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Effects of high-volume, rapid-fluid therapy on cardiovascular function and hematological values during isoflurane-induced hypotension in healthy dogs
2012
Valverde, Alex | Gianotti, Giacomo | Rioja-Garcia, Eva | Hathway, Amanda
The objective of this study was to determine the effects of the administration of a high volume of isotonic crystalloid at a rapid rate on cardiovascular function in normovolemic, isoflurane-anesthetized dogs during induced hypotension. Using a prospective study, 6 adult dogs were induced to general anesthesia and cardiovascular and hematological values were measured while the dogs were maintained at 3 hemodynamic states: first during light anesthesia with 1.3% end-tidal isoflurane (ETI); then during a hypotensive state induced by deep anesthesia with 3% ETI for 45 min while administered 1 mL/kg body weight (BW) per minute of isotonic fluids; and then decreased to 1.6% ETI while receiving 1 mL/kg BW per minute of fluids for 15 min. End-tidal isoflurane (ETI) at 3.0 ± 0.2% decreased arterial blood pressure (ABP), cardiac index (CI), and stroke volume index (SVI), and increased stroke volume variation (SVV) and central venous pressure (CVP). Fluid administration during 3% ETI decreased only SVV and systemic vascular resistance index (SVRI), while CVP increased progressively. Decreasing ETI to 1.6 ± 0.1% returned ABP and SVI to baseline (ETI 1.3 ± 0.1%), while CI and heart rate increased and SVV decreased. There was significant progressive clinical hemodilution of hemoglobin (Hb), packed cell volume (PCV), total protein (TP), colloid osmotic pressure (COP), arterial oxygen content (CaO2), and central-venous oxygen content (CcvO2). High-volume, rapid-rate administration of an isotonic crystalloid was ineffective in counteracting isoflurane-induced hypotension in normovolemic dogs at a deep plane of anesthesia. Cardiovascular function improved only when anesthetic depth was reduced. Excessive hemodilution and its adverse consequences should be considered when a high volume of crystalloid is administered at a rapid rate.
Mostrar más [+] Menos [-]Correlation of hematocrit, platelet concentration, and plasma coagulation factors with results of thromboelastometry in canine whole blood samples
2012
Smith, Stephanie A. | McMichael, Maureen A. | Gilor, Shir | Galligan, Alyssa J. | Hoh, Crystal M.
Objective: To evaluate the components of canine whole blood samples that contribute to results of thromboelastometry (TEM). Animals: 127 healthy dogs.Procedures: For each dog, a blood sample was collected from a jugular vein into tubes containing no anticoagulant, EDTA, or citrate anticoagulant. Citrated whole blood samples underwent TEM with tissue factor and TEM with ellagic acid. Indicators of RBC mass and platelet concentration were evaluated, and plasma coagulation tests were performed; data obtained were compared with results of TEM. For technical reasons, samples were not available from all dogs for all tests. Results: Coagulation time was correlated with concentrations of primarily extrinsic pathway coagulation factors for TEM with tissue factor and with most factors via TEM with ellagic acid. Clot formation time, α angle, and maximum clot firmness were highly correlated with fibrinogen and platelet concentrations and some individual factor concentrations. Sample Hct was strongly correlated with most measured variables; low Hct was associated with relative hypercoagulability, and high Hct was associated with relative hypocoagulability. Conclusions and Clinical Relevance: For TEM of canine blood samples, coagulation time was primarily a function of coagulation factor concentrations, whereas other variables were dependent on platelet and fibrinogen concentrations. Sample Hct strongly influenced the results of TEM, likely because RBCs act as a diluent for plasma coagulation factors. Thromboelastometry appeared to be affected by abnormalities of coagulation factors, platelet concentrations, and RBC mass. In samples from anemic patients, results of TEM indicative of hypercoagulability may be artifactual because of low RBC mass.
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