Association between computed tomographic thoracic injury scores and blood gas and acid–base balance in dogs with blunt thoracic trauma

Abstract

Objective To determine the association between thoracic injuries evaluated by computed tomography (CT) and arterial blood gas and acid–base status in dogs with blunt thoracic trauma caused by motor vehicle accidents. Design Prospective observational clinical study. Setting University teaching hospital. Animals Thirty‐one client owned traumatized dogs and 15 healthy dogs. Procedures All trauma group dogs underwent a CT scan and simultaneous arterial blood gas analysis within 24 hours, but not before 4 hours, after the traumatic incident within a 45‐month enrollment period. Measurements and Main Results Thorax injuries were classified as pulmonary, pleural space, or rib cage and each of these components was scored for severity using a CT composite pulmonary, pleural, and rib score. The trauma group arterial blood gas and acid–base status were evaluated for statistical difference from the control group. The pulmonary–arterial oxygen pressure was significantly lower in the trauma group compared to the control group that was supported by significant differences in the calculated variables of arterial blood oxygenation as well. There was also a significant correlation between the composite lung score and pleural score and the variables of arterial oxygen status. The pulmonary–arterial carbon dioxide pressure was not significantly different to any of the thoracic injury variables indicating normal alveolar ventilation. Acid–base imbalances were generally mild, insignificant, and variable. Conclusions and Clinical Relevance Blunt thoracic trauma causes significant pulmonary and pleural injury and the blood oxygen economy is significantly affected by this. The functional measures of arterial blood oxygenation were well correlated with thoracic CT pathology. Alveolar ventilation was mostly spared but a clinically significant ventilation perfusion mismatch was present.

CT findings and the prognostic value of the Koret CT score in cats with traumatic brain injury

“…In recent years, CT has become increasingly used as a diagnostic tool for assessing traumatic injuries in veterinary medicine. [17][18][19] While CT scans require sedation in most patients, the use of head and whole body CT scanning following traumatic injuries provides detailed anatomical information at high resolution in a relatively short time. This wealth of cross-sectional data allows for accurate diagnosis and assists in treatment planning, including surgery.…”

Surgical correction of a persistent right aortic arch in a kitten with concurrent mitral and tricuspid valve insufficiency and long‐term post‐operative management of residual megaoesophagus

“…Cats with constricting VRAs are also at high risk for suffering from concurrent aspiration pneumonia, and patients should be carefully evaluated for any signs of respiratory compromise 8–11,13,17,23,28 . Arterial blood gas analysis is very sensitive in detecting pulmonary pathology and it may be wise to perform arterial blood gas on all patients prior to general anaesthesia when there are any clinical signs of respiratory compromise even in the light of normal diagnostic imaging findings 40 …”

Radiography is less sensitive relative to CT for detecting thoracic radiographic changes in dogs affected by blunt trauma secondary to a motor vehicle accident

“…This was multiplied again by the percentage the lobe made up of the total aeration volume of the lung . The totals of the seven lobes were added together to give a composite pulmonary trauma index that represented a semi‐objective estimation of the total degree of lung lobe contusion or collapse …”

“…A total radiologic lung contusion score, adapted from a previous human study and two other veterinary thoracic trauma studies, was calculated by grading the severity and extent of lung contusions and then determining the fractional contribution of that lung lobe to the overall lung capacity in canines . Severity scores were assigned as mild (1) when only an interstitial lung pattern was present, moderate (2) if there was an interstitial to early alveolar lung pattern, or severe (3) if there was an advanced alveolar lung pattern present.…”

“…11 The totals of the seven lobes were added together to give a composite pulmonary trauma index that represented a semi-objective estimation of the total degree of lung lobe contusion or collapse. 12 Digital radiographs were acquired for all included dogs using a standardized protocol (Apelum Baccara 90/20, Italy) using a Fuji CR con- A total radiologic lung contusion score, adapted from a previous human study and two other veterinary thoracic trauma studies, was calculated by grading the severity and extent of lung contusions and then determining the fractional contribution of that lung lobe to the overall lung capacity in canines. 1,[11][12][13][14] Severity scores were assigned as mild (1) when only an interstitial lung pattern was present, moderate (2) if there was an interstitial to early alveolar lung pattern, or severe (3) if there was an advanced alveolar lung pattern present.…”