Dose-dependent effects of isoflurane and dobutamine on cardiovascular function in dogs with experimental mitral regurgitation

Goya, Seijirow; Wada, Tomoki; Shimada, Kazumi; Hirao, Daiki; Tanaka, Ryou

doi:10.1016/j.vaa.2018.03.010

Cited by 14 publications

(14 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…this study was to investigate the utility of EV-based SVV for predicting fluid responsiveness in dogs with PH secondary to MMVD undergoing emergency abdominal surgery. In this study, fluid challenge was performed in the presence of inotropic support with dobutamine to ameliorate the 'false-positive' effect of SVV elevation attributable to PH in lowering afterload [22,23].…”

Section: Plos Onementioning

confidence: 99%

Noninvasive assessment of fluid responsiveness for emergency abdominal surgery in dogs with pulmonary hypertension: Insights into high-risk companion animal anesthesia

2020

View full text Add to dashboard Cite

Objective Optimizing cardiac stroke volume during high-risk surgical anesthesia is of particular interest with regard to a therapeutic target to reduce the incidence of postoperative complications. However, intensive fluid management in critically ill small animals with pulmonary hypertension (PH) has been empirically performed, and thus it can be challenging. Stroke volume variation (SVV) has been used as a dynamic preload predictor of fluid responsiveness. We hypothesized that if SVV exhibited robust reliability in the setting of hemodynamically unstable condition, it would provide more precise information on fluid resuscitation to translate it into veterinary anesthesia. Thus the aim of this study was to investigate the utility of SVV measured by the electrical velocimetry (EV) method for predicting fluid responsiveness in dogs with PH. Methods Sixteen dogs undergoing emergency abdominal surgery and diagnosed with PH secondary to myxomatous mitral valve disease (MMVD) on preoperative transthoracic echocardiogram were included. Dogs were randomly assigned to 2 groups with and without inotropic cardiac support with dobutamine. Hemodynamic measurements including stroke volume and SVV derived from the EV device were performed under general anesthesia before (baseline) and after surgery (fluid challenge with a colloid solution defined by a SV increase of ≥ 10%). Results In both groups, SVV elevated significantly after abdominal surgery compared with baseline. In dobutamine infused group, the SVV values decreased significantly after fluid challenge ( P < 0.05) with a greater number of responders than saline infused control group ( P < 0.01). Receiver operating curve analysis of SVV confirmed high positive predictive value for dogs during dobutamine infusion ( P < 0.05; cut-off value of 15%; specificity 90%, sensitivity 82%). Conclusions Noninvasive EV monitoring may be useful for the prediction of fluid responsiveness in critically ill dogs with left-sided heart failure-related PH. This normalization of dynamic preload indices, which could be achieved more precisely under inotropic support, may prevent further detrimental consequence of fluid loading.

show abstract

Section: Plos Onementioning

confidence: 99%

Noninvasive assessment of fluid responsiveness for emergency abdominal surgery in dogs with pulmonary hypertension: Insights into high-risk companion animal anesthesia

2020

View full text Add to dashboard Cite

show abstract

“…Echocardiography has been used previously in animals and humans to assess the effects of various drugs on cardiac function [17][18][19][20]. Several echocardiographic methods can be used for hemodynamic monitoring [17,21] and its main advantage is the safety of its noninvasive approach.…”

Section: Discussionmentioning

confidence: 99%

Conventional Echocardiography and Two-Dimensional Speckle Tracking in Healthy Sevoflurane-Anesthetized Dogs Undergoing Continuous Rate Infusion of Nalbuphine

Marques

Siqueira

et al. 2020

Veterinary Medicine International

View full text Add to dashboard Cite

Nalbuphine is an agonist-antagonist opioid with adequate analgesic properties and few depressant effects on the respiratory system. However, there are no detailed reports available on cardiovascular effects of nalbuphine in dogs. The aim of this study was to assess the effects of a continuous rate infusion (CRI) of nalbuphine on left ventricular systolic and diastolic function of healthy sevoflurane-anesthetized dogs. Eighteen mixed-breed bitches aged 1–4 years and weighing 9.9 ± 3.8 kg were used. Dogs were randomly assigned to one of two groups: nalbuphine (GN, n = 9) and control (GC, n = 9). Anesthesia was induced and maintained with sevoflurane (2V%) followed by an intravenous (IV) bolus of nalbuphine (0.3 mg/kg) or 0.9% NaCl at equal volume and then CRI of nalbuphine (0.4 mg/kg/h) or 0.9% NaCl at an equal infusion rate. Echocardiographic and hemodynamic variables were determined at baseline and 20, 40, 60, and 80 minutes following start of CRI. No differences were found between groups for left ventricular systolic and diastolic variables obtained through conventional echocardiography and two-dimensional speckle tracking. Likewise, hemodynamic variables did not differ between groups. The E′/A′ ratio significantly increased at 20 minutes compared to baseline only in GN. Nalbuphine given at a CRI does not influence left ventricular systolic and diastolic function in healthy sevoflurane-anesthetized dogs.

show abstract

“…Considering the diagnosed reduction in myocardial contractility with severe ventricular dysfunction, together with the likely further reduction produced by sevoflurane in the present case, the administration of dobutamine was considered from the beginning of the anesthesia. Dobutamine has dose-dependent positive inotropic effects and may increase blood pressure without affecting left atrial pressure or afterload (Goya et al ., 2018). This drug increases arterial pressure and enhances myocardial contractility in isoflurane-anesthetized dogs with surgically induced mitral insufficiency (Goya et al ., 2018).…”

Section: Discussionmentioning

confidence: 99%

“…Dobutamine has dose-dependent positive inotropic effects and may increase blood pressure without affecting left atrial pressure or afterload (Goya et al ., 2018). This drug increases arterial pressure and enhances myocardial contractility in isoflurane-anesthetized dogs with surgically induced mitral insufficiency (Goya et al ., 2018). Thus, the inotropic effect counteracted the cardiovascular effect without increasing afterload.…”

Section: Discussionmentioning

confidence: 99%

Anesthetic management of a dog with severe subaortic stenosis and mitral valve disease complicated with atrial fibrillation undergoing ovariohysterectomy

2019

View full text Add to dashboard Cite

The anesthetic management in patients with subaortic stenosis and mitral valve disease should involve intensive monitoring and the anesthesiologist’s main concern is to ensure oxygen delivery and tissue perfusion. Since anesthetic procedures in such patients are rare, there is no previous report about the anesthetic management. A 5.5-year old, 32-kg Boxer, suffering a severe heart disease due to a final stage subaortic stenosis and mitral insufficiency, was anesthetized for an ovariohysterectomy to remove an ovarian tumor that was producing high-volume ascites. Methadone (0.3 mg kg −1 ) was administered intramuscularly (IM) for pre-anesthetic medication, etomidate (1.3 mg kg −1 ) and midazolam (0.2 mg kg −1 ) were used for the induction of anesthesia and after endotracheal intubation, anesthesia was maintained with sevoflurane vaporized in oxygen and air. Fentanyl (5–10 μg kg −1 h −1 ) and paracetamol (15 mg kg −1 ) were administered to improve analgesia. Previous persistent atrial fibrillation was refractory to medication (digoxin, diltiazem, and pimobendan) and continued during the anesthetic procedure. Dobutamine (1.5–5 μg kg −1 minute −1 ) helped to maintain mean arterial blood pressure above 60 mmHg. Epidural morphine (0.1 mg kg −1 ) and incisional bupivacaine (2 mg kg −1 ) were administered at the end of surgery to provide postoperative analgesia. Anesthesia was otherwise uneventful, and recovery was considered excellent.

show abstract

Dose-dependent effects of isoflurane and dobutamine on cardiovascular function in dogs with experimental mitral regurgitation

Cited by 14 publications

References 32 publications

Noninvasive assessment of fluid responsiveness for emergency abdominal surgery in dogs with pulmonary hypertension: Insights into high-risk companion animal anesthesia

Noninvasive assessment of fluid responsiveness for emergency abdominal surgery in dogs with pulmonary hypertension: Insights into high-risk companion animal anesthesia

Conventional Echocardiography and Two-Dimensional Speckle Tracking in Healthy Sevoflurane-Anesthetized Dogs Undergoing Continuous Rate Infusion of Nalbuphine

Anesthetic management of a dog with severe subaortic stenosis and mitral valve disease complicated with atrial fibrillation undergoing ovariohysterectomy

Contact Info

Product

Resources

About