心包置管治疗犬心包积液18例回顾性分析(2007-2015)。

Simon Cook, Stefano Cortellini, Karen Humm
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引用次数: 4

摘要

目的:描述心包导管在犬心包积液(PE)中的应用,并详细描述任何相关的不良事件。设计:回顾性研究。单位:大学教学医院。动物:在2007年5月至2015年1月期间,18只客户拥有的狗放置了心包导尿管进行心包液引流。干预措施:没有。测量和主要结果:所有心包导管均在5小时内放置,通常在1小时内(中位72.5分钟,范围45-300分钟)。18例患者中10例给予布托啡诺镇静,4例加用咪达唑仑镇静。其中4例仅放置心包导管进行单次引流,并立即拔除。其余14例心包导管放置时间中位数为18小时(范围2-88小时)。其余14例患者中有10例在放置心包导管后重新引流。6/18例报告的主要不良事件为新发心律失常,其中4例给予抗心律失常治疗。无感染性或功能性并发症报道。出院10例,死亡1例,实施安乐死7例。结论:经改良seldinger技术将胸腔引流导管置入犬的心包间隙中,有助于pe的治疗。主要的相关不良事件是心律失常。放置时需要最小程度的镇静,而且狗往往不需要术后镇痛。导管可以留在原位重复引流,潜在地减少人员配置时间和重复镇静。它们的使用与需要治疗的心律失常率相关,为22%,而单独使用针心包穿刺的心律失常率为13%。使用许多设施中可用的设备,它们很容易定位。
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Retrospective evaluation of pericardial catheter placement in the management of pericardial effusion in dogs (2007-2015):18 cases.

Objective: To describe the use of pericardial catheters in dogs with pericardial effusion (PE), and detail any associated adverse events.

Design: Retrospective study.

Setting: University teaching hospital.

Animals: Eighteen client-owned dogs that had pericardial catheters placed for pericardial fluid drainage between May 2007 and January 2015.

Interventions: None.

Measurements and main results: All pericardial catheters were placed within 5 hours of presentation, usually within 1 hour (median 72.5 min, range 45-300 min). Ten of 18 cases were sedated with butorphanol, and 4 with additional midazolam. Four had pericardial catheters positioned for single drainage only and were immediately removed. The other 14 pericardial catheters remained in situ for a median of 18 hours (range 2-88 h). Ten of the remaining 14 cases were redrained after pericardial catheter placement. The main adverse events reported were new arrhythmias in 6/18 cases, with 4 of these 6 patients being administered anti-arrhythmic therapy. No infectious or functional complications were reported. Ten patients were discharged, 1 died and 7 were euthanized.

Conclusions: Thoracic drainage catheters inserted into the pericardial space via a modified-Seldinger technique can be positioned in dogs to aid management of PEs. The main associated adverse event is arrhythmia. Minimal sedation is required for placement, and dogs tend not to require postprocedural analgesia. Catheters can remain in situ for repeated drainage, potentially decreasing staffing time requirement and repeat sedation. Their use is associated with a rate of arrhythmia requiring treatment of 22%, compared to that of needle pericardiocentesis alone at 13%. They are easy to position using equipment available in many facilities.

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