Assessment and treatment of perfusion abnormalities in the emergency patient

Boag, A. K.; Hughes, Dez

doi:10.1016/j.cvsm.2004.10.010

Cited by 57 publications

(92 citation statements)

References 97 publications

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“…16,17 Additionally, there were 10 hyperlactatemic cats in the study that were included in the no shock category because they were classified as having normal perfusion and had SAP > 90 mm Hg. It should be noted that there was overlap in lactate concentrations among cats in the no shock, mild to moderate shock, and severe shock categories.…”

Section: Discussionmentioning

confidence: 99%

“…In conditions of poor tissue perfusion where there is inadequate oxygen delivery, cells switch from aerobic to anaerobic metabolism for cellular energy production, leading to increased production of lactate. 16 In a recent study 17 evaluating the use of shock index (where shock index = heart rate divided by SAP), dogs with hemorrhage were assigned to shock categories according to severity (level 1 [no shock] to 4 [severe shock]). 6 In conditions of circulatory dysfunction, prolonged hyperlactatemia may occur because the liver becomes a net producer of lactate and clearance of lactate is impaired as well.…”

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confidence: 99%

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Association of blood lactate concentration with physical perfusion variables, blood pressure, and outcome for cats treated at an emergency service

Reineke¹,

Rees²,

Drobatz³

2015

javma

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Association of blood lactate concentration with physical perfusion variables, blood pressure, and outcome for cats treated at an emergency service

Reineke¹,

Rees²,

Drobatz³

2015

javma

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“…However, there is a lack of experimental research and clinical trials concerning the optimal resuscitation strategy for hemorrhagic shock specifically relating to veterinary clinical patients [3,9].…”

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confidence: 99%

Vasopressor Therapy Using Vasopressin Prior to Crystalloid Resuscitation in Irreversible Hemorrhagic Shock under Isoflurane Anesthesia in Dogs

Yoo

Kim

Eom

et al. 2007

The Journal of Veterinary Medical Science

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ABSTRACT. In the present study, we tested the hypothesis that vasopressin administration prior to crystalloid resuscitation can be used to improve hemodynamic and oxygen delivery functions. Hemorrhagic shock was experimentally induced by maintaining mean arterial pressure at 60 mmHg for 30 min in sixteen healthy dogs weighing from 8 to 10.6 kg. Vasopressin was administered and then volume resuscitation was performed for the 6 dogs of V-C group, while vasopressin was administered at the end of volume resuscitation in the 5 dogs of C-V group. The control group (n=5) was administered 0.4 IU/kg of vasopressin after induction of shock without fluid resuscitation. In all groups, hemodynamic parameters were measured pre-and post-hemorrhage and for 60 min after fluid resuscitation. The dogs in V-C group had substantially increased systolic arterial pressure (SAP) for 60 min and improved pulmonary capillary wedge pressure (PCWP), cardiac output (CO), oxygen delivery, and oxygen consumption indexes compared with C-V and control groups. Diastolic pressure and systemic vascular resistance was significantly lower in the V-C group than those in the C-V and control groups (P<0.05). In the V-C group, there was effective and rapid restoration of the SAP, CO, PCWP, and oxygen delivery parameters after treatment. This study indicates that vasopressin administration before crystalloid resuscitation is a more efficient way of improving hemodynamic and oxygen delivery functions in hemorrhagic shock in dogs.

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“…Valendo ressaltar que para uma avaliação consistente, não é necessário a presença de aparelhos de multiparâmetros modernos e caros, mas apenas uma avaliação física minuciosa de todos os parâmetros clínicos (BOAG;HUGHES, 2005). Segundo Conti-Patara (2009), devemos nos basear na monitoração da frequência cardíaca, pressão arterial, saturação de oxigênio periférica, frequência respiratória, temperatura corpórea, gasometria arterial e venosa central nos casos de pacientes graves ou sépticos.…”

Section: Monitoramento E Reposição Volêmicaunclassified

Reposição Volêmica em cães portadores de sepse grave: Revisão de Literatura

et al. 2013

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RESUMO:A água por ser um componente vital para todas as formas de vida torna-se uma ferramenta importante na terapia de várias afecções. A utilização da reposição volêmica visa restabelecer as perdas hidroeletrolíticas e a homeostase do organismo. Quando pacientes apresentam-se no quadro de sepse grave, uma síndrome complexa de caráter emergencial há a presença da instabilidade hemodinâmica levando ao quadro de hipoperfusão e hipóxia tecidual, podendo evoluir para a disfunção múltipla de órgãos. Contudo, um exame físico minucioso associado ao diagnóstico precoce e a realização da terapia de reposição volêmica, podem reduzir a alta taxa de mortalidade destes pacientes, sendo este um desafio para o médico veterinário. Com isso, buscou-se realizar uma atualização bibliográfica, destacando as principais definições, classificações, fisiopatogenia, sinais clínicos e causas de sepse grave, enfatizando a necessidade de terapia e protocolos de reposição volêmica neste contexto, bem como a importância do monitoramento clínico dos pacientes.Palavras-chave: Sepse. Volemia. Fluidoterapia. Cães. SUMMARY:The water to be a vital component in all forms of life becomes an important tool in the therapy of various disorders. The use of volume replacement aims to restore losses and electrolyte homeostasis. When patients are under severe sepsis, a syndrome of emergency, there is the presence of hemodynamic instability leading to the picture of hypoperfusion and tissue hypoxia, which may progress to multiple organ dysfunction. However, a thorough physical examination associated with early diagnosis and the realization of fluid replacement therapy, may reduce the high mortality rate of these patients, which is a challenge for the veterinarian. Therefore, we attempted to perform an updated, highlighting key definitions, classifications, pathophysiology, clinical signs and causes of severe sepsis, emphasizing the need for therapy and fluid resuscitation protocols in this context, as well as the importance of monitoring patients' clinical. Keywords:Sepsis. Blood volume. Fluid therapy. Dogs . INTRODUÇÃOA água é um componente fundamental para a homeostase orgânica, na qual estão disseminadas substâncias coloidais de grande complexidade (HOUPT, 1996). Para a manutenção e controle de sua composição, são necessários que os líquidos corporais banhem as células e os tecidos, auxiliando no desempenho de funções específicas como oxigenação e nutrição hidroeletrolítica celular HALL, 2002). A fluidoterapia, um procedimento clínico utilizado na rotina médica veterinária, tem por objetivo restaurar o volume, composição e a manutenção dos fluidos corporais, de modo que o ganho se iguale às perdas. Atualmente, há uma grande variedade de fluidos à disposição dos clínicos, como também suas recomendações necessárias, indicações, dosagem, velocidade de infusão e vias de administrações mais adequadas (SENIOR, 1997).

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Assessment and treatment of perfusion abnormalities in the emergency patient

Cited by 57 publications

References 97 publications

Association of blood lactate concentration with physical perfusion variables, blood pressure, and outcome for cats treated at an emergency service

Association of blood lactate concentration with physical perfusion variables, blood pressure, and outcome for cats treated at an emergency service

Vasopressor Therapy Using Vasopressin Prior to Crystalloid Resuscitation in Irreversible Hemorrhagic Shock under Isoflurane Anesthesia in Dogs

Reposição Volêmica em cães portadores de sepse grave: Revisão de Literatura

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