Biomedical subjects

K J Blissitt

Publications and source records attributed to K J Blissitt.

15 recordsLinked to original sources

PubMed2000

Effect of a 30-minute infusion of dobutamine hydrochloride on hind limb blood flow and hemodynamics in halothane-anesthetized horses.

OBJECTIVE: To evaluate the hemodynamic effects of dobutamine hydrochloride (0.5 microg/kg of body weight/min) in halothane-anesthetized horses. ANIMALS: 6 adult Thoroughbred horses. PROCEDURE: Anesthesia was induced by use of romifidine (100 microg/kg) and ketamine (2.2 mg/kg), IV. Anesthesia was maintained by halothane (end-tidal concentration 0.9 to 1.0%). Aortic, left ventricular, and right atrial pressures were measured, using catheter-mounted strain gauge transducers. Cardiac output (CO), velocity time integral, maximal aortic blood flow velocity and acceleration, and left ventricular preejection period and ejection time were measured from aortic velocity waveforms obtained by transesophageal Doppler echocardiography. Velocity waveforms were recorded from the femoral vessels, using Doppler ultrasonography. The time-averaged mean velocity and early diastolic deceleration slope (EDDS) were measured. Pulsatility index (PI) and volumetric flow were calculated. Microvascular perfusion was measured in the semimembranosus muscles by laser Doppler flowmetry. Data were recorded 60 minutes after induction of anesthesia (control) and at 15 and 30 minutes after start of an infusion of dobutamine (0.5 microg/kg/min). RESULTS: Aortic pressures were significantly increased during the infusion of dobutamine. No change was observed in the indices of left ventricular systolic function including CO. Femoral arterial flow significantly increased, and the PI and EDDS decreased. No change was observed in the femoral venous flow or in microvascular perfusion. CONCLUSIONS AND CLINICAL RELEVANCE: At this dosage, dobutamine did not alter left ventricular systolic function. Femoral blood flow was preferentially increased as the result of local vasodilatation. The lack of effect of dobutamine on microvascular perfusion suggests that increased femoral flow is not necessarily associated with improved perfusion of skeletal muscles.

Adrenergic beta-Agonists↗

PubMed2000

Cardiac output measured by lithium dilution, thermodilution, and transesophageal Doppler echocardiography in anesthetized horses.

OBJECTIVE: To assess the suitability of lithium dilution as a method for measuring cardiac output in anesthetized horses, compared with thermodilution and transesophageal Doppler echocardiography. ANIMALS: 6 horses (3 Thoroughbreds, 3 crossbreeds). PROCEDURE: Cardiac output was measured in 6 anesthetized horses as lithium dilution cardiac output (LiDCO), thermodilution cardiac output (TDCO), and transesophageal Doppler echocardiographic cardiac output (DopplerCO). For the LiDCO measurements, lithium chloride was administered i.v., and cardiac output was derived from the arterial lithium dilution curve. Sodium nitroprusside, phenylephrine hydrochloride, and dobutamine hydrochloride were used to alter cardiac output. Experiments were divided into 4 periods. During each period, 3 LiDCO measurements, 3 DopplerCO measurements, and 3 sets of 3 TDCO measurements were obtained. RESULTS: 70 comparisons were made between LiDCO, DopplerCO, and triplicate TDCO measurements over a range of 10 to 43 L/min. The mean (+/- SD) of the differences of LiDCO - TDCO was -0.86 +/- 2.80 L/min; LiDCO = -1.90 + 1.05 TDCO (r = 0.94). The mean of the differences of DopplerCO - TDCO was 1.82 +/- 2.67 L/min; DopplerCO = 2.36 + 0.98 TDCO (r = 0.94). The mean of the differences of LiDCO - DopplerCO was -2.68 +/- 3.01 L/min; LiDCO = -2.53 + 0.99 DopplerCO (r = 0.93). CONCLUSIONS AND CLINICAL RELEVANCE: These results indicate that lithium dilution is a suitable method for measuring cardiac output in horses. As well as being accurate, it avoids the need for pulmonary artery catheterization and is quick and safe to use. Monitoring cardiac output during anesthesia in horses may help reduce the high anesthetic mortality in this species.

Animals↗

PubMed2000

A comparison of the haemodynamic effects of isoflurane and halothane anaesthesia in horses.

The purpose of this study was to compare the haemodynamic effects of equipotent isoflurane and halothane anaesthesia. Six adult horses were investigated on two separate occasions at least 4 weeks apart. On both occasions anaesthesia was induced by ketamine 2.2 mg/kg bwt given 5 min after i.v. administration 100 microg/kg bwt romifidine. Anaesthesia was maintained either by halothane or isoflurane (end-tidal concentrations 0.9-1.0% and 1.3-1.4%, respectively). Horses were ventilated by intermittent positive pressure to maintain PaCO2 between 40-50 mmHg. Haemodynamic variables were measured using catheter-mounted strain gauge transducers in the left and right ventricle, aorta, and right atrium. Cardiac output (CO), velocity time integral (VTI), maximal aortic blood flow velocity (Vmax) and acceleration (dv/dt(max)), left ventricular pre-ejection period (PEP) and ejection time (ET) were measured from aortic blood flow velocity waveforms obtained by transoesophageal Doppler echocardiography. Flow velocity waveforms were recorded from the femoral arteries and veins using low pulse repetition frequency Doppler ultrasound. Time-averaged mean velocity (TAV), velocity of component a (TaVa), velocity of component b (TaVb) and early diastolic deceleration slope (EDDS) were measured. Pulsatility index (PI) and volumetric flow were calculated. Microvascular blood flow was measured in the left and right semimembranosus muscles by laser Doppler flowmetry. Maximal rate of rise of LV pressure (LVdp/dt(max)), CO, Vmax, dv/dt(max), ET, VTI were significantly higher at all time points during isoflurane anaesthesia compared to halothane anaesthesia. Pre-ejection period and diastolic aortic blood pressure were significantly less throughout isoflurane anaesthesia compared to halothane. Isoflurane anaesthesia was associated with significantly lower systemic vascular resistance than halothane anaesthesia. Femoral arterial and venous blood flow were significantly higher and EDDS and PI were significantly lower during isoflurane anaesthesia compared to halothane anaesthesia. In addition during both halothane and isoflurane anaesthesia, femoral arterial flow was higher and EDDS and PI lower in the left (dependent) artery compared to the right (nondependent) artery. This study supports previous work demonstrating improved left ventricular systolic function during isoflurane compared to halothane anaesthesia. This improvement was still evident after premedication with a potent-long acting alpha2-adrenoreceptor agonist, romifidine, and induction of anaesthesia with ketamine. There was also evidence of increased hindlimb blood flow during isoflurane anaesthesia. However, there were differences observed in flow between the left and right hindlimb during maintenance of anaesthesia with each agent, suggesting that there were differences in regional perfusion in anaesthetised horses caused by factors unrelated to agents administered.

Anesthetics, Inhalation↗

PubMed1998

Haemodynamic effects of a sixty minute infusion of dopamine hydrochloride in horses anaesthetised with halothane.

To describe the haemodynamic effects of a 60 min infusion of dopamine 4 microg/kg bwt/min during halothane anaesthesia, 7 mature Thoroughbred horses were studied. The infusion began 1 h after induction of anaesthesia by romifidine (100 microg/kg) and ketamine (2.2 mg/kg bwt). Throughout the period of dopamine infusion and for 30 min after its discontinuation, the horses were ventilated by intermittent positive pressure to maintain PaCO2 between 4.6-5.4 KPa. Inspired halothane concentration was adjusted to maintain an end tidal halothane concentration of 0.9%. Haemodynamic variables were measured using intracardiac strain gauge transducers sited in the left and right ventricle, aorta, and pulmonary artery. Left ventricular pressure was differentiated to obtain maximal rate of increase of intraventricular pressure (LVdp/dtmax). Transoesophageal Doppler echocardiography was performed to measure maximum aortic blood flow velocity (vmax) and acceleration (dv/dtmax), left ventricular velocity time integral (vTI) and cardiac output (CO), and left ventricular pre-ejection period (PEP) and ejection time (ET). Measurements were made during the 60 min infusion, and for 30 min after the infusion was discontinued. Infusion of dopamine 4 microg/kg/min significantly decreased mean aortic pressure, while left and right ventricular end-diastolic pressure and mean pulmonary artery pressure remained unchanged. There was a small, but significant, increase in heart rate during dopamine infusion. Maximum acceleration of aortic blood flow, CO and vTI were also significantly increased by dopamine infusion. Maximal rate of increase of intraventricular pressure (LVdp/dtmax) was significantly decreased 10 min after commencing infusion, but then returned to baseline for the remainder of the study. Left ventricular pre-ejection period (PEP) decreased during dopamine infusion whilst ejection time (ET) significantly increased. All measured variables except LVET had returned to baseline values within 30 min of discontinuing the infusion. This study demonstrated beneficial effects of dopamine infusion upon left ventricular systolic function. However, the therapeutic value of the drug is likely to be limited in clinical anaesthesia due to the simultaneous falls in arterial blood pressure which accompany its administration.

Anesthesia, Inhalation↗

PubMed1998

Temporal effects of an infusion of dobutamine hydrochloride in horses anesthetized with halothane.

OBJECTIVE: To evaluate temporal hemodynamic effects of dobutamine in horses anesthetized with halothane. ANIMALS: 8 adult Thoroughbreds. PROCEDURE: Anesthesia was induced by i.v. administration of romifidine and ketamine and maintained using halothane in oxygen. After 60 minutes, dobutamine was administered i.v. for 60 minutes at 4 micrograms/kg of body weight/min. Measurements of left ventricular function were obtained by transesophageal echocardiography and cardiac catheterization. RESULTS: Mean, systolic, diastolic, aortic, pulmonary arterial, and left and right ventricular end-diastolic and systolic pressures, maximal rate of increase of intraventricular pressure (LVdp/dtmax), maximum acceleration (dv/dtmax) and velocity (Vmax) of aortic blood flow, cardiac output, and left ventricular velocity time integral were significantly increased, whereas left ventricular pre-ejection period and ejection time significantly decreased. Cardiac output, LVdp/dtmax, Vmax, and dv/dtmax increased throughout infusion. Heart rate was significantly less after 10 minutes and significantly greater at 60 minutes than before infusion. Supraventricular tachycardia developed in 2 horses. Cardiac output, LVdp/dtmax, Vmax, dv/dtmax, left ventricular and aortic systolic pressures, and mean aortic pressure had not returned to control values 30 minutes after infusion was discontinued. CONCLUSIONS: At this dosage, dobutamine did not achieve peak effect on many hemodynamic variables within 40 minutes of commencing infusion, and effects of 60-minute infusion persisted after infusion was discontinued. CLINICAL RELEVANCE: Dobutamine has a hemodynamic profile suited to treatment of low cardiac output in anesthetized horses; however, sustained administration may be associated with supraventricular tachycardia and a protracted time to peak effect.

Anesthesia, Inhalation↗

PubMed1997

Comparison of three injectable anaesthetic techniques in pigs.

Forty-six near-adult pigs (mean age 10 months, mean weight 156 kg) were anaesthetised for laparoscopy. After intramuscular azaperone (1.0 mg/kg) and ketamine (2.5 mg/kg), 14 of the pigs received intravenous etomidate (200 micrograms/kg) and midazolam (100 micrograms/kg) and 17 were given ketamine (2 mg/kg) and midazolam (100 micrograms/kg). The other 15 pigs were anaesthetised with pentobarbitone (15 to 20 mg/kg) without pre-anaesthetic medication. The duration and adequacy of anaesthesia, recovery rate, and seven physiological variables (ECG, heart rate, indirect arterial blood pressure, respiratory rate, minute volume, mean end-tidal carbon dioxide concentration and percentage oxygen saturation of haemoglobin) were compared. Repeated injections were needed in 29 of the 46 cases. Pentobarbitone was the least satisfactory drug because although the haemodynamic variables were greater, it caused more respiratory depression and a higher overall complication rate than the other methods. Apnoea occurred in two pigs, and was fatal in one, and positive pressure ventilation with oxygen was needed in three others. Intubation conditions were poorer and the times to standing, walking and rooting were longer in the pigs anaesthetised with pentobarbitone.

Adjuvants, Anesthesia↗

PubMed1997

Measurement of cardiac output in standing horses by Doppler echocardiography and thermodilution.

Measurement of cardiac output by Doppler echocardiography were compared to simultaneous measurements by thermodilution in 9 conscious horses. In the Doppler technique, mean blood flow velocities for estimation of cardiac output were recorded from the aorta and pulmonary artery. The flow area of each vessel was calculated from the vessel diameter, measured from a 2-dimensional ultrasound image. Differences in the site and method of measuring the vessel diameter altered the estimation of cardiac output by the Doppler method. Cardiac output was modified by the i.v. infusion of 4 micrograms/kg bwt/min dopamine and 4 micrograms/kg bwt/min dobutamine and by the i.v. administration of 10 micrograms/kg bwt detomidine and 20 micrograms/kg bwt butorphanol. Doppler measurements of cardiac output correlated closely with measurement by thermodilution. Measurements from the aortic outflow correlated more closely with thermodilution, than those from the pulmonary artery (r = 0.89 and r = 0.77, respectively). Doppler measurements when the mean flow velocity was recorded from the aorta and the flow area was measured from the ascending aorta using the leading edge method. There was no significant bias between the 2 techniques when Doppler flow velocities were recorded by this method and the limits of agreement were narrow (+/- 12.26 l/min). The differences between the 2 methods increased with increasing cardiac output. Doppler echocardiography is a safe noninvasive method of measuring cardiac output in horses. The agreement between Doppler echocardiography and thermodilution in this study is similar to that reported in man and is similar to that reported between thermodilution and other techniques in man.

Analgesics↗

PubMed1997

Temporal effects of an infusion of dopexamine hydrochloride in horses anesthetized with halothane.

OBJECTIVE: To evaluate the hemodynamic effects of a 60-minute infusion of dopexamine in horses anesthetized with halothane. ANIMALS: 7 adult Thoroughbreds. PROCEDURE: Measurements of left ventricular function obtained by transesophageal Doppler echocardiography and cardiac catheterization. RESULTS: Infusion of dopexamine (4 micrograms/kg of body weight/min) significantly increased heart rate, cardiac output, maximal rates of increase and decrease of left ventricular pressure, and maximal acceleration and maximal velocity of aortic blood flow. Left ventricular ejection time significantly increased, and pre-ejection period decreased during the infusion. Cardiac output, maximal rate of increase of left ventricular pressure, and maximal acceleration continued to increase as the infusion progressed. Right ventricular end-diastolic pressure was significantly decreased after 20 minutes of infusion and decreased progressively throughout the remaining time of infusion. Many hemodynamic variables, including right ventricular end-diastolic pressure, had not returned to control values 30 minutes after the infusion was discontinued. A number of undesirable adverse effects were observed in horses receiving dopexamine infusion; during administration, profuse sweating occurred in every horse. In 6 horses, recovery from anesthesia was associated with excitement and violent shivering. Colic developed in 2 horses within 3 hours of recovery. CONCLUSIONS: Dopexamine (4 micrograms/kg/min) does not achieve a peak effect on many hemodynamic variables within a short period of commencing administration, and the effects of infusion may persist for extended periods after drug administration is discontinued. CLINICAL RELEVANCE: Dopexamine has a hemodynamic profile suited to treatment of low cardiac output in anesthetized horses; however, at the dosage rate studied (4 micrograms/kg/min), its administration was associated with a number of undesirable adverse effects which could preclude its clinical use.

Anesthetics, Inhalation↗

PubMed1996

Measurement of cardiac output by transoesophageal Doppler echocardiography in anaesthetized horses: comparison with thermodilution.

In order to determine if transoesophageal Doppler echocardiography could be used to estimate cardiac output in anaesthetized horses, we have compared the technique with estimations of cardiac output by thermodilution in eight healthy adult thoroughbreds. Measurements of aortic blood flow velocity were made by high pulse repetition frequency (HPRF) and continuous wave (CW) Doppler echocardiography from a 3.5-MHz transoesophageal probe. Cardiac output was increased during the study by administration of dobutamine, providing a range of cardiac output measurements by thermodilution from 15.0 to 64.4 liter min-1. Estimations derived from CW Doppler overestimated cardiac output compared with thermodilution (bias = 4.0 litre min-1). Estimations from HPRF Doppler echocardiography more closely reflected measurements obtained by thermodilution (bias = 0.7 litre min-1). Limits of agreement between the techniques were similar for both modes of insonation (HPRF = -7.7 to 9.1 litre min-1, CW = -4.9 to 12.8 litre min-1). There were significant differences in bias between both Doppler techniques and thermodilution for individual horses. As a result, for any individual horse, limits of agreement between the techniques were closer (HPRF = +/- 6.4 litre min-1, CW = +/- 7.6 litre min-1). We conclude that transoesophageal echocardiography provided an alternative, effective and non-invasive method for measurement of cardiac output in anaesthetized horses.

Anesthesia, General↗

PubMed1995

Pulsed wave Doppler echocardiography in normal horses.

Reference values were established for selected Doppler derived variables from a group of 40 normal Thoroughbred and Thoroughbred cross horses. Standard two-dimensional (2-D) images used for guiding the Doppler sampling site allowed accurate alignment with flow. Tricuspid inflow velocities during rapid filling (E) and atrial contraction (A) were significantly higher when recorded from a right parasternal angled view than from a right parasternal long-axis view. In 8 horses the tricuspid inflow peak A velocity was higher than the peak E velocity. The peak acceleration of blood flow was higher (P = 0.000) in the aorta (mean 8.01 m/s/s) than in the pulmonary artery (4.45 m/s/s). Significant differences were also noted in the pre-ejection period, ejection time and acceleration time between the 2 vessels. Horses with functional ejection murmurs had lower peak aortic acceleration and a longer acceleration time than horses without flow murmurs. Horses with filling murmurs over the left hemithorax had a significantly higher peak mitral E velocity than horses without such murmurs. Measurements from Doppler waveforms were repeatable and may prove useful in assessing ventricular function in this species.

Aging↗

PubMed1995

Colour flow Doppler echocardiography in normal horses.

Colour flow Doppler echocardiography is a technique that is used with two-dimensional (2-D) echocardiography to study blood flow patterns in the heart and blood vessels. This method was used to define normal flow patterns and to evaluate valvular function in 40 clinically normal Thoroughbred and Thoroughbred cross horses. Flow patterns from 10 standardised echocardiographic images were described in relation to anatomic landmarks and timing during the cardiac cycle. Consistent intracardiac flow patterns were identified in the normal horses. High velocity flow signals or regurgitant jets were recorded at the tricuspid (77.5%), mitral (67.5%), aortic (47.5%) and pulmonary valves (40%) in clinically normal horses. Most of these signals were transient, and many were associated with valve closure. This study demonstrates that colour flow Doppler echocardiography is a sensitive technique for the detection of intracardiac flow in horses. It will provide a basis by which to compare studies in horses suspected of having valvular heart disease.

Animals↗

PubMed1995

Feasibility of transoesophageal echocardiography for evaluation of left ventricular performance in anaesthetised horses.

Transoesophageal Doppler echocardiography was performed in 7 Thoroughbred horses anaesthetised with halothane. The procedure was performed on 4 occasions under standard conditions. On one occasion dobutamine hydrochloride was infused at 4 micrograms/kg/min for 20 min. Recordings of aortic blood velocity, obtained using high pulsed repetition frequency Doppler echocardiography (HPRF), were used to derive maximum acceleration (dv/dtmax), maximum velocity (Vmax), left ventricular ejection time (ET), pre-ejection period (PEP), velocity time integral (VTI) and cardiac output (CO). The coefficient of variation and 95% confidence intervals were narrower for the Doppler variables than for those obtained from cardiac catheterisation. For each horse the anaesthetic to anaesthetic repeatability of the Doppler indices of left ventricular function, exceeded that of maximum rate of rise of left ventricular pressure (LVdp/dtmax). The horse to horse variability was significant for heart rates Vmax, dv/dtmax, and VTI. After dobutamine infusion there were significant changes in all measured variables except heart rate, VTI and CO. The % change that occurred exceeded the predicted 95% confidence intervals for single measurements in all significantly affected variables. This suggests Doppler indices of cardiac performance may be useful to assess changes in haemodynamic function. Passage of the probe into the oesophagus was not associated with serious adverse effects. Mild serous nasal discharge was visible for up to 24 h after the horses recovered from anaesthesia. Mild nasal haemorrhage occurred on 5 occasions during probe insertion. It is concluded that transoesophageal Doppler echocardiography provides a minimally invasive, continuous method for monitoring left ventricular systolic performance in anaesthetised horses.

Adrenergic beta-Agonists↗

PubMed1995

Colour flow Doppler echocardiography in horses with cardiac murmurs.

Thirty-two horses with cardiac murmurs typical of tricuspid, mitral and aortic regurgitation were studied using colour flow Doppler echocardiography. The dimensions and duration of any regurgitant signals, recorded at the cardiac valve suspected as being the site of origin of the murmur, were measured. Results were compared with flow signals described at the valves of normal horses (Blissitt and Bonagura 1995). Horses with murmurs suggestive of tricuspid (n = 8) and aortic (n = 8) regurgitation showed larger regurgitant signals at the tricuspid and aortic valves respectively, than has been reported in normal horses. Horses with murmurs suggestive of mitral regurgitation (n = 8) had a regurgitant signal of longer duration than occurs in normal horses, but the jets were not larger. Comparison of two groups of horses with low and high grade murmurs of tricuspid regurgitation, showed that horses with louder murmurs had significantly longer jets of larger area than those with low grade murmurs. This study demonstrates that colour flow Doppler echocardiography is a sensitive technique for the detection of valvular regurgitation in horses. However, quantification of jet size and duration are important for distinguishing physiological backflow which occurs in normal horses (Blissitt and Bonagura 1995) from valvular regurgitation associated with cardiac murmurs.

Animals↗

PubMed1995

Echocardiography.

Echocardiography encompasses a number of specific imaging techniques. The two-dimensional (2-D) echocardiogram is used to identify lesions of the heart and great vessels, assess myocardial function and provide a template for guiding contrast echocardiography, colour-coded Doppler echocardiography and spectral Doppler studies. M-mode echocardiography is used to measure cardiac size and ventricular function and can be combined with contrast or colour-coded Doppler studies for accurate timing of flow events. Pulsed wave and continuous wave Doppler echocardiography display the direction and velocity of red blood cells within the heart and circulation. Continuous wave Doppler studies are used to calculate pressure gradients in the circulation. Any of the Doppler techniques can be used to identify abnormal or high velocity flow responsible for pathologic heart murmurs. Each Doppler format is complementary to the others: colour-coded Doppler is used to screen large areas for flow disturbances; pulsed wave Doppler can pinpoint regions of abnormal flow; and continuous wave Doppler quantifies the maximal velocities of blood flow across cardiac lesions. Echocardiographic studies are very useful for the diagnosis and assessment of horses with cardiac murmurs, arrhythmias, and poor exercise performance. A number of cardiac disorders can be evaluated by echocardiography, including: cardiac malformation, valvular heart disease, cardiomyopathy, bacterial endocarditis, pericardial effusion, and congestive heart failure. When combined with a careful clinical examination, exercise evaluation and results of electrocardiography, the echocardiogram provides the best overall clinical assessment of the equine heart.

Animals↗

PubMedDate not supplied

Measurements of hindlimb blood flow recorded using Doppler ultrasound during administration of vasoactive agents in halothane-anesthetized horses.

The purpose of the study was to determine the ability of Doppler ultrasound to detect changes in femoral blood flow during pharmacologic manipulation of arterial blood pressure. Doppler ultrasonography was performed in the femoral vessels of six halothane-anesthetized horses before and during administration of phenylephrine HCI and sodium nitroprusside. The time-averaged mean velocity and volumetric flow were calculated. The contour of the velocity waveform was assessed, and the early diastolic deceleration slope (EDDS) and pulsatility index (PI) were calculated. Administration of phenylephrine HCI resulted in increased mean aortic blood pressure (MABP) by 40% (29.3-53.0%). This caused significant decrease in cardiac output (26.8 to 13.5 l/min), femoral arterial velocity (left artery 7.20 to 4.00 cm/s; right artery 5.01 to 3.39 cm/s) and volumetric flow (left artery 556 to 221 ml/min; right artery 397 to 193 ml/min) in the femoral vessels and significant increase in systemic vascular resistance (163 to 433 dyn-s/cm5), EDDS (1a: 285 to 468: ra: 250 to 481) and PI (1a: 9.38 to 20.4; ra 17.1 to 29.1). Administration of sodium nitroprusside resulted in a decreased MABP of 27.2% (22.5-33%). This increased cardiac output (20.8 to 32.4 L/min), however, no significant changes were observed in femoral blood flow. Despite obvious changes in the waveform contour, no significant change occurred in EDDS or PI. These results suggest that Doppler ultrasound may be useful for measuring femoral blood flow in anesthetized horses. However, waveform analysis appears to be limited when multiple changes occur in central and peripheral haemodynamics.

Anesthetics, Inhalation↗