钝性胸外伤犬ct胸椎损伤评分与血气和酸碱平衡的关系。

Robert M Kirberger, Andrew L Leisewitz, Yolandi Rautenbach, Chee Kin Lim, Nerissa Stander, Nicky Cassel, Luke Arnot, Marizelle deClercq, Richard Burchell
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引用次数: 4

摘要

目的:探讨机动车事故致钝性胸外伤犬CT评价的胸椎损伤与动脉血气和酸碱状态的关系。设计:前瞻性观察性临床研究。单位:大学教学医院。动物:31个客户拥有受伤的狗,15个健康的狗。程序:在45个月的登记期内,所有创伤组的狗在创伤事件发生后24小时内(但不早于4小时)接受CT扫描并同时进行动脉血气分析。测量结果和主要结果:胸部损伤分为肺、胸膜间隙或胸腔,并使用CT综合肺、胸膜和肋骨评分对这些部分的严重程度进行评分。评估创伤组动脉血气、酸碱状态与对照组比较有无统计学差异。与对照组相比,创伤组肺动脉氧压明显降低,这也得到了动脉氧合计算变量的显著差异的支持。复合肺评分、胸膜评分与动脉血氧状态变量之间也存在显著相关性。肺动脉二氧化碳压与任何表明肺泡通气正常的胸部损伤变量无显著差异。酸碱失衡通常是轻微的、不显著的和可变的。结论及临床意义:钝性胸外伤可造成明显的肺、胸膜损伤,并显著影响血氧经济性。动脉血氧功能指标与胸部CT病理有良好的相关性。肺泡通气大多被保留,但存在临床上显著的通气灌注错配。
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Association between computed tomographic thoracic injury scores and blood gas and acid-base balance in dogs with blunt thoracic trauma.

Objective: To determine the association between thoracic injuries evaluated by computed tomography (CT) and arterial blood gas and acid-base status in dogs with blunt thoracic trauma caused by motor vehicle accidents.

Design: Prospective observational clinical study.

Setting: University teaching hospital.

Animals: Thirty-one client owned traumatized dogs and 15 healthy dogs.

Procedures: All trauma group dogs underwent a CT scan and simultaneous arterial blood gas analysis within 24 hours, but not before 4 hours, after the traumatic incident within a 45-month enrollment period.

Measurements and main results: Thorax injuries were classified as pulmonary, pleural space, or rib cage and each of these components was scored for severity using a CT composite pulmonary, pleural, and rib score. The trauma group arterial blood gas and acid-base status were evaluated for statistical difference from the control group. The pulmonary-arterial oxygen pressure was significantly lower in the trauma group compared to the control group that was supported by significant differences in the calculated variables of arterial blood oxygenation as well. There was also a significant correlation between the composite lung score and pleural score and the variables of arterial oxygen status. The pulmonary-arterial carbon dioxide pressure was not significantly different to any of the thoracic injury variables indicating normal alveolar ventilation. Acid-base imbalances were generally mild, insignificant, and variable.

Conclusions and clinical relevance: Blunt thoracic trauma causes significant pulmonary and pleural injury and the blood oxygen economy is significantly affected by this. The functional measures of arterial blood oxygenation were well correlated with thoracic CT pathology. Alveolar ventilation was mostly spared but a clinically significant ventilation perfusion mismatch was present.

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