• 1. Heard DJ. Monitoring. In: West G, Heard D, Caulkett N, eds. Zoo and wildlife immobilization and anesthesia. Ames, Iowa: Blackwell Publishing, 2007;8391.

    • Search Google Scholar
    • Export Citation
  • 2. Lamont LA, Grimm KA. Clinical pharmacology. In: West G, Heard D, Caulkett N, eds. Zoo and wildlife immobilization and anesthesia. 2nd ed. Somerset, NJ: Wiley, 2014;541.

    • Search Google Scholar
    • Export Citation
  • 3. Forsyth SF, Machon RG, Walsh VP. Anaesthesia of a Sumatran tiger on eight occasions with ketamine, medetomidine and isoflurane. N Z Vet J 1999;47:105108.

    • Search Google Scholar
    • Export Citation
  • 4. Vigani A. Cardiac output measurement. In: Grimm KA, Lamont LA, Tranquilli WJ, et al, eds. Veterinary anaesthesia and analgesia. 5th ed. Ames, Iowa: Wiley, 2015;474.

    • Search Google Scholar
    • Export Citation
  • 5. Cannesson M, Besnard C, Durand PG, et al. Relation between respiratory variations in pulse oximetry plethysmographic waveform amplitude and arterial pulse pressure in ventilated patients. Crit Care 2005;9:R562R568.

    • Search Google Scholar
    • Export Citation
  • 6. Granelli AD, Ostman-Smith I. Noninvasive peripheral perfusion index as a possible tool for screening for critical left heart obstruction. Acta Paediatr 2007;96:14551459.

    • Search Google Scholar
    • Export Citation
  • 7. Cannesson M, Delannoy B, Morand A, et al. Does the Pleth variability index indicate the respiratory-induced variation in the plethysmogram and arterial pressure waveforms? Anesth Analg 2008;106:11891194.

    • Search Google Scholar
    • Export Citation
  • 8. Chandler JR, Cooke E, Petersen C, et al. Pulse oximeter plethysmograph variation and its relationship to the arterial waveform in mechanically ventilated children. J Clin Monit Comput 2012;26:145151.

    • Search Google Scholar
    • Export Citation
  • 9. Cannesson M, Desebbe O, Rosamel P, et al. Pleth variability index to monitor the respiratory variations in the pulse oximeter plethysmographic waveform amplitude and predict fluid responsiveness in the operating theatre. Br J Anaesth 2008;101:200206.

    • Search Google Scholar
    • Export Citation
  • 10. Hofer CK, Cannesson M. Monitoring fluid responsiveness. Acta Anaesthesiol Taiwan 2011;49:5965.

  • 11. Perel A, Pizov R, Cotev S. Systolic blood pressure variation is a sensitive indicator of hypovolemia in ventilated dogs subjected to graded hemorrhage. Anesthesiology 1987;67:498502.

    • Search Google Scholar
    • Export Citation
  • 12. Forget P, Lois F, de Kock M. Goal-directed fluid management based on the pulse oximeter-derived Pleth Variability Index reduces lactate levels and improves fluid management. Anesth Analg 2010;111:910914.

    • Search Google Scholar
    • Export Citation
  • 13. Tsuchiya M, Yamada T, Asada A. Pleth Variability Index predicts hypotension during anesthesia induction. Acta Anaesthesiol Scand 2010;54:596602.

    • Search Google Scholar
    • Export Citation
  • 14. Gelman S. Venous function and central venous pressure: a physiologic story. Anesthesiology 2008;108:735748.

  • 15. Bille C, Auvigne V, Libermann S, et al. Risk of anaesthetic mortality in dogs and cats: an observational cohort study of 3,546 cases. Vet Anaesth Analg 2012;39:5968.

    • Search Google Scholar
    • Export Citation
  • 16. Gaynor JS, Dunlop CI, Wagner AE, et al. Complications and mortality associated with anesthesia in dogs and cats. J Am Anim Hosp Assoc 1999;35:1317.

    • Search Google Scholar
    • Export Citation
  • 17. Mazzaferro E, Wagner A. Hypotension during anesthesia in dogs and cats: recognition, causes and treatment. Compend Contin Educ Pract Vet 2001;23:728737.

    • Search Google Scholar
    • Export Citation
  • 18. Traber DL, Meyer J, Traber LD. Cardiac function during hypovolemia. In: Schlag G, Redl H, eds. Pathophysiology of shock, sepsis, and organ failure. Berlin: Springer, 1993;194195.

    • Search Google Scholar
    • Export Citation
  • 19. Ruffolo RR. Review: the pharmacology of dobutamine. Am J Med Sci 1987;294:244248.

  • 20. Klein AV, Teixeira-Neto FJ, Garofalo NA, et al. Changes in pulse pressure variation and plethysmographic variability index caused by hypotension-inducing hemorrhage followed by volume replacement in isoflurane-anesthetized dogs. Am J Vet Res 2016;77:280287.

    • Search Google Scholar
    • Export Citation
  • 21. Diniz MS, Teixeira-Neto FJ, Candido TD, et al. Effects of dexmedetomidine on pulse pressure variation changes induced by hemorrhage followed by volume replacement in isoflurane-anesthetized dogs. J Vet Emerg Crit Care (San Antonio) 2014;24:681692.

    • Search Google Scholar
    • Export Citation
  • 22. Berkenstadt H, Friedman Z, Preisman S, et al. Pulse pressure and stroke volume variations during severe haemorrhage in ventilated dogs. Br J Anaesth 2005;94:721726.

    • Search Google Scholar
    • Export Citation
  • 23. Julien F, Hilly J, Sallah TB, et al. Plethysmographic variability index (PVI) accuracy in predicting fluid responsiveness in anesthetized children. Paediatr Anaesth 2013;23:536546.

    • Search Google Scholar
    • Export Citation
  • 24. Szold A, Pizov R, Segal E, et al. The effect of tidal volume and intravascular volume state on systolic pressure variation in ventilated dogs. Intensive Care Med 1989;15:368371.

    • Search Google Scholar
    • Export Citation
  • 25. Bennett FM, Tenney SM. Comparative mechanics of mammalian respiratory system. Respir Physiol 1982;49:131140.

  • 26. Keller G, Cassar E, Desebbe O, et al. Ability of Pleth Variability Index to detect hemodynamic changes induced by passive leg raising in spontaneously breathing volunteers. Crit Care 2008;12:R37.

    • Search Google Scholar
    • Export Citation
  • 27. Delerme S, Renault R, Le Manach Y, et al. Variations in pulse oximetry plethysmographic waveform amplitude induced by passive leg raising in spontaneously breathing volunteers. Am J Emerg Med 2007;25:637642.

    • Search Google Scholar
    • Export Citation
  • 28. Sinclair MD. A review of the physiological effects of α2 agonists related to the clinical use of medetomidine in small animal practice. Can Vet J 2003;44:885897.

    • Search Google Scholar
    • Export Citation

Advertisement

Use of plethysmographic variability index and perfusion index to evaluate changes in arterial blood pressure in anesthetized tigers (Panthera tigris)

View More View Less
  • 1 Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996.
  • | 2 Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996.
  • | 3 Office of Information and Technology, University of Tennessee, Knoxville, TN 37996.
  • | 4 Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996.
  • | 5 Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996.
  • | 6 Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996.

Abstract

OBJECTIVE To investigate use of the plethysmographic variability index (PVI) and perfusion index (PI) for evaluating changes in arterial blood pressure in anesthetized tigers (Panthera tigris).

ANIMALS 8 adult tigers.

PROCEDURES Each tiger was anesthetized once with a combination of ketamine, midazolam, medetomidine, and isoflurane. Anesthetic monitoring included assessment of PI, PVI, direct blood pressure measurements, anesthetic gas concentrations, esophageal temperature, and results of capnography and ECG. Mean arterial blood pressure (MAP) was maintained for at least 20 minutes at each of the following blood pressure conditions: hypotensive (MAP = 50 ± 5 mm Hg), normotensive (MAP = 70 ± 5 mm Hg), and hypertensive (MAP = 90 ± 5 mm Hg). Arterial blood gas analysis was performed at the beginning of anesthesia and at each blood pressure condition.

RESULTS Mean ± SD PI values were 1.82 ± 2.38%, 1.17 ± 0.77%, and 1.71 ± 1.51% and mean PVI values were 16.00 ± 5.07%, 10.44 ± 3.55%, and 8.17 ± 3.49% for hypotensive, normotensive, and hypertensive conditions, respectively. The PI values did not differ significantly among blood pressure conditions. The PVI value for the hypotensive condition differed significantly from values for the normotensive and hypertensive conditions. The PVI values were significantly correlated with MAP (r = −0.657). The OR of hypotension to nonhypotension for PVI values ≥ 18% was 43.6.

CONCLUSIONS AND CLINICAL RELEVANCE PVI was a clinically applicable variable determined by use of noninvasive methods in anesthetized tigers. Values of PVI ≥ 18% may indicate hypotension.

Abstract

OBJECTIVE To investigate use of the plethysmographic variability index (PVI) and perfusion index (PI) for evaluating changes in arterial blood pressure in anesthetized tigers (Panthera tigris).

ANIMALS 8 adult tigers.

PROCEDURES Each tiger was anesthetized once with a combination of ketamine, midazolam, medetomidine, and isoflurane. Anesthetic monitoring included assessment of PI, PVI, direct blood pressure measurements, anesthetic gas concentrations, esophageal temperature, and results of capnography and ECG. Mean arterial blood pressure (MAP) was maintained for at least 20 minutes at each of the following blood pressure conditions: hypotensive (MAP = 50 ± 5 mm Hg), normotensive (MAP = 70 ± 5 mm Hg), and hypertensive (MAP = 90 ± 5 mm Hg). Arterial blood gas analysis was performed at the beginning of anesthesia and at each blood pressure condition.

RESULTS Mean ± SD PI values were 1.82 ± 2.38%, 1.17 ± 0.77%, and 1.71 ± 1.51% and mean PVI values were 16.00 ± 5.07%, 10.44 ± 3.55%, and 8.17 ± 3.49% for hypotensive, normotensive, and hypertensive conditions, respectively. The PI values did not differ significantly among blood pressure conditions. The PVI value for the hypotensive condition differed significantly from values for the normotensive and hypertensive conditions. The PVI values were significantly correlated with MAP (r = −0.657). The OR of hypotension to nonhypotension for PVI values ≥ 18% was 43.6.

CONCLUSIONS AND CLINICAL RELEVANCE PVI was a clinically applicable variable determined by use of noninvasive methods in anesthetized tigers. Values of PVI ≥ 18% may indicate hypotension.

Contributor Notes

Address correspondence to Dr. Smith (ckeenansmith@gmail.com).