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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Use of aortic flow indexes derived from transthoracic echocardiography to evaluate response to a fluid challenge in anesthetized dogs

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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