Equine echocardiography: Can dobutamine infusion correct alterations due to sedation with alpha-2 agonists?
Authors: Vitale Valentina, Vezzosi Tommaso, Di Franco Chiara, Briganti Angela, Tognetti Rosalba, Conte Giuseppe, Bucchioni Elena, Sgorbini Micaela
Journal: PloS one
Summary
# Editorial Summary: Dobutamine Cannot Reverse Sedation-Induced Cardiac Changes in Horses Echocardiography in equine practice presents a challenge: whilst sedation may be necessary for anxious horses to tolerate examination and produce diagnostic-quality images, alpha-2 agonists like romifidine significantly alter cardiac dimensions and contractile indices, potentially confounding clinical interpretation. Vitale and colleagues investigated whether concurrent dobutamine infusion could pharmacologically counteract these sedation-induced changes by conducting three separate echocardiographic examinations on 12 healthy Standardbred mares—unsedated, sedated with romifidine alone, and sedated with romifidine plus dobutamine infusion—with blinded offline analysis of left ventricular measurements. Dobutamine infusion failed to normalise the key alterations: left ventricular internal diameter in diastole, left ventricular free wall thickness in systole, and fractional shortening all remained significantly reduced in the sedated groups compared to unsedated baseline, with no meaningful difference between romifidine-only and romifidine-plus-dobutamine protocols. Clinicians requiring sedation for difficult cases should recognise that these cardiac measurements cannot be reliably interpreted as representative of the horse's true cardiovascular status, and any dosing decisions or prognostic assessments based on echocardiographic findings obtained under sedation may be misleading until the horse can be re-examined in an unsedated state.
Read the full abstract on PubMed
Practical Takeaways
- •If sedation is necessary for echocardiography in uncooperative horses, expect that cardiac measurements will be altered regardless of whether dobutamine is used—plan accordingly and document the sedation used when reporting results
- •Dobutamine infusion should not be relied upon to normalize cardiac parameters in sedated horses, so it offers no practical advantage for improving diagnostic accuracy of echocardiographic examinations
- •Consider the necessity of sedation carefully, as unsedated baseline measurements are more representative of true cardiac function; use alternatives like patience, training, or physical restraint when possible
Key Findings
- •Romifidine sedation significantly reduced left ventricular internal diameter in diastole, left ventricular free wall in systole, and fractional shortening compared to unsedated baseline measurements
- •Concurrent dobutamine infusion did not counteract or reverse the cardiovascular alterations induced by romifidine sedation
- •Dobutamine co-infusion produced similar echocardiographic measurements to romifidine alone, suggesting no additive benefit for correcting sedation-induced changes