Changes in tissue perfusion parameters in dogs with severe sepsis/septic shock in response to goal‐directed hemodynamic optimization at admission to ICU and the relation to outcome

Conti-Patara, Andreza; Caldeira, Juliana de Araújo; Mattos-Junior, Ewaldo; Carvalho, Haley da Silva de; Reinoldes, Adriane; Pedron, Bruno Gregnanin; Patara, Marcelo; Talib, Mariana Semião Francisco; Faustino, Marcelo; Oliveira, Clair Motos de; Cortopassi, Silvia Renata Gaído

doi:10.1111/j.1476-4431.2012.00769.x

Cited by 93 publications

(109 citation statements)

References 36 publications

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“…1 Bloodwork parameters such as lactate levels and central venous oxygen saturation, when available, can be serially monitored to ensure improvement with fluid therapy. 7 Regardless, both human and veterinary medicine prioritize the use of fluid therapy for the rapid treatment of shock. This is because there is growing evidence to suggest that normalization of conventional macrohemodynamic parameters does not necessarily reflect improved oxygen delivery and perfusion at the tissue level.…”

Section: Resuscitation Endpoints and Monitoringmentioning

confidence: 99%

Shock Fluids and Fluid Challenge

Balakrishnan¹,

Silverstein²

2015

Small Animal Critical Care Medicine

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Section: Resuscitation Endpoints and Monitoringmentioning

confidence: 99%

Shock Fluids and Fluid Challenge

Balakrishnan¹,

Silverstein²

2015

Small Animal Critical Care Medicine

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“…Dogs are currently recognized as a more suitable animal species than rodents for studying the development of sepsis (Otto, 2007), and natural sepsis models are highly physiologically relevant. The canine disease pyometra, caused by an opportunistic bacterial infection of the uterus (Hagman et al, 2006b), leads to sepsis in nearly 60% of the cases (Fransson et al, 2007) and is therefore a relevant natural model of sepsis (Conti-Patara et al, 2012). The findings obtained using this model may be important for both human and veterinary medicine.…”

Section: Introductionmentioning

confidence: 99%

Increased concentrations of C-reactive protein but not high-mobility group box 1 in dogs with naturally occurring sepsis

Karlsson

Wernersson

Ambrosen

et al. 2013

Veterinary Immunology and Immunopathology

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Sepsis is difficult to diagnose and remains a common mortality cause worldwide in both humans and animals. The uterine infection pyometra causes sepsis in more than half of affected dogs and therefore allows the natural physiological development of sepsis to be studied. To find a sepsis-specific biochemical marker that could be combined with conventional clinical criteria for a more robust and quick diagnosis of sepsis, we measured systemic concentrations of high-mobility group box 1 (HMGB1) in 23 healthy control dogs and in 27 dogs with pyometra, 74% of which had sepsis.We also measured concentrations of the major acute phase protein C-reactive protein (CRP) and an indicator for endotoxaemia, prostaglandin F 2α metabolite (PGM) to assess the relative contribution of HMGB1 to the detection of systemic inflammation and endotoxaemia. We found that HMGB1 concentrations, in line with concentrations of CRP and PGM, were significantly increased in dogs with pyometra, and that concentrations of CRP, but not HMGB1, were significantly higher in dogs with sepsis compared to dogs without sepsis. Although serum HMGB1 did not differ between dogs with or without sepsis and was not correlated with either CRP or PGM concentrations, HMGB1 was correlated with the total white blood cell counts, suggesting an independent regulation and involvement in inflammation.

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“…A PvmO 2 diminui 20% no GMF e 25% no GCM, levando a diminuição da SvmO 2 em 14% no GCM e em 15% no GCM, em relação ao basal (79,6±2,6% no GMF e 81,2±2,7% no GCM) devido ao aumento da TEO 2 , que ocorreu em ambos os grupos (Haskins, 2006). Taxas de SvmO 2 acima de 74% têm sido associadas com melhor prognóstico em pacientes críticos (Conti-patara et al, 2012), porém a diminuição da taxa metabólica e de VO 2 promoveu adequação da necessidade fisiológica, não provocando hipoxemia. As médias do HCO 3 -no momento basal (24,5±1,4 no GMF e 24,7±2,8 no GCM) permaneceram levemente acima dos valores preconizados para a espécie, de 20 a 23 mEq/L (Ha et al, 2013), possivelmente devido à tentativa de tamponar a leve acidemia observada pela diminuição do pH nesse momento.…”

Section: Resultsunclassified

Avaliação metabólica e hemodinâmica de dois protocolos de sedação prolongada em cães

Regalin

Gehrcke

Comassetto

et al. 2017

Arq. Bras. Med. Vet. Zootec.

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RESUMOObjetivou-se determinar a viabilidade de dois protocolos de sedação para ventilação prolongada em cães e seus efeitos hemodinâmicos e metabólicos. Doze cães, alocados aleatoriamente em dois grupos (n=6), receberam infusão contínua de midazolam (0,5mg/kg/h), fentanil (10µg/kg/h) e propofol (18mg/kg/h) no GMF ou cetamina (0,6mg/kg/h), morfina (0,26mg/kg/h) e propofol (18mg/kg/h) no GCM, durante 24 horas. Os cães foram ventilados mecanicamente com FiO 2 de 40%, mantendo-se a normocapnia. A FC diminuiu 32% no GMF e 34% no GCM ao longo do tempo, reduzindo o IC em 24% no GMF e em 29% no GCM. A CaO 2 , o CvmO 2 , a DO 2 e o VO 2 diminuíram no GCM (5%, 16%, 31% e 7%) e no GMF (4%, 19%, 26% e 15%), respectivamente. A TEO 2 aumentou 32% no GMF e 36% no GCM, sem diferenças entre grupos, porém a calorimetria indireta demonstrou diminuição do VO 2 , minimizando a redução da DO 2 . Não houve diferença entre os tempos para extubação, deambulação e recuperação total, com médias globais (minutos) de 33,8±15,9, 134,8±60,7 e 208±77,5, respectivamente. Conclui-se que ambos os protocolos permitiram a ventilação mecânica, com redução do IC e da DO 2 , porém sem prejuízos hemodinâmicos e metabólicos, podendo ser utilizados com segurança em cães hígidos.Palavras-chave: ventilação mecânica, propofol, cetamina, midazolam, opioides GMF and 34% in GCM during infusion time reducing CI in 24% at GMF and 29% at GCM. CaO GCM (5%, 16%, 31% and 7% respectively) and GMF (4%, 19%, 26% and 15% respectively). Extraction ratio increased 32% in GMF and 36% in GCM without differences between groups; however, decreased VO 2 , evaluated for indirect calorimetry, suggests minimization of DO 2 reduction. No differences between time to extubation, sternal recumbency and total recovery time were observed between groups, with an average of 33,8±15,9, 134,8±60,7 e 208±77,5 ABSTRACT We aimed to determine the hemodynamic and metabolic parameters of two sedative protocols for long-term ventilation in dogs. Twelve dogs, were randomly allocated in two groups (n=6) who received constant rate infusion (CRI) of midazolam (0,5mg/kg/h), fentanyl (10µg/kg/h) and propofol (18mg/kg/h) in GMF or ketamine (0,6 mg/kg/h), morphine (0,26mg/kg/h) and propofol (18mg/kg/h) in GCM, during 24 hours. The dogs were mechanically ventilated to normocapnia with FiO 2 of 40%. Heart rate decreased 32% in

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Changes in tissue perfusion parameters in dogs with severe sepsis/septic shock in response to goal‐directed hemodynamic optimization at admission to ICU and the relation to outcome

Abstract: Our study suggests that ScvO(2) and base deficit are useful in predicting the prognosis of dogs with severe sepsis and septic shock; animals with a higher ScvO(2) and lower base deficit at admission to the ICU have a lower probability of death.

Cited by 93 publications

References 36 publications

Shock Fluids and Fluid Challenge

Shock Fluids and Fluid Challenge

Increased concentrations of C-reactive protein but not high-mobility group box 1 in dogs with naturally occurring sepsis

Avaliação metabólica e hemodinâmica de dois protocolos de sedação prolongada em cães

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