The use of electrical impedance tomography (EIT) to evaluate pulse rate in anaesthetised horses

Electrical impedance tomography (EIT) provides clinically useful lung images; however, it would be an advantage to extract additional cardiovascular information from the data. The aim of this study was to evaluate if cardiac-related changes measured by EIT can be used to measure pulse rate (PR) under physiological as well as high and low blood pressure states in anaesthetised horses. Electrical impedance tomography data and PR from seven horses anaesthetised in dorsal recumbency were recorded over 1 min during mechanical ventilation and 1 min of apnoea. Data were collected at four measurement time points; before and during intravenous administration of nitroprusside and phenylephrine, respectively. Nine pixels, estimated to represent the heart, were chosen from the EIT image. A novel algorithm detected peaks of impedance change for these pixels over 10 s intervals. Concurrent PR measured using an invasive blood pressure trace, was recorded every 10 s. EIT- and pulse-rate data were compared using Bland-Altman assessment for multiple measurements on each horse. Overall, 288 paired datasets from six of seven horses were available for analysis. There was excellent agreement for baseline measurements, as well as during hypertension and hypotension, with a bias of -0.26 and lower and upper limit of agreement at -2.22 (95% confidence intervals [CI], -2.89 to -1.86) and 1.69 (95% CI, 1.34-2.36) beats per min, respectively. EIT can be used to evaluate PR using cardiac-related impedance changes. More work is required to determine bias that might occur in anaesthetised horses in other recumbencies or clinical situations.