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

Autor: Combet-Curt J; Université de Lyon, Intensive care unit (SIAMU), VetAgro Sup, 1 Avenue Bourgelat, 69280 Marcy l'Etoile, France.; Université de Lyon, UP 2021.A101 APCSe Agressions Pulmonaires et Circulatoires dans le Sepsis, VetAgro Sup, 1 Avenue Bourgelat, 69280 Marcy l'Etoile, France., Pouzot-Nevoret C; Université de Lyon, Intensive care unit (SIAMU), VetAgro Sup, 1 Avenue Bourgelat, 69280 Marcy l'Etoile, France.; Université de Lyon, UP 2021.A101 APCSe Agressions Pulmonaires et Circulatoires dans le Sepsis, VetAgro Sup, 1 Avenue Bourgelat, 69280 Marcy l'Etoile, France., Cambournac M; Centre hospitalier vétérinaire Fregis, service d'Urgences, Réanimation et Soins-intensifs, 43, avenue Aristide Briand 94110 Arcueil, France., Magnin M; Université de Lyon, UP 2021.A101 APCSe Agressions Pulmonaires et Circulatoires dans le Sepsis, VetAgro Sup, 1 Avenue Bourgelat, 69280 Marcy l'Etoile, France.; Université de Lyon, Unité de Physiologie, Pharmacodynamie et Thérapeutique, 1 Avenue Bourgelat, 69280 Marcy l'Etoile, France., Nectoux A; Université de Lyon, Intensive care unit (SIAMU), VetAgro Sup, 1 Avenue Bourgelat, 69280 Marcy l'Etoile, France.; Université de Lyon, UP 2021.A101 APCSe Agressions Pulmonaires et Circulatoires dans le Sepsis, VetAgro Sup, 1 Avenue Bourgelat, 69280 Marcy l'Etoile, France., Bonnet-Garin JM; Université de Lyon, UP 2021.A101 APCSe Agressions Pulmonaires et Circulatoires dans le Sepsis, VetAgro Sup, 1 Avenue Bourgelat, 69280 Marcy l'Etoile, France.; Université de Lyon, Unité de Physiologie, Pharmacodynamie et Thérapeutique, 1 Avenue Bourgelat, 69280 Marcy l'Etoile, France., Goy-Thollot I; Université de Lyon, Intensive care unit (SIAMU), VetAgro Sup, 1 Avenue Bourgelat, 69280 Marcy l'Etoile, France., Barthélemy A; Université de Lyon, Intensive care unit (SIAMU), VetAgro Sup, 1 Avenue Bourgelat, 69280 Marcy l'Etoile, France.; Université de Lyon, UP 2021.A101 APCSe Agressions Pulmonaires et Circulatoires dans le Sepsis, VetAgro Sup, 1 Avenue Bourgelat, 69280 Marcy l'Etoile, France.
Jazyk: angličtina
Zdroj: The Journal of small animal practice [J Small Anim Pract] 2023 Nov; Vol. 64 (11), pp. 669-679. Date of Electronic Publication: 2023 Jul 15.
DOI: 10.1111/jsap.13654
Abstrakt: Objectives: To 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 Methods: Perfusion 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.
Results: Twenty-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 Significance: In 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.
(© 2023 The Authors. Journal of Small Animal Practice published by John Wiley & Sons Ltd on behalf of British Small Animal Veterinary Association.)
Databáze: MEDLINE
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