11.5 cm length of PE 50 and PE 240) of the required calories for warming the injectate to 37 degrees C. Data is provided for correction of heat loss across the wall of a given length and diameter of polyethylene tubing.