| Texto completo | |
| Autor(es): |
Fantoni, Denise T.
[1, 2]
;
Ida, Keila K.
[2]
;
Gimenes, Andre M.
[3]
;
Mantovani, Matheus M.
[3]
;
Castro, Jacqueline R.
[3]
;
Patricio, Geni C. F.
[1]
;
Ambrosio, Aline M.
[1]
;
Otsuki, Denise A.
[2]
Número total de Autores: 8
|
| Afiliação do(s) autor(es): | [1] Univ Sao Paulo, Fac Vet Med & Anim Sci, Dept Surg, Sao Paulo - Brazil
[2] Univ Sao Paulo, Sch Med, Lab Med Invest 8, Anesthesiol, Sao Paulo - Brazil
[3] Univ Sao Paulo, Fac Vet Med & Anim Sci, Dept Internal Med, Sao Paulo - Brazil
Número total de Afiliações: 3
|
| Tipo de documento: | Artigo Científico |
| Fonte: | VETERINARY ANAESTHESIA AND ANALGESIA; v. 44, n. 4, p. 710-718, JUL 2017. |
| Citações Web of Science: | 4 |
| Resumo | |
Objective To investigate whether pulse pressure variation (PPV) can predict fluid responsiveness in healthy dogs during clinical surgery. Study design Prospective clinical study. Animals Thirty-three isoflurane-anesthetized dogs with arterial hypotension during orthopedic surgery. Methods Fluid challenge with lactated Ringer's solution (15 mL kg(-1) in 15 minutes) was administered in mechanically ventilated dogs (tidal volume 10 mL kg(-1)) with hypotension {[}mean arterial pressure (MAP) < 65 mmHg]. The volume expansion was considered effective if cardiac output (CO; transesophageal Doppler) increased by >= 15%. Cardiopulmonary data were analyzed using two-way ANOVA, receiver operating characteristics (ROC) curves and Spearman coefficient; p < 0.05 was considered significant. Results Effective volume expansion, mean +/- standard deviation 42 +/- 4% increase in CO (p < 0.0001) was observed in 76% of the dogs, resulting in a decrease in PPV (p < 0.0001) and increase in MAP (p < 0.0001), central venous pressure (CVP; p = 0.02) and ejection fraction (p < 0.0001) compared with before the fluid challenge. None of these changes occurred when volume expansion resulted in a nonsignificant CO increase of 4 +/- 5%. No significant differences were observed in blood gas analysis between responsive and nonresponsive dogs. The increase in CO was correlated with the decrease in PPV (r = -0.65; p < 0.0001) but absolute values of CO and PPV were not correlated. The PPV performance (ROC curve area: 0.89 +/- 0.06, p = 0.0011) was better than that of CVP (ROC curve area: 0.54 +/- 0.12) and MAP (ROC curve area: 0.59 +/- 0.13) to predict fluid responsiveness. The best cut-off for PPV to distinguish responders and nonresponders was 15% (50% sensitivity and 96% specificity). Conclusions and clinical relevance In mechanically ventilated, healthy, isoflurane-anesthetized dogs, PPV predicted fluid responsiveness to volume expansion, and MAP and CVP did not show such applicability. (AU) | |
| Processo FAPESP: | 12/18024-0 - Determinação da variação da pressão de pulso em equinos anestesiados com isofluorano e mecanicamente ventilados submetidos à reposição volêmica |
| Beneficiário: | Denise Tabacchi Fantoni |
| Modalidade de apoio: | Auxílio à Pesquisa - Regular |