Journal of veterinary emergency and critical care最新文献_第3页

Bioreactance noninvasive cardiac output monitoring in euvolemic adult horses subjected with 7.2% saline and 6% hydroxyethyl starch (130/0.4) solution infusions 在输注 7.2% 生理盐水和 6% 羟乙基淀粉（130/0.4）溶液的无水成年马体内进行生物反应无创心排血量监测。

IF 1.1 3区农林科学 Q3 VETERINARY SCIENCES

Journal of veterinary emergency and critical care

Pub Date : 2024-09-10 DOI: 10.1111/vec.13418

Alicia E. Long DVM, Samuel Hurcombe BSc, BVSc, MS, DACVIM, DACVECC, Klaus Hopster DrMedVet, PhD, DACVAA

Objective

To compare the ability of bioreactance noninvasive cardiac output (BR-NICO) with thermodilution cardiac output (TDCO) for the measurement of cardiac output (CO) in healthy adult horses receiving 2 different IV volume replacement solutions.

Design

Prospective randomized crossover study from September to November 2021.

Setting

University teaching hospital.

Animals

Six university-owned adult horses.

Interventions

Horses were randomly assigned to receive 7.2% hypertonic saline solution (HSS) or 6% hydroxyethyl starch (130/0.4) solution (HETA). BR-NICO and TDCO were measured simultaneously at baseline, 10, 20, 30, 40, 50, 60, 90, and 120 minutes before fluid administration and again at the same times after starting a bolus infusion of IV volume replacers. All solutions were administered within 10 minutes.

Measurements and Main Results

BR-NICO and TDCO were strongly correlated (Pearson r² = 0.93; P < 0.01). Regression analysis showed the relationship between TDCO and BR-NICO was BR-NICO = 0.48 × TDCO + 0.6. For the corrected BR-NICO values, the Bland–Altman agreement mean bias and lower/upper limits of agreement were −0.62 and −5.3 to 3.9 L/min, respectively. Lin's concordance (95% confidence interval) between methods was 0.894 (0.825–1.097). Compared with baseline, HSS increased the CO at 10 and 20 minutes (TDCO and BR-NICO). Compared with baseline, HETA decreased the CO at 10 and 20 minutes (TDCO and BR-NICO) and increased the CO at 90 (TDCO only) and 120 minutes (TDCO and BR-NICO).

Conclusions

BR-NICO strongly agreed with TDCO in the measurement of CO in healthy unsedated adult horses. HSS administration significantly increased CO in the first 30 minutes, while HETA initially decreased CO at 10 minutes but increased CO to above baseline values by 90 minutes.

目的比较生物反应性无创心排血量（BR-NICO）和热稀释心排血量（TDCO）在健康成年马接受两种不同的静脉注射容量补充溶液时测量心排血量（CO）的能力：设计：2021 年 9 月至 11 月进行的前瞻性随机交叉研究：地点：大学教学医院：干预措施随机分配马匹接受 7.2% 高渗盐水溶液 (HSS) 或 6% 羟乙基淀粉 (130/0.4) 溶液 (HETA)。在输液前的基线、10、20、30、40、50、60、90 和 120 分钟同时测量 BR-NICO 和 TDCO，并在开始静脉注射容量补充剂后的相同时间再次测量。所有溶液均在 10 分钟内输注：BR-NICO 与 TDCO 高度相关（Pearson r2 = 0.93；P 结论：BR-NICO 与 TDCO 高度一致：BR-NICO与TDCO在测量健康未休息成年马的CO方面非常一致。给马服用 HSS 可在前 30 分钟内明显增加 CO，而 HETA 在 10 分钟内会降低 CO，但到 90 分钟时 CO 会增加到基线值以上。

{"title":"Bioreactance noninvasive cardiac output monitoring in euvolemic adult horses subjected with 7.2% saline and 6% hydroxyethyl starch (130/0.4) solution infusions","authors":"Alicia E. Long DVM, Samuel Hurcombe BSc, BVSc, MS, DACVIM, DACVECC, Klaus Hopster DrMedVet, PhD, DACVAA","doi":"10.1111/vec.13418","DOIUrl":"10.1111/vec.13418","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare the ability of bioreactance noninvasive cardiac output (BR-NICO) with thermodilution cardiac output (TDCO) for the measurement of cardiac output (CO) in healthy adult horses receiving 2 different IV volume replacement solutions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Prospective randomized crossover study from September to November 2021.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>University teaching hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Animals</h3>\u0000 \u0000 <p>Six university-owned adult horses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interventions</h3>\u0000 \u0000 <p>Horses were randomly assigned to receive 7.2% hypertonic saline solution (HSS) or 6% hydroxyethyl starch (130/0.4) solution (HETA). BR-NICO and TDCO were measured simultaneously at baseline, 10, 20, 30, 40, 50, 60, 90, and 120 minutes before fluid administration and again at the same times after starting a bolus infusion of IV volume replacers. All solutions were administered within 10 minutes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements and Main Results</h3>\u0000 \u0000 <p>BR-NICO and TDCO were strongly correlated (Pearson <i>r</i><sup>2</sup> = 0.93; <i>P </i>< 0.01). Regression analysis showed the relationship between TDCO and BR-NICO was BR-NICO = 0.48 × TDCO + 0.6. For the corrected BR-NICO values, the Bland–Altman agreement mean bias and lower/upper limits of agreement were −0.62 and −5.3 to 3.9 L/min, respectively. Lin's concordance (95% confidence interval) between methods was 0.894 (0.825–1.097). Compared with baseline, HSS increased the CO at 10 and 20 minutes (TDCO and BR-NICO). Compared with baseline, HETA decreased the CO at 10 and 20 minutes (TDCO and BR-NICO) and increased the CO at 90 (TDCO only) and 120 minutes (TDCO and BR-NICO).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>BR-NICO strongly agreed with TDCO in the measurement of CO in healthy unsedated adult horses. HSS administration significantly increased CO in the first 30 minutes, while HETA initially decreased CO at 10 minutes but increased CO to above baseline values by 90 minutes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"34 5","pages":"437-445"},"PeriodicalIF":1.1,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of a whole blood point-of-care coagulation analyzer in dogs 评估狗全血护理点凝血分析仪。

IF 1.1 3区农林科学 Q3 VETERINARY SCIENCES

Journal of veterinary emergency and critical care

Pub Date : 2024-09-03 DOI: 10.1111/vec.13416

Elizabeth M. Conroy VMD, Bridget M. Lyons VMD, DACVECC, Amie Koenig DVM, DACVIM, DACVECC

Objective

To compare the accuracy of a point-of-care coagulation analyzer (POCCA) with a reference laboratory coagulation analyzer (LabCA) and to evaluate for confounding factors that could alter the performance of the POCCA.

Design

Prospective, observational study.

Setting

Two university veterinary teaching hospitals.

Animals

Forty-three client-owned dogs undergoing coagulation testing between April 2020 and June 2021.

Methods

Samples were obtained from dogs undergoing coagulation testing as part of a diagnostic workup. Prothrombin time (PT) and activated partial thromboplastin time (aPTT) were measured on the POCCA and on the LabCA. PCV, platelet count, total plasma protein, hyperbilirubinemia, hemolysis, lipemia, and autoagglutination were recorded.

Results

Moderate correlation was seen for PT and strong correlation was seen for aPTT between the POCCA and the LabCA (PT: 0.59, P < 0.0001; aPTT: 0.71, P < 0.0001). The POCCA results were consistent with normal or hypocoagulable samples for 30 of 38 PT and 33 of 37 aPTT results, as identified by the LabCA. Samples with PCV of 30%–55% were moderately correlated (PT: 0.63, P = 0.0004; aPTT: 0.63, P = 0.0003), but those outside that range were more likely to register an error message on the POCCA or provide disparate results. When hemolysis was present, there was a weak correlation between the POCCA and the LabCA for PT (rho: 0.38 [95% confidence interval: 0.19–0.76], P = 0.18) and a strong correlation for aPTT (rho: 0.86 [95% confidence interval: 0.62–0.95], P < 0.0001). Samples with hyperbilirubinemia were strongly correlated for PT (0.97, P = 0.002) but not for aPTT. Lipemia and autoagglutination were not observed.

Conclusion

There was an acceptable correlation in patients with PCV within the manufacturer's recommended reference range; however, measurements on samples with PCV outside the reference range were inconsistent with the LabCA. Caution should be used when using the POCCA in patients with coagulopathy and anemia or other potential confounders.

目的比较床旁凝血分析仪（POCCA）与参考实验室凝血分析仪（LabCA）的准确性，并评估可能改变床旁凝血分析仪性能的混杂因素：设计：前瞻性观察研究：地点：两所大学兽医教学医院：在 2020 年 4 月至 2021 年 6 月期间接受凝血检测的 43 只客户自养犬：作为诊断工作的一部分，从接受凝血检测的狗身上采集样本。在 POCCA 和 LabCA 上测量凝血酶原时间（PT）和活化部分凝血活酶时间（aPTT）。记录 PCV、血小板计数、血浆总蛋白、高胆红素血症、溶血、脂血和自身凝集素：结果：POCCA 和 LabCA 之间的 PT 呈中度相关，aPTT 呈高度相关（PT：0.59，P 结论：POCCA 和 LabCA 之间的 PT 和 aPTT 呈高度相关：对于 PCV 在制造商推荐参考范围内的患者，其相关性是可以接受的；但对于 PCV 超出参考范围的样本，其测量结果与 LabCA 不一致。在有凝血病、贫血或其他潜在混杂因素的患者中使用 POCCA 时应谨慎。

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引用次数: 0

Clinical features and outcome of dogs and cats with gastrointestinal pneumatosis: 30 cases (2010–2021) 患有胃肠道积气症的猫狗的临床特征和预后：30 个病例（2010-2021 年）。

IF 1.1 3区农林科学 Q3 VETERINARY SCIENCES

Journal of veterinary emergency and critical care

Pub Date : 2024-08-26 DOI: 10.1111/vec.13417

Nadine Jones BVMedSci (Hons), BVM, BVS, MVetMed, DACVECC, DECVECC, Karen Humm MA, VetMB, DACVECC, DECVECC, Helen Dirrig BVetMed (Hons), MVetMed, DACVR, DECVDI, Melissa Beth Glenn Espinoza MS, Igor Yankin DVM, DACVECC, Rachael Birkbeck DVM, MVetMed, DACVECC, Laura Cole MA, VetMB, MVetMed, DACVECC, DECVECC

Objectives

To describe the presentation, etiology, and outcome of dogs and cats diagnosed with gastrointestinal pneumatosis (GP).

Design

Retrospective study.

Setting

Three referral institutions.

Animals

Twenty-six dogs and 4 cats.

Interventions

None.

Measurements and Main Results

The most common sites of GP were the stomach (n = 19), followed by the colon (n = 8) and small intestine (n = 2). One case had pneumatosis of both the stomach and the colon. GP was most commonly associated with gastrointestinal disease in dogs (18/26 [69%]) and cats (3/4 [75%]), with common diagnoses including gastric dilatation and volvulus (n = 5), acute hemorrhagic diarrhea syndrome (n = 4), and gastrointestinal ulceration (n = 4). Of the 4 cases of gastrointestinal ulceration, 3 were dogs with a history of glucocorticosteroid or nonsteroidal anti-inflammatory drug administration and vomiting and diarrhea. Six of 30 cases (20%), all of which were dogs, were determined to have a surgical indication for exploratory celiotomy, although not solely on the basis of diagnosis of GP. Five cases underwent exploratory celiotomy, of which 1 (20%) survived to hospital discharge. Of the medically managed cases, 13 of 24 (54%) survived to hospital discharge. Overall, 14 of 30 cases (47%) survived to hospital discharge.

Conclusions

GP is an uncommon diagnostic imaging finding that is associated with a variety of disease processes. Its development is often related to primary gastrointestinal diseases. In the absence of other surgical disease, exploratory celiotomy based solely on the diagnosis of GP is unlikely to be indicated.

目的描述被诊断为胃肠道积气（GP）的猫狗的表现、病因和结果：设计：回顾性研究：动物：26 只狗和 4 只猫干预措施：无：测量和主要结果最常见的GP部位是胃（19例），其次是结肠（8例）和小肠（2例）。有一个病例同时患有胃和结肠气肿。狗（18/26 [69%]）和猫（3/4 [75%]）的GP最常见于胃肠道疾病，常见诊断包括胃扩张和胃内卷（5例）、急性出血性腹泻综合征（4例）和胃肠道溃疡（4例）。在4例胃肠道溃疡病例中，有3例犬曾服用糖皮质激素或非类固醇抗炎药物，并有呕吐和腹泻病史。在 30 个病例中，有 6 个病例（20%）被确定为有手术指征进行探查性腹腔切开术，但并非仅以 GP 诊断为依据，所有病例均为犬。5 例病例接受了探查性腹腔切开术，其中 1 例（20%）存活出院。在接受药物治疗的病例中，24 例中有 13 例（54%）存活出院。总体而言，30 例病例中有 14 例（47%）存活出院：GP是一种不常见的影像诊断结果，与多种疾病过程有关。其发病通常与原发性胃肠道疾病有关。在没有其他外科疾病的情况下，仅凭 GP 诊断而进行探查性开腹手术的可能性不大。

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引用次数: 0

Uroabdomen secondary to spontaneous bladder rupture in a dog with dystocia 一只患有难产的狗因自发性膀胱破裂而继发尿腹症。

IF 1.1 3区农林科学 Q3 VETERINARY SCIENCES

Journal of veterinary emergency and critical care

Pub Date : 2024-08-26 DOI: 10.1111/vec.13415

Sukjung Lim DVM, Geoffrey Stuart Hennig DVMMS, DACVS, Alicia Niedzwecki DVM, DACVECC, Igor Yankin DVM, DACVECC

Objective

To describe the development of uroabdomen secondary to spontaneous bladder rupture in a dog with dystocia.

Case Summary

A 2-year-old intact female Boston Terrier was referred for prolonged labor of 72 hours. At presentation, the dog had delivered 8 puppies at home, with the last pup being stillborn. The dog was in hypovolemic shock and had free abdominal effusion. Abdominal radiographs showed no evidence of remaining fetuses. Abdominal fluid analysis revealed a fluid potassium that was 1.8 times higher than the peripheral blood potassium. Retrograde positive contrast cystography identified leakage of contrast into the abdomen, consistent with uroabdomen secondary to bladder rupture. Bloodwork abnormalities included a mild monocytic leukocytosis with a left shift, moderate azotemia, mild hyperbilirubinemia, mild increase of alkaline phosphatase activity, moderate hyponatremia, and moderate hypochloremia. The dog was resuscitated with IV fluids and received IV antimicrobials out of concerns for septic peritonitis and sepsis. An exploratory laparotomy revealed a moderate volume abdominal effusion, uterine enlargement with no identifiable fetuses, and a small rupture of the urinary bladder wall apex. The bladder wall defect was repaired, and the dog underwent an ovariohysterectomy. Perioperative systemic hypotension was treated with a norepinephrine constant rate infusion and resolved within 24 hours. The dog was discharged 5 days later. The combined peritoneal fluid and uterine fluid culture and sensitivity testing revealed Enterococcus spp. and Staphylococcus pseudintermedius, both susceptible to amoxicillin/clavulanic acid and enrofloxacin. Bladder wall histopathology revealed severe mural congestion, edema, and hemorrhage, without evidence of neoplasia, cystitis, or urolithiasis.

Unique Information Provided

This is the first case report of a dog with uroabdomen secondary to a bladder wall rupture associated with dystocia. Early recognition of this rare phenomenon and vigilance in treatment is essential for a good prognosis and outcome.

目的：描述一只患有难产的犬因自发性膀胱破裂而发生尿崩症的情况：病例摘要：一只两岁大的完好无损的雌性波士顿梗犬因产程延长 72 小时而被转诊。就诊时，该犬已在家中产下 8 只幼犬，最后一只幼犬胎死腹中。该犬处于低血容量休克状态，并有游离性腹腔积液。腹部 X 光片显示没有剩余胎儿的迹象。腹腔积液分析显示，积液中的血钾是外周血钾的 1.8 倍。逆行造影剂阳性膀胱造影发现造影剂渗入腹腔，与膀胱破裂引起的尿腹症一致。血常规异常包括轻度单核细胞白细胞左移、中度氮质血症、轻度高胆红素血症、碱性磷酸酶活性轻度升高、中度低钠血症和中度低氯血症。出于对化脓性腹膜炎和败血症的担忧，医生对该犬进行了静脉输液抢救，并静脉注射了抗菌素。探查性开腹手术发现了中等量的腹腔积液、子宫增大（无法辨认胎儿）以及膀胱壁顶端的小破裂。对膀胱壁缺损进行了修补，并对该犬进行了卵巢切除术。围手术期使用去甲肾上腺素恒速输注治疗全身性低血压，并在 24 小时内缓解。该犬 5 天后出院。腹腔液和子宫液的联合培养和药敏试验显示，该犬感染了肠球菌属和假中间葡萄球菌，这两种球菌对阿莫西林/克拉维酸和恩诺沙星均敏感。膀胱壁组织病理学检查显示有严重的壁层充血、水肿和出血，但没有肿瘤、膀胱炎或尿路结石的证据：这是首例因膀胱壁破裂并伴有子宫收缩而继发尿崩症的病例报告。要想获得良好的预后和治疗效果，及早发现这种罕见现象并保持警惕至关重要。

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引用次数: 0

Issue Information - Prelim 发行信息 - 初稿

IF 1.1 3区农林科学 Q3 VETERINARY SCIENCES

Journal of veterinary emergency and critical care

Pub Date : 2024-08-08 DOI: 10.1111/vec.13306

引用次数: 0

Delayed transforaminal brain herniation in a cat following bromethalin intoxication 一只猫在溴甲烷中毒后出现延迟性椎间孔脑疝。

IF 1.1 3区农林科学 Q3 VETERINARY SCIENCES

Journal of veterinary emergency and critical care

Pub Date : 2024-08-05 DOI: 10.1111/vec.13413

Erica Matula VMD, DACVECC, Alicia Mastrocco DVM, DACVECC, Jennifer Prittie DVM, DACVIM, DACVECC, Taryn Donovan DVM, DACVP

Objective

To report a case of delayed death after initial successful treatment of severe bromethalin intoxication in a cat.

Case Summary

A 2-year-old neutered male domestic shorthair cat presented as a referral for bromethalin toxicosis and progressive neurological decline. At the time of referral, the cat was nonambulatory tetraparetic with minimal motor function in all 4 limbs and exhibited a dull mentation. Within the first 4 hours of hospitalization, the cat's neurological status continued to rapidly decline, and osmotherapy, corticosteroids, and intralipids were administered. The treatment regimen also included levetiracetam, thiamine, cholestyramine, vitamin E, and gingko biloba. Six days after bromethalin ingestion, the cat displayed marked neurological improvement with near normal mentation and mild tetraparesis and was discharged. The cat continued to do well at home with improving neurological status and function. Nine days after discharge, the cat was presented dead on arrival. Postmortem examination revealed transforaminal brain herniation secondary to spongy degeneration of the white matter and increased intracranial pressure as the cause of death.

New Information Provided

To the authors’ knowledge, this is the first report of a cat that suffered delayed death despite initial neurological improvement after being treated for severe bromethalin toxicosis.

目的：报告一例严重溴甲烷中毒的猫在初步成功治疗后延迟死亡的病例：病例摘要：一只两岁大的阉割雄性家养短毛猫因溴甲烷中毒和神经系统功能逐渐衰退而转诊。转诊时，这只猫四肢瘫痪，不能行走，四肢运动功能极弱，神志呆滞。在住院的最初 4 小时内，猫咪的神经状况持续迅速恶化，医生为其注射了渗透疗法、皮质类固醇和体内类脂。治疗方案还包括左乙拉西坦、硫胺素、胆碱、维生素 E 和银杏叶。摄入溴甲烷六天后，猫咪的神经系统明显好转，精神状态接近正常，四肢轻度瘫痪，并已出院。猫咪在家中的表现依然良好，神经状况和功能都有所改善。出院九天后，这只猫突然死亡。尸检显示，死因是继发性脑白质海绵状变性和颅内压增高引起的跨椎间孔脑疝：据作者所知，这是第一份关于猫咪在接受严重溴甲烷中毒治疗后，尽管最初神经系统症状有所改善，但却延迟死亡的报告。

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引用次数: 0

Retrospective evaluation of the neutrophil-to-lymphocyte ratio as a prognostic marker in cats with blunt trauma (2018–2021): 177 cases 中性粒细胞与淋巴细胞比值作为钝性创伤猫预后标志物的回顾性评估（2018-2021 年）：177例。

IF 1.1 3区农林科学 Q3 VETERINARY SCIENCES

Journal of veterinary emergency and critical care

Pub Date : 2024-07-30 DOI: 10.1111/vec.13414

Pavlos G. Doulidis DVM, Yasamin Vali DVM, Caroline Frizzo Ramos DVM, Abigail Guija-de-Arespacochaga DVM, DECVCP

Objective

To investigate the utility of the neutrophil-to-lymphocyte ratio (NLR) as a prognostic marker in cats with blunt trauma.

Design

Retrospective study from January 2018 to December 2021.

Setting

University teaching hospital.

Animals

Medical records of 177 cats admitted with blunt trauma were evaluated. History, clinical findings, blood cell count-based ratios, thoracic radiographs on presentation, and outcome were reviewed. The Animal Trauma Triage (ATT) score was assessed in each cat and classified as mild (1–3), moderate (4–7), and severe trauma (≥8). Forty-eight healthy blood donor cats served as the control population. NLR, neutrophil counts, and lymphocyte counts were compared between cats with blunt trauma and controls, and among trauma patients.

Interventions

None

Measurements and Main Results

NLR, neutrophil counts, and lymphocyte counts significantly differ in cats with blunt trauma compared to controls (p < 0.001), and NLR was higher in patients with thoracic trauma (p = 0.044). Nonsurvivors had lower lymphocyte counts (p = 0.041), although those values do not appear to be clinically relevant. A significant increase in NLR was observed with increasing severity of trauma (p < 0.001). The NLR was not associated with the length of hospitalization, intensive care assistance, or mortality.

Conclusion

NLR is a widely available diagnostic tool, which can be used in addition to ATT to assess trauma severity, although in our study it was not predictive of the outcome.

目的研究中性粒细胞与淋巴细胞比值（NLR）作为钝性创伤猫预后标志物的实用性：2018年1月至2021年12月的回顾性研究：大学教学医院：评估了 177 只因钝性外伤入院的猫的病历。回顾了病史、临床发现、基于血细胞计数的比率、发病时的胸部X光片以及结果。评估了每只猫的动物创伤分诊（ATT）评分，并将其分为轻度（1-3）、中度（4-7）和重度创伤（≥8）。48 只健康献血猫作为对照组。比较钝性创伤猫与对照组以及创伤患者的 NLR、中性粒细胞计数和淋巴细胞计数：测量和主要结果：与对照组相比，钝挫伤猫的 NLR、中性粒细胞计数和淋巴细胞计数均有显著差异（P 结论：NLR 是一种广泛应用的诊断方法：NLR 是一种广泛使用的诊断工具，可与 ATT 一起用于评估创伤严重程度，但在我们的研究中，NLR 并不能预测结果。

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引用次数: 0

Retrospective evaluation of the short-term response of human intravenous immunoglobulin therapy in the management of canine immune-mediated thrombocytopenia (2010–2015): 27 cases 回顾性评估人静脉注射免疫球蛋白疗法在治疗犬免疫介导的血小板减少症中的短期反应（2010-2015 年）：27 例病例。

IF 1.1 3区农林科学 Q3 VETERINARY SCIENCES

Journal of veterinary emergency and critical care

Pub Date : 2024-07-22 DOI: 10.1111/vec.13408

Andrea Zoia DVM, MSc, PhD, DECVIM, Francesca Busato DVM, DECVIM, Michele Drigo DVM, PhD

Objective

To describe the short-term response, early prognostic markers, and survival after treatment of canine immune-mediated thrombocytopenia (ITP) with human intravenous immunoglobulin (hIVIG) and methylprednisolone.

Design

Retrospective cohort study.

Settings

Private referral veterinary medical center.

Animals

Twenty-seven client-owned dogs with primary or secondary ITP.

Interventions

All dogs received 2 mg/kg IV methylprednisolone once daily and a single infusion of 5% hIVIG administered over 6–12 hours.

Measurements and Main Results

A substantial increase in platelet count within 60 ± 12 hours post-hIVIG infusion (T₆₀) was observed in 19 of the 27 (70%) dogs with ITP (responders). Thirty-four variables, including serum immunoglobulin (Ig) G concentration 24 ± 12 hours post-hIVIG infusion (T₂₄IgG) and increase in serum IgG concentration 24 ± 12 hours post-hIVIG infusion (T₂₄Δ_IgG), were compared between responders and nonresponders at 5 different time points. Mortality rates of responders and nonresponders were evaluated 14 days post-hIVIG infusion. Serum T₂₄IgG and serum T₂₄Δ_IgG were both significantly higher at T₆₀ in responders. All responders were alive 14 days post-hIVIG infusion, and their mortality rate was significantly lower compared with nonresponders.

Conclusions

Responder dogs had an excellent 14-day survival rate. Serum T₂₄IgG and serum T₂₄Δ_IgG concentrations accurately predicted response status at 60 hours post-hIVIG infusion.

目的描述使用人静脉注射免疫球蛋白（hIVIG）和甲基强的松龙治疗犬免疫介导的血小板减少症（ITP）后的短期反应、早期预后指标和存活率：设计：回顾性队列研究：私立转诊兽医医疗中心：27只患有原发性或继发性ITP的客户自养犬：所有狗每天一次接受 2 毫克/千克甲基强的松龙静脉注射，并在 6-12 小时内单次输注 5% hIVIG：在 27 只（70%）患有 ITP 的狗（应答者）中，有 19 只在输注 hIVIG 后 60 ± 12 小时内（T60）观察到血小板计数大幅增加。在 5 个不同的时间点比较了应答者和非应答者的 34 个变量，包括输注 hIVIG 后 24 ± 12 小时的血清免疫球蛋白 (Ig) G 浓度（T24IgG）和输注 hIVIG 后 24 ± 12 小时的血清 IgG 浓度增加（T24ΔIgG）。在输注 hIVIG 后 14 天评估了应答者和非应答者的死亡率。应答者的血清 T24IgG 和血清 T24ΔIgG 在 T60 时均显著升高。所有应答者在输注 HIVIG 后 14 天均存活，其死亡率明显低于非应答者：结论：应答犬的 14 天存活率极高。血清 T24IgG 和血清 T24ΔIgG 浓度可准确预测输注 hIVIG 后 60 小时的应答状态。

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引用次数: 0

Evaluation of the implementation, frequency of use, type, and impact of veterinary emergency service pause systems 评估兽医紧急服务暂停系统的实施情况、使用频率、类型和影响。

IF 1.1 3区农林科学 Q3 VETERINARY SCIENCES

Journal of veterinary emergency and critical care

Pub Date : 2024-07-22 DOI: 10.1111/vec.13410

Andrew Linklater DVM, DACVECC

Objective

To determine the prevalence of veterinary emergency service pause systems (VESPSs) and describe aspects of implementation and perceived impact.

Design

Electronic questionnaire

Setting

Membership of the Veterinary Emergency and Critical Care Society (VECCS).

Animals

None.

Interventions

None.

Measurement and Main Results

A questionnaire was distributed to 6176 VECCS members with 1168 responses. Seventy-six percent of the respondents were veterinarians. Ninety-one percent of respondents practice in the United States, with 74% of them working at 24/7 multispecialty practices. Eighty-seven percent of respondents indicated patient volume had increased, and 75% reported that a VESPS had been implemented between September 2020 and December 2021. Sixty-two percent reported that their emergency service had been paused or closed once per week or more. The top reasons for implementing a VESPS included excessive caseload and staffing shortages. A variety of methods were utilized to implement a pause. Sixty-nine percent reported their VESPS was less than ideal for effectiveness. Pause systems were reported to be highly supported by medical staff. Seventy-seven percent reported increased client frustration and complaints, and 57% reported staff were stressed from denying care. Of those who do not currently have a VESPS in place, 74% would prefer to have one.

Conclusions

VESPSs were in widespread use at the time of this survey, and most have been implemented between September 2020 and December 2021. The majority of VESPSs were employed to mitigate increased caseload and staffing shortages. Although VESPSs are largely supported by medical staff, drawbacks may include staff stress and client frustrations, and improvements are warranted.

目的确定兽医紧急服务暂停系统（VESPS）的普及率，并描述其实施方面和可感知的影响：设计：电子问卷调查：动物：无：动物：无：测量和主要结果向 6176 名 VECCS 会员发放了调查问卷，收到 1168 份回复。76%的受访者是兽医。91%的受访者在美国执业，其中74%在全天候多专科诊所工作。87%的受访者表示患者数量有所增加，75%的受访者表示已在 2020 年 9 月至 2021 年 12 月期间实施了 VESPS。62%的受访者表示，他们的急诊服务每周暂停或关闭一次或更多次。实施 VESPS 的首要原因包括案件量过大和人员短缺。实施暂停的方法多种多样。69%的机构表示，他们的 VESPS 在有效性方面不够理想。暂停系统得到了医务人员的大力支持。有 77% 的医务人员表示客户的不满和投诉增加了，有 57% 的医务人员表示因拒绝提供护理服务而感到压力。在目前尚未安装 VESPS 的医务人员中，74% 的人表示希望安装 VESPS：在本次调查时，VESPS 已被广泛使用，大多数已在 2020 年 9 月至 2021 年 12 月期间实施。大多数 VESPS 的使用是为了缓解增加的案件量和人员短缺问题。虽然 VESPS 在很大程度上得到了医务人员的支持，但其缺点可能包括员工压力和客户挫败感，因此需要加以改进。

{"title":"Evaluation of the implementation, frequency of use, type, and impact of veterinary emergency service pause systems","authors":"Andrew Linklater DVM, DACVECC","doi":"10.1111/vec.13410","DOIUrl":"10.1111/vec.13410","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine the prevalence of veterinary emergency service pause systems (VESPSs) and describe aspects of implementation and perceived impact.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Electronic questionnaire</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Membership of the Veterinary Emergency and Critical Care Society (VECCS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Animals</h3>\u0000 \u0000 <p>None.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interventions</h3>\u0000 \u0000 <p>None.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurement and Main Results</h3>\u0000 \u0000 <p>A questionnaire was distributed to 6176 VECCS members with 1168 responses. Seventy-six percent of the respondents were veterinarians. Ninety-one percent of respondents practice in the United States, with 74% of them working at 24/7 multispecialty practices. Eighty-seven percent of respondents indicated patient volume had increased, and 75% reported that a VESPS had been implemented between September 2020 and December 2021. Sixty-two percent reported that their emergency service had been paused or closed once per week or more. The top reasons for implementing a VESPS included excessive caseload and staffing shortages. A variety of methods were utilized to implement a pause. Sixty-nine percent reported their VESPS was less than ideal for effectiveness. Pause systems were reported to be highly supported by medical staff. Seventy-seven percent reported increased client frustration and complaints, and 57% reported staff were stressed from denying care. Of those who do not currently have a VESPS in place, 74% would prefer to have one.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>VESPSs were in widespread use at the time of this survey, and most have been implemented between September 2020 and December 2021. The majority of VESPSs were employed to mitigate increased caseload and staffing shortages. Although VESPSs are largely supported by medical staff, drawbacks may include staff stress and client frustrations, and improvements are warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"34 5","pages":"455-464"},"PeriodicalIF":1.1,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Development of a novel scoring system to predict mortality in canine patients with infection 开发新型评分系统，预测犬类感染患者的死亡率。

IF 1.1 3区农林科学 Q3 VETERINARY SCIENCES

Journal of veterinary emergency and critical care

Pub Date : 2024-07-18 DOI: 10.1111/vec.13405

Mallory V. Horridge DVM, Bridget M. Lyons VMD, DACVECC, Darko Stefanovski BS, MS, PhD, Deborah C. Silverstein BS, DVM, DACVECC

Objectives

To develop a novel illness severity scoring system to identify canine patients with infection that are at higher risk of mortality.

Key Findings

Mentation (Modified Glasgow Coma Scale and the Acute Patient Physiologic and Laboratory Evaluation mentation score), heart rate, pH, P_vco₂, potassium, and total plasma protein were found to be associated with mortality on univariate analysis. Logistic regression found that mentation, heart rate, and P_vco₂ combined to form the following score: [(100 × mentation score) + (3 × heart rate) + (10 × P_vco₂], which was predictive of mortality (area under the receiver operating characteristic curve: 0.88). A cutoff of 900 provided a sensitivity of 80% and a specificity of 80%. If the cutoff was changed to 800, the sensitivity was 100% and the specificity was 50%.

Significance

A novel scoring system was developed to predict mortality in hospitalized dogs with confirmed or suspected infection. Further prospective evaluation in a larger patient cohort is necessary to validate this score.

目的：开发一种新的疾病严重程度评分系统，用于识别死亡风险较高的犬感染患者：开发一种新的疾病严重程度评分系统，以确定死亡率风险较高的犬感染患者：主要研究结果：通过单变量分析发现，精神状态（改良格拉斯哥昏迷量表和急性患者生理和实验室评估精神状态评分）、心率、pH值、Pvco2、血钾和总血浆蛋白与死亡率有关。逻辑回归发现，精神状态、心率和 Pvco2 组合成以下评分：[（100 × 精神状态评分）+（3 × 心率）+（10 × Pvco2]，可预测死亡率（接收器操作特征曲线下面积：0.88）。900 分界点的灵敏度为 80%，特异度为 80%。如果将临界值改为 800，则灵敏度为 100%，特异性为 50%：意义：我们开发了一种新的评分系统来预测确诊或疑似感染的住院犬的死亡率。有必要在更大的患者群中进行进一步的前瞻性评估，以验证该评分。

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引用次数: 0