Caudal vena cava measurements and fluid responsiveness in hospitalized cats with compromised hemodynamics and tissue hypoperfusion

被引:2
作者
Donati, Pablo A. [1 ,2 ,4 ]
Tunesi, Marcela [2 ]
Araos, Joaquin [3 ]
机构
[1] Univ Buenos Aires, Fac Ciencias Vet, Buenos Aires, Argentina
[2] Cooperat Vet Intens Care Unit UCICOOP, Buenos Aires, Argentina
[3] Cornell Univ, Coll Vet Med, Dept Clin Sci, Ithaca, NY USA
[4] Cooperat Vet Intens Care Unit UCICOOP, Jose Maria Moreno 635,CP 1424,C1424AAG, Buenos Aires, Argentina
关键词
awake patients; critically ill cats; fluid responsiveness; spontaneous ventilation; CARDIAC-OUTPUT; HEALTHY CATS; ULTRASOUND; DOGS; ULTRASONOGRAPHY; CONSENSUS; THERAPY; SHOCK;
D O I
10.1111/vec.13272
中图分类号
S85 [动物医学(兽医学)];
学科分类号
0906 ;
摘要
ObjectiveTo evaluate the use of the caudal vena cava collapsibility index (CVCCI) and the inspiratory/minimum and expiratory/maximum diameters of the vena cava to predict fluid responsiveness in hospitalized, critically ill cats with hemodynamic and tissue perfusion abnormalities. DesignDiagnostic test study in a prospective cohort of hospitalized cats. SettingPrivate practice referral hospital. AnimalsTwenty-four hospitalized cats with spontaneous breathing and compromised hemodynamics and tissue hypoperfusion. InterventionsUltrasonographic examination before and after fluid expansion with 10 ml/kg of lactated Ringer's solution. Measurements and Main ResultsFluid responsiveness was evaluated using the velocity-time integral (VTI) of the subaortic blood flow, by measuring it before and after a fluid load of 10 ml/kg of lactated Ringer's solution. The CVCCI was calculated using the following formula: (maximum diameter - minimum diameter / maximum diameter) x 100. Ten cats were fluid responders (42 %) and 14 were nonresponders (58 %). The area under the receiver operating characteristic curve (AUROC) with their 95% confidence interval for the predictors and the best cutoff values were as follows: CVCCI, AUROC = 0.83 (0.66-1.00) and cutoff = 31%; inspiratory/minimum diameter, AUROC = 0.86 (0.70-1.00) and cutoff = 0.24 cm; expiratory/maximum diameter, AUROC = 0.88 (0.74-1.00) and cutoff = 0.22 cm. A significant lineal correlation was observed between the percentage of increase in VTI after expansion and CVCCI (r(s) = 0.68, P < 0.001), expiratory/maximum diameter (r(s) = -0.72, P < 0.001), and inspiratory/minimum diameter (r(s) = -0.71, P < 0.001). The intraobserver and interobserver variability was low for VTI, and the expiratory/maximum diameter and inspiratory/minimum diameter were high for CVCCI. ConclusionsCaudal vena cava measurements could be useful to predict the response to fluids in hospitalized cats with hemodynamic and tissue perfusion alterations. Additional studies are required to draw definitive conclusions about the role of these variables to guide fluid administration in cats.
引用
收藏
页码:29 / 37
页数:9
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