Objective: To evaluate the use of the caudal vena cava collapsibility index (CVCCI) as a predictor of fluid responsiveness in hospitalized, critically ill dogs with hemodynamic or tissue perfusion abnormalities.

No abstract

ObjectiveTo evaluate a novel physiological approach for setting the tidal volume in mechanical ventilation according to inspiratory capacity, and to determine if it results in an appropriate mechanical and gas exchange measurements in healthy and critically ill dogs.MethodsTwenty healthy animals were included in the study to assess the tidal volume expressed as a percentage of inspiratory capacity. For inspiratory capacity measurement, the mechanical ventilator was set as follows: pressure control mode with 35cmH2O of inspired pressure and zero end-expiratory pressure for 5 seconds. Subsequently, the animals were randomized into four groups and ventilated with a tidal volume corresponding to the different percentages of inspiratory capacity. Subsequently, ten critically ill dogs were studied.ResultsHealthy dogs ventilated with a tidal volume of 17% of the inspiratory capacity showed normal respiratory mechanics and presented expected PaCO2 values more frequently than the other groups. The respiratory system and transpulmonary driving pressure were significantly higher among the critically ill dogs but below 15 cmH2O in all cases.ConclusionsThe tidal volume based on the inspiratory capacity of each animal has proven to be a useful and simple tool when setting ventilator parameters. A similar approach should also be evaluated in other species, including human beings, if we consider the potential limitations of tidal volume titration based on the calculated ideal body weight.

This paper compares and describes the tidal volume ( Vt ) used in mechanically ventilated dogs under a range of clinical conditions. Twenty-eight dogs requiring mechanical ventilation (MV) were classified into 3 groups: healthy dogs mechanically ventilated during surgery (group I, n = 10), dogs requiring MV due to extra-pulmonary reasons (group II, n = 7), and dogs that required MV due to pulmonary pathologies (group III, n = 11). The median Vt used in each group was 16 mL/kg (interquartile range [IQR], 15.14–21) for group I, 12.59 mL/kg (IQR, 9–14.25) for group II, and 12.59 mL/kg (IQR, 10.15–14.96) for group III. The Vt used was significantly lower in group III than in group I ( p = 0.016). The thoraco-pulmonary compliance was significantly higher in group I than in groups II and III ( p = 0.011 and p = 0.006, respectively). The median driving pressure was similar among the groups with a median of 9, 11, and 10 cmH 2 O in groups I, II, and III, respectively ( p = 0.260). Critically-ill dogs requiring MV due to the primary pulmonary pathology received a significantly lower Vt than healthy dogs but with a range of values that were markedly higher than those recommended by human guidelines.

No abstract

Objective To evaluate the use of the caudal vena cava collapsibility index (CVCCI) and the inspiratory/minimum and expiratory/maximum diameters of the vena cava to predict fluid responsiveness in hospitalized, critically ill cats with hemodynamic and tissue perfusion abnormalities. Design Diagnostic test study in a prospective cohort of hospitalized cats. Setting Private practice referral hospital. Animals Twenty‐four hospitalized cats with spontaneous breathing and compromised hemodynamics and tissue hypoperfusion. Interventions Ultrasonographic examination before and after fluid expansion with 10 ml/kg of lactated Ringer's solution. Measurements and Main Results Fluid responsiveness was evaluated using the velocity–time integral (VTI) of the subaortic blood flow, by measuring it before and after a fluid load of 10 ml/kg of lactated Ringer's solution. The CVCCI was calculated using the following formula: (maximum diameter – minimum diameter / maximum diameter) × 100. Ten cats were fluid responders (42 %) and 14 were nonresponders (58 %). The area under the receiver operating characteristic curve (AUROC) with their 95% confidence interval for the predictors and the best cutoff values were as follows: CVCCI, AUROC = 0.83 (0.66–1.00) and cutoff = 31%; inspiratory/minimum diameter, AUROC = 0.86 (0.70–1.00) and cutoff = 0.24 cm; expiratory/maximum diameter, AUROC = 0.88 (0.74–1.00) and cutoff = 0.22 cm. A significant lineal correlation was observed between the percentage of increase in VTI after expansion and CVCCI (rs = 0.68, P < 0.001), expiratory/maximum diameter (rs = –0.72, P < 0.001), and inspiratory/minimum diameter (rs = –0.71, P < 0.001). The intraobserver and interobserver variability was low for VTI, and the expiratory/maximum diameter and inspiratory/minimum diameter were high for CVCCI. Conclusions Caudal vena cava measurements could be useful to predict the response to fluids in hospitalized cats with hemodynamic and tissue perfusion alterations. Additional studies are required to draw definitive conclusions about the role of these variables to guide fluid administration in cats.

Objective: To evaluate the prognostic utility of quick Sepsis-related Organ Failure Assessment (qSOFA) for prediction of in-hospital mortality and length of hospitalization in dogs with pyometra.

Objective To evaluate the accuracy of selected echocardiographic variables used to predict fluid responsiveness in hospitalized dogs with compromised hemodynamics and tissue hypoperfusion. Design Diagnostic test study in a prospective cohort of hospitalized dogs. Setting Veterinary referral clinics. Animals Forty‐four hospitalized dogs with compromised hemodynamics and tissue hypoperfusion were utilized in this study. Interventions Echocardiographic examination before and after fluid replacement with 30 ml/kg of lactated Ringer's solution. Measurements and Main Results Pre‐fluid replacement measurements of velocity of transmitral E wave (E‐peak), the left ventricular end‐diastolic internal diameter normalized to body weight (LVIDdN), and the left ventricular end‐systolic internal diameter normalized to body weight (LVIDsN) were significantly lower in fluid‐responsive patients compared with nonresponders (P < 0.001). The area under the receiver operating characteristic curve (AUROC) with its 95% confidence interval (CI) for each significant predictor was as follows: E‐peak 0.907 (0.776–1.000, P < 0.001) and LVIDdN 0.919 (0.801–1.000, P < 0.001). The predictive capacity of LVIDsN was not significantly better than chance (AUROC, 0.753; 95% CI, 0.472–1.000, P = 0.078). A significant negative linear correlation was observed between the percentage of increase in velocity–time integral after expansion and the echocardiographic variables LVIDdN (rs = –0.452, P = 0.023) and E‐peak (rs = –0.396, P = 0.008) pre‐fluid replacement. The intraobserver and interobserver variability was very low (<5 %) for all measurements. Conclusions In this study using critically ill dogs with compromised hemodynamics and tissue hypoperfusion, pre‐fluid replacement measurements of LVIDdN and E‐peak adequately predict fluid responsiveness. Because a small number of fluid nonresponders were involved in the present study (11.4%), further studies that include larger numbers of fluid‐nonresponsive animals are required.