Reliability of lithium dilution cardiac output in anaesthetized sheep

Axiak Flammer, S. M.; Critchley, L. A.; Weber, A.; Pirbodaghi, T.; Brinks, Henriette; Vandenberghe, S. (2013). Reliability of lithium dilution cardiac output in anaesthetized sheep. British journal of anaesthesia, 111(5), pp. 833-839. Oxford University Press 10.1093/bja/aet220

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BACKGROUND: Cardiac output (CO) measurement with lithium dilution (COLD) has not been fully validated in sheep using precise ultrasonic flow probe technology (COUFP). Sheep generate important cardiovascular research models and the use of COLD has become more popular in experimental settings. METHODS: Ultrasonic transit-time perivascular flow probes were surgically implanted on the pulmonary artery of 13 sheep. Paired COLD readings were taken at six time points, before and after implantation of a left ventricular assist device (LVAD) and compared with COUFP recorded just after lithium injection. RESULTS: The mean COLD was 5.7 litre min(-1) (range 3.8-9.6 litre min(-1)) and mean COUFP 5.9 litre min(-1) (range 4.0-9.2 litre min(-1)). The bias (standard deviation) was 0.3 (1.0) litre min(-1) [5.1 (16.9)%] and limits of agreement (LOA) were -1.7 to 2.3 litre min(-1) (-28.8 to 39.0%) with a percentage error (PE) of 34.4%. Data to assess trending [rate (95% confidence intervals)] included a 78 (62-93)% concordance rate in the four-quadrant plot (n=27). In the half moon polar plot (n=19), the mean polar angle was +5°, the radial LOA were -49 to +35° and 68 (47-89)% of data points fell within 22.5° of the mean polar angle. Both tests indicated moderate to poor trending ability. CONCLUSION: COLD is not precise when evaluated against COUFP in sheep based on the statistical criteria set, but the results are comparable with previously published animal studies. KEYWORDS:

Item Type:

Journal Article (Original Article)


05 Veterinary Medicine > Department of Clinical Veterinary Medicine (DKV) > DKV - Anaesthesiology
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Cardiovascular Engineering (CVE)

UniBE Contributor:

Axiak, Shannon; Weber, Alberto; Pirbodaghi, Tohid; Most, Henriette and Vandenberghe, Stijn


600 Technology > 610 Medicine & health




Oxford University Press




Francesco Clavica

Date Deposited:

09 Apr 2014 17:17

Last Modified:

24 Oct 2019 06:30

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

anaesthesia, veterinary, data interpretation, statistical, measurement techniques, cardiac output, measurement techniques, lithium dilution, sheep




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