What were the primary findings of a study by Pavlisko et al regarding tissue oxygen saturation measurements in dogs?
Pavlisko et al. Evaluation of tissue oxygen saturation with near-infrared spectroscopy during experimental acute hemorrhagic shock and resuscitation in dogs. AJVR 2014 75.
- There was a strong correlation throughout this study between StO2 and oxygen delivery (across all time points–hypovolemia, normovolemia, hypervolemia) suggesting that StO2 may be used to estimate oxygen delivery.
What were the primary findings in a case report detailing CDI following CPA in a dog by Bellis et al?
Bellis et al. Central diabetes insipidus following cardiopulmonary arrest in a dog. JVECC 2015 25 6.
- An 8 week old dog presented for care following resuscitation for CPA; had neuo deficits, marked PU, isosthenuria and low urine osmolality.
- Treatment with DDAVP resulted in improvement of signs, suggesting a diagnosis of partial CDI.
What were the primary findings of a study by Uhrikova et al evaluating CRP and HMGB1 in dogs with GDV?
Uhrikova et al. CRP and HMGB1 in dogs with GDV. JVECC 2015 25 4.
- CRP increased significantly from post-surgery samling to 18-22 hours postsurgery, while HMGB1 did not change over time.
- There was a significant difference in HMGB1 between survivors and non-survivors
- There was no significant difference in CRP between survivors/non-survivors
- HMGB1 was significantly higher in dogs with gastric wall necrosis
- Both parameters correlated only mildly with SIRS at presentation
- HMGB1 appears to better reflect the severity of tissue injury in dogs with GDV than CRP
What were the primary findings of a study by Segev et al reporting a scoring system for dogs with heatstroke?
Segev et al. A novel severity scoring system for dogs with heatstroke. JVECC 2015 25 2.
- Porposed 2 models that were applicable for objective assessment of severity and prognosis of heatstroke, however, require independent validation
- Factors including acute collapse, seizures, neurologic abnormalities and petechiation were associated with higher risk of mortality
- Shock, AKI, DIC–>higher risk of death
What were the primary findings of a study by McIntyre et al assessing CPR in dogs and cats at a university teaching hospital?
McIntyre et al. Assessment of CPR in 121 dogs and 30 cats at a university teaching hospital. JVECC 2014 24 6.
- 58% of animals achieved ROSC
- 32% had ROSC >20 min
- 10% alive at 24 hours
- 5% survived to discharge
- Associated with ROSC
- Presence of IVC at arrest
- Presence of palpated pulses during CPR
- Associated with failure to achieve ROSC
- Neurologic cause for arrest
- Increased time from CPA to initiation of CPR
- Longer duration of CPR
What were the major conclusions of a study on the comparison of thermodilution, lithium dilution and pulse contour analysis techniques for CO measurement by Morgaz et al?
Morgaz et al. Comparison of thermodilution, lithium dilution and pulse contour analysis for the measurement of CO in 3 different hemodynamic states in dogs. JVECC 2014 24 5.
- LiDCO and PiCCOTD agreed well with PAC_TD for measurement of CO under different hemodynamic conditions (normodynamic/hypo/hyper).
- The PiCCOTD appeared to be an accurate method for monitoring continuous CO as it was similar to pulse contour analysis
What were the primary findings of a study by Boysen et al evaluating the effects of L-LRS on plasma lactate in healthy dogs?
Boysen et al. Effects of rapid intravenous 100% L-isomer LRS administration on plasma lactate concentration in healthy dogs. JVECC 204 24 5.
- 180ml/kg LRS administered over 60 min and lactate concentrations measured
- Significant increases in plasma lactate were identified after 10 minutes and returned to baseline 60 minutes after cessation of therapy
- Could have implications in how plasma lactate concentration is interpreted with respect to prognosis in patients receiving resuscitative rates of LRS
What were the primary conclusions of a study by Hopper et al examining acid base, electrolyte, glucose and lactate values during CPR?
Hopper et al. Acid base, electrolyte, glucose and lactate values during CPR in dogs and cats. JVECC 2014 24 2.
- A moderate to severe metabolic acidosis developed in all cases, had a concurrent respiratory acidose in 88% of cases
- Progressive increase in lactate was seen in all cases during CPR; the degree of elevation may reflect the efficacy of resuscitative efforts
- Giving epinephrine may also contribute, as it accelerates glycolysis
- Elevated PCO2 was seen in 88% of cases during CPR, 61% following ROSC
- During CPR, PCO2 represents a low blood flow state and accumulation in the tissues rather than ventilation
- Hyperkalemia occured in 65% of cases
- Due to global ischemia causing failure of energy dependent cellular ion pumps and subsequent K+ efflux from cells
- Hypocalcemia developed in 18%
- Due to intracellular accumulation following ischemia/reperfusion injury
- Hyperglycemia in 62%
- Effects of exogenous and endogenous catecholamines
No significant difference in any of the variables during the first 15 minutes of CPA versus the first 15 minutes after CPA.
pH and PvO2 lower in the CPR gropu during the first 5 minutes of ROSC compared to during CPR.
What were the primary findings of a study by Young et al examining the ScvO2 in sick dogs following resuscitation to end-point parameters?
Young et al. Decreased central venous oxygen saturation despite normalization of heart rate and blood pressure post shock resuscitation in sick dogs. JVECC 2014 24 2.
- 38% of initially hypotensive canine shock patients had post-resuscitation ScVO2 <70% despite normalization of traditional perfusion parameters and clearance of venous hyperlactatemia
- Patients with a low ScVO2 were significantly more anemic (34%) than patients with a >70% ScVO2 (41%)
- Decreased oxygen carrying capacity will adversely impact CaO2 and potentially DO2 if increase in cardiac output can’t compensate
- The persistence of a low ScVO2 in the face of high CVP, normal BP, perfusion parameters indicates need to evaluate for/address inadequecies in CaO2 (i.e. decreased PCV, PaO2), consider inotropic support to increase CO and DO2
What were the primary findings of a study by Wendelburg et al regarding survival time in dogs with splenic HSA treated by splenectomy with or without adjuvant chemotherapy?
Wendelburg et al. Survival time in dogs with splenic HSA treated by splenectomy with or without adjuvant chemotherapy. jAVMA 2015 247.
- Stages of HSA:
- Stage 1: spleen alone
- Stage 2: ruptured or with nodal metastases
- Stage 3: distant metastases
- Clnical stage was the only prognostic factor significantly associated with survival time
- An MST of 1.6 months was present for dogs treated with splenectomy alone
- Over the entire followup period, there was no significant difference in survival time for dogs receiving chemo+ surgery or just surgery, although when adjusting for clinical stage, survival was significantly prolonged in the first 4 months following surgery for dogs who also received chemo
What were the major conclusions from a study by Ateca et al regarding lactate and blood pressure in critically ill dogs?
Ateca et al. Survival analysis of critically ill dogs with hypotension with or without hyperlactatemia: 67 cases. JAVMA 2015 246.
- Only 19/67 (28%) of dogs survived and were discharged from the hospital
- Hypotensive dogs wihtout hyperlactatemia had a significantly higher systolic blood pressure and were 3.23 times as likely to survive as compared to hypotensive dogs with hyperlactatemia.
- i.e blood lactate was negatively associated with systolic blood pressure and survival probability
- No other parameter differed significantly between hypotensive dogs with and without hyperlactatemia.
What were the primary findings of a study by Reineke et al examining the association of blood lactate concentration with various parameters in cats?
Reinke et al. Association of blood lactate concentration with physical perfusion variables, blood pressure and outcome for cats treated at an emergency service. JAVA 2015 247.
- Median inital blood lactate concentration was 2.7.
- Cats with white mucous membranes, abnormal peripheral pulses, and hypothermia had significantly higher lactate concentrations than cats without these findings.
- Median lactate for cats with an SBP <90mmHg was significantly higher (3.3mmol/L) than for cats with an SBP >90mmHg (2.35)
- Median initial lactate concentration at admission did not differ between cats that did and did not survive to discharge from the hospital.
- Change in lactate concentration was not associated with outcome.
What were the primary conclusions of a study by Wendelburg et al examining risk factors for perioperative death in dogs undergoing splenectomy for splenic masses?
Wendelburg et al. Risk factors for perioperative death in dogs undergoing splenectomy for splenic masses. jAVMA 2014 245.
- 7.6% of dogs died in the perioperative period; thrombotic and coagulopathic syndromes and uncontrolled bleeding from metastatic lesions were the most common cause of death.
- For each decrease in platelet count by 10,000, odds of death increased by 6%
- Dogs with PCV <30% were twice as likely to die
- Dogs developing ventricular arrhythmias intra-op were twice as likely to die
What were the primary findings of a study on dogs with trauma by Hall et al?
Hall et al. Multicenter prospective evaluation of dogs with trauma. JAVMA 2014 244.
- Most common cause of injury was blunt trauma followed by penetrating trauma
- 90% survival to discharge
- Dogs with penetrating trauma more likely to survive compared to blunt trauma
- ATT, MGCS and blood lactate at the time of admission were predictive of outcome
- ATT 2.1 compared to 7.9
- MCGS 17.8 compared to 15.3
- Lactate 2.8 compared to 6.5
- Penetrating trauma, low blood lactate concentration and performance of surgical procedures were predictive of survival to hospital discharge
What were the findings of a study by Redavid et al evaluating hyperlactatemia and serial lactate measurements in sick cats?
JVECC 2016 26 (4)
- The incidence of hyperlactatemia in sick cats being admitted for hospitalization in a private referral center was 23%
- Lactate concentration on admission and serial lactate measurements over time were not prognostic in this group of hospitalized cats
What were the findings of a study by Hoffberg et al in a retrospective evaluation of concurrent intra-abdominal injuires in dogs with traumatic pelvic fractures (83 cases)?
JVECC 2016 26(2)
- Dogs with sacral fractures were more likely to have IA than dogs without sacral fractures
- Dogs were more likely to require a transfusion if they had IA or hemoabdomen specificically
- Pelvic fracture characterization had no bearing on the presence of IA (pubic ischial, SI lux etc)
What were the findings of a study by Reineke et al on the prediction of SBP using peripheral pulse palpation in cats?
JVECC 2016 26(1)
- Peripheral pulse quality assessment correlates with SBP.
- With progressive decreases in blood pressure, metatarsal pulses will disappear and only with severe hypotension that femoral pulses are absent
- Cats with absent metatarsal and femoral pulses had median SBP of 30mmHg
- Cats with strong metatarsal pulses had SBP of 135mmHg
What were the findings of a study by McMurray et al regarding focused assessment with sonography in nontraumatized dogs and cats in the emergency and critical care setting?
JVECC 2016 26(1)
- Free fluid was identified on AFAST/TFAST in 33% of dogs and cats in the study, particularly in those who cardiovascularly unstable or dyspneic
- Results support the use of AFAST/TFAST to detect free fluid in nontraumatized dogs and cats
