Evaluation of the caudal vena cava diameter to abdominal aortic diameter ratio and the caudal vena cava respiratory collapsibility for predicting fluid responsiveness in a heterogeneous population of hospitalized conscious dogs

被引:12
作者
Rabozzi, Roberto [1 ]
Oricco, Stefano [2 ]
Meneghini, Caterina [1 ]
Bucci, Massimo [3 ]
Franci, Paolo [4 ]
机构
[1] CVRS Policlin Vet Roma Sud, Rome 00173, RM, Italy
[2] Ctr Vet Imperiese, Imperia 18100, IM, Italy
[3] Univ Padua, Sch Agr & Vet Med, Dept Anim Med Prod & Hlth, Legnaro 35020, PD, Italy
[4] Univ Turin, Dept Vet Sci, Grugliasco 10095, TO, Italy
关键词
dog; fluid; hemodynamic assessment; point-of-care; ultrasound; SYSTOLIC PRESSURE VARIATION; CRITICALLY-ILL PATIENTS; AMERICAN-SOCIETY; DYNAMIC INDEXES; CARDIAC-OUTPUT; VOLUME STATUS; ECHOCARDIOGRAPHY; ULTRASOUND; VELOCITY; GUIDELINES;
D O I
10.1292/jvms.19-0028
中图分类号
S85 [动物医学(兽医学)];
学科分类号
0906 ;
摘要
Fluid responsiveness, defined as the response of stroke volume to fluid loading, is a tool to individualize fluid administration in order to avoid the deleterious effects of hypovolemia or hypervolemia in hospitalized patients. To evaluate the accuracy of two ultrasound indices, the caudal vena cava to abdominal aorta ratio (CVC/Ao) and the respiratory collapsibility of the caudal vena cava ( cCVC), as independent predictors of fluid responsiveness in a heterogeneous population of spontaneously breathing, conscious, hospitalized dogs. A prospective, multicenter, observational, cross-sectional study was designed in twenty-five dogs. The accuracy of CVC/Ao and cCVC in predicting fluid responsiveness was evaluated by the area under the receiver operating characteristic curve (AUROC) in a group of hospitalized dogs after receiving a mini-fluid bolus of 4 ml/kg of Hartmann's solution. Dogs with an increased aortic velocity time integral >15% were classified as fluid responders. Twenty-two dogs were finally included. Ten were classified as responders and 12 as non-responders. The AUROC curves were 0.88 for the CVC/Ao ratio (95% confidence interval, CI, 0.67-0.98; P=0.0001) and 0.54 for cCVC (95% CI 0.32-0.75; P=0.75). The CVC/Ao threshold optimized for best sensitivity (SE) and specificity (SP) values was 0.83 (SE 100%; SP 75%). In spontaneously breathing hospitalized dogs, the CVC/Ao measurement predicted stroke volume increase after a fluid bolus, while the respiratory variations in the cCVC did not discriminate between fluid responders and non-responders.
引用
收藏
页码:337 / 344
页数:8
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