| Full text | |
| Author(s): |
de Oliveira, V, Guillermo C.
;
Teixeira-Neto, Francisco J.
[1, 2]
;
Dalmagro, Tabata L.
[2]
;
Alfonso, Angelica
[1]
;
Celeita-Rodriguez, Nathalia
[2]
;
Lobo, Cesar P. C.
[2]
;
Lourenco, Maria L. G.
[1]
Total Authors: 7
|
| Affiliation: | [1] de Oliveira, Guillermo C., V, Univ Estadual Paulista UNESP, Fac Med Vet & Zootecnia, Dept Vet Surg & Anim Reprod, Botucatu, SP - Brazil
[2] Univ Estadual Paulista UNESP, Fac Med, Dept Anesthesiol, Botucatu, SP - Brazil
Total Affiliations: 2
|
| Document type: | Journal article |
| Source: | VETERINARY ANAESTHESIA AND ANALGESIA; v. 48, n. 2, p. 187-197, MAR 2021. |
| Web of Science Citations: | 0 |
| Abstract | |
Objective To evaluate the ability of transthoracic echocardiographic aortic flow measurements to discriminate response to a fluid challenge (FC) in healthy anesthetized dogs. Study design Prospective experimental study. Animals A total of 48 isoflurane-anesthetized dogs (14.2-35.0 kg) undergoing elective surgery. Methods Fluid responsiveness was evaluated before surgery by FC (lactated Ringer's 10 mL kg(-1) intravenously over 5 minutes). Percentage increases in transpulmonary thermodilution stroke volume (Delta SVTPTD) >15% from values recorded before FC defined responders to volume expansion. A group of 24 animals were assigned as nonresponders (Delta SVTPTD <= 15%). When Delta SVTPTD was >15% after the first FC, additional FC were administered until Delta SVTPTD was <= 15%. Final fluid responsiveness status was based on the response to the last FC. Percentage increases after FC in aortic flow indexes {[}velocity time integral (Delta VTIFC) and maximum acceleration (Delta Vmax(FC))] and in mean arterial pressure (Delta MAP(FC) ) were compared with Delta SVTPTD. Results After one FC, 24 animals were responders. For nonresponders, Delta SVTPTD was <= 15% after one, two and three FCs in eight/24, 15/24 and one/24 animals, respectively. The FC that defined responsiveness increased Delta SVTPTD by 29 (18-53)% in responders and by 8 (-3 to 15)% in nonresponders {[}mean (range)]. The area under the receiver operating characteristics curve (AUROC) of Delta VTI (FC) (0.901) was larger than the AUROCs of Delta Vmax(FC) (0.774, p = 0.041) and Delta MAP(FC) (0.519, p < 0.0001). Delta MAP(FC) did not predict responsiveness (p = 0.826). Best cut-off thresholds for discriminating responders, with respective zones of diagnostic uncertainty (gray zones) were >14.7 (10.8-17.6)% for Delta VTIFC and >8.6 (-0.3 to 14.7)% for Delta Vmax(FC). Animals within the gray zone were 17% (Delta VTIFC) and 50% (Delta Vmax(FC)). Conclusions and clinical relevance Changes in VTI induced by FC can determine responsiveness with reasonable accuracy in dogs and could play an important role in goal-directed fluid therapy. (AU) | |
| FAPESP's process: | 18/25610-0 - Use of less invasive/non invasive methods for evaluating and predicting fluid responsiveness in dogs |
| Grantee: | Francisco José Teixeira Neto |
| Support Opportunities: | Regular Research Grants |