Classification of Septic Shock Phenotypes Based on the Presence of Hypotension and Hyperlactatemia in Cats

Troìa, Roberta; Buzzurra, Francesca; Ciuffoli, Elena; Mascalzoni, Giulia; Foglia, Armando; Magagnoli, Ilaria; Dondi, Francesco; Giunti, Massimo

doi:10.3389/fvets.2021.692528

Cited by 7 publications

(6 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2013) and recently described in cats (Troia et al . 2021). Although not yet studied in dogs, this subclassification of shock phenotypes could explain the normal blood lactate we found in 12 dogs with clinical signs consistent with circulatory shock.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Ultrasonographic measurement of caudal vena cava to aorta ratio during fluid resuscitation of dogs with spontaneous circulatory shock

Combet-curt

Pouzot‐Nevoret

Cambournac

et al. 2023

J of Small Animal Practice

View full text Add to dashboard Cite

ObjectivesTo describe the change in the caudal vena cava to aorta ratio (CVC:Ao) ratio during fluid resuscitation of circulatory shock in dogs and compare these results with those of the physical examination and blood lactate.Materials and MethodsPerfusion parameters and blood lactate were recorded at admission. An abdominal point‐of‐care ultrasound protocol was performed, during which the caudal vena cava to aorta ratio was measured on the spleno‐renal view. Measurements were performed within 5 minutes before and after a 10 mL/kg crystalloid fluid bolus. Investigators were not blinded to therapeutic interventions.ResultsTwenty‐nine dogs with physical signs of circulatory shock were enrolled. Caudal vena cava to aorta ratios were below reference interval in 28 of 29 dogs. After bolus administration, median caudal vena cava diameter increased by 0.14 cm (0.69 to 0.83 cm) and median aorta diameter increased by 0.03 cm (0.87 to 0.90 cm) and caudal vena cava to aorta ratio returned to within reference range in 65% of dogs (13/29). Bolus administration was associated with an increase in median caudal vena cava to aorta ratio of 0.10 (95% CI=0.05 to 0.16, P=0.0005). Blood lactate did not change significantly. Heart rate and capillary refill time decreased significantly after fluid bolus (heart rate: estimate=−19 bpm, 95% CI=−30 to −8, P=0.002; capillary refill time: estimate=−1.0 s, 95% CI=−1.3 to −0.7, P < 0.0001).Clinical SignificanceIn this population of dogs with circulatory shock, the caudal vena cava to aorta ratio significantly increased after a fluid bolus. Future studies that implement blinding of the outcome assessors are warranted to confirm these findings.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Finally, subclassification of different phenotypes of shock was not performed in this study. The vasoplegic shock phenotype, defined as hypotension with normal blood lactate, and cryptic shock, defined as hyperlactataemia alone, are well recognised in humans (Ranzani et al 2013) and recently described in cats (Troia et al 2021).…”

Section: Discussionmentioning

confidence: 99%

Ultrasonographic measurement of caudal vena cava to aorta ratio during fluid resuscitation of dogs with spontaneous circulatory shock

Combet-curt

Pouzot‐Nevoret

Cambournac

et al. 2023

J of Small Animal Practice

View full text Add to dashboard Cite

show abstract

“…Acute cardiopulmonary arrest in tetanus patients may be the consequence of respiratory muscle paralysis and/or cardiac dysrhythmias. Nevertheless, it is also important to consider that the outcome in cats with vasoplegic shock compared to the other two phenotypes of septic shock (cryptic and dysoxic) is worse, with a reported mortality rate of 91% ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

Case report: A severe case of generalized tetanus in a young cat

Zilli,

Häußler,

Ives

et al. 2023

Front. Vet. Sci.

View full text Add to dashboard Cite

A 10-month-old, 3 kg, female spayed Domestic Shorthair cat was presented with a chronic, infected wound at the level of the proximo-lateral left pelvic limb. General physical examination revealed a weight-bearing lameness of the left pelvic limb, which was moderately and circumferentially swollen and edematous proximal to the tarsal joint. On the lateral aspect of the proximal thigh, there was a chronic wound of 1 cm in diameter and an additional exudative skin lesion was present throughout the whole length of the caudo-lateral thigh. Complete blood count and serum biochemistry profile revealed mild anemia, increased serum amyloid A, hyponatraemia, hypochloraemia, hypocalcaemia, hyperkalaemia, hypermagnesaemia, hyperglycaemia, increased creatine kinase, and increased liver parameters. Surgical exploration of the wound was performed, and necrotizing fasciitis was suspected. The affected limb was amputated and swabs for bacterial culture were taken from both the skin lesions and surgical site before wound closure. One day after surgery, mild muscular contractions on the forehead and an increased muscle tone of the right pelvic limb were evident. One day later, the cat developed a generalized increase in extensor tone, with intermittent opisthotonos, resulting in lateral recumbency. Based on these clinical signs, a diagnosis of generalized tetanus was made and treatment with midazolam, methocarbamol, and metronidazole was started. Despite an improvement of all blood parameters, the cat progressively deteriorated and 4 days after surgery, it developed episodes of tetanic convulsions, associated with hyperthermia and ventricular arrhythmias. Despite intensive care and medical management, the cat died following a cardio-respiratory arrest 3 days later. This case report describes a rare case of severe generalized tetanus in a young cat.

show abstract

“…Blood pressure is only an indirect marker of perfusion, and hyperlactatemia may arise in patients with blood pressures within the reference range, although hyperlactatemia was shown to be related to lower ABP [ 13 , 14 ]. Patients presenting both hypotension and hyperlactatemia have higher illness severity scores and lower survival rates [ 13 , 15 , 16 ]. Hyperlactatemia is typically observed in cases of acute circulatory failure, and numerous studies in different critically ill patient populations have demonstrated the prognostic value of lactate levels [ 17 , 18 , 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Blood Lactate, Heart Rate, Blood Pressure, and Shock Index, and Their Association with Prognosis in Calves

Casalta,

Bayrou,

Djebala

et al. 2024

Veterinary Sciences

View full text Add to dashboard Cite

Diseases in young calves received as emergencies are often associated with hypovolemic and/or septic shocks. The objectives of our study were to (1) assess the correlation between clinical hemodynamic parameters and blood L-lactates (LAC), systolic blood pressure (SBP), and the shock index (SI) recorded upon arrival; and (2) to evaluate how these parameters were related to short-term outcomes in calves under 4 months of age presented as emergencies. We conducted a single-observer prospective observational study on calves aged from 1 day to 4 months, presented to the Veterinary Clinic for Ruminants of Liège from December 2020 to May 2022. Forty-five calves were included in the study. The statistical analysis revealed a significant correlation between LAC and heart rate (r = 0.570; p < 0.05) and LAC and SI (r = 0.373; p < 0.05). A high LAC value at admission was significantly associated with a negative outcome (death) (p < 0.05). In calves suffering from obstructive digestive diseases, the SI was related to the outcome and the analysis indicated a cut-off value of 1.13 (Se = 0.77, Spe = 1). In conclusion, in our study, the initial blood L-lactate value was correlated with heart rate, the shock index, and the clinical shock score, and admission hyperlactatemia was associated with a poor prognosis in calves under 4 months of age. In this cohort, the shock index in calves suffering from digestive diseases was linked with mortality.

show abstract

Classification of Septic Shock Phenotypes Based on the Presence of Hypotension and Hyperlactatemia in Cats

Cited by 7 publications

References 28 publications

Ultrasonographic measurement of caudal vena cava to aorta ratio during fluid resuscitation of dogs with spontaneous circulatory shock

Ultrasonographic measurement of caudal vena cava to aorta ratio during fluid resuscitation of dogs with spontaneous circulatory shock

Case report: A severe case of generalized tetanus in a young cat

Evaluation of Blood Lactate, Heart Rate, Blood Pressure, and Shock Index, and Their Association with Prognosis in Calves

Contact Info

Product

Resources

About