Effect of three resuscitative fluid therapy strategies on NT‐proBNP concentration in healthy dogs

Khoo, Alison; Waldner, Cheryl L.; Carr, Anthony P.; Gaunt, M. Casey

doi:10.1111/vec.12812

Cited by 4 publications

(6 citation statements)

References 10 publications

(15 reference statements)

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“…Given the timing of clinical presentation, it is difficult to completely negate the impact of these treatments on NT‐proBNP and cTnI concentrations. However, a previous study evaluating the effects of resuscitative fluid treatments on NT‐proBNP concentrations in dogs indicated that NT‐proBNP concentrations do not increase above reference ranges 63 . This finding may suggest that despite many dogs being on maintenance fluid therapy before phlebotomy, fluid administration may not have impacted NT‐proBNP concentrations in our study.…”

Section: Discussioncontrasting

confidence: 50%

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N‐terminal brain natriuretic peptide, cardiactroponin‐I, and point‐of‐care ultrasound in dogs with cardiac and noncardiac causes of nonhemorrhagic ascites

Morey

Lamb²,

Karnia

et al. 2023

Veterinary Internal Medicne

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Background: Nonhemorrhagic ascites (NHA) can be caused by cardiac diseases (cNHA) and noncardiac diseases (ncNHA). N-terminal brain natriuretic peptide (NT-proBNP), cardiac troponin-I (cTnI), and point-of-care ultrasound (POCUS) may differentiate between cNHA and ncNHA.Hypothesis/Objectives: We compared NT-proBNP and cTnI concentrations as well as POCUS findings in dogs presented with cNHA and ncNHA. Animals: Dogs (n = 60) were enrolled based on identification of NHA with an effusion packed cell volume < 10%. Methods: Blood samples were collected and POCUS was performed on all dogs. Dogs were diagnosed with cNHA (n = 28) or ncNHA (n = 32) based on echocardiography. The cNHA group was subdivided into cardiac non-pericardial disease (n = 17) and pericardial disease (n = 11).Results: The NT-proBNP concentration (median; range pmol/L) was significantly higher in the cNHA group (4510; 250-10 000) compared to the ncNHA group (739.5; 250-10 000; P = .01), with a sensitivity of 53.8% and specificity of 85.7% using a cut-off of 4092 pmol/L. The NT-proBNP concentrations were significantly higher in the cardiac non-pericardial disease group (8339; 282-10 000) compared with the pericardial disease group (692.5; 250-4928; P = .002). A significant difference in cTnI concentration (median; range ng/L) between the cNHA group (300; 23-112 612) and ncNHA group (181; 17-37 549) was not detected (P = .41). A significantly higher number of dogs had hepatic venous and caudal vena cava distension in the cNHA group compared to the ncNHA group, respectively (18/28 vs 3/29, P < .0001 and 13/27 vs 2/29, P < .001). Gall bladder wall edema was not significantly different between groups (4/28 vs 3/29, P = .74).

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Section: Discussioncontrasting

confidence: 50%

“…However, a previous study evaluating the effects of resuscitative fluid treatments on NT-proBNP concentrations in dogs indicated that NT-proBNP concentrations do not increase above reference ranges. 63 This finding may suggest that…”

Section: Discussionmentioning

confidence: 98%

N‐terminal brain natriuretic peptide, cardiactroponin‐I, and point‐of‐care ultrasound in dogs with cardiac and noncardiac causes of nonhemorrhagic ascites

Morey

Lamb²,

Karnia

et al. 2023

Veterinary Internal Medicne

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“…One study of 6 healthy dogs showed that a 90 mL/kg of isotonic crystalloid fluids provided as a bolus could increase median plasma NT-proBNP concentrations to 797 pmol/L (range: 250-985 pmol/L) 12 hours after fluid administration. 46 Although this study emphasizes cautious interpretation of cardiac biomarkers in dogs with concurrent AP, it should be noted that various other noncardiac disorders have been associated with elevated cardiac biomarker concentrations, including systemic inflammatory response syndrome, gastric dilatation and volvulus, and infectious diseases. 37,[47][48][49][50] In our study we utilized a Holter monitor to investigate the prevalence of conduction abnormalities in dogs with AP.…”

Section: Associations With Disease Severity Indicesmentioning

confidence: 79%

“…Potential causes of myocardial stretch in AP include the effects of fluid resuscitation. One study of 6 healthy dogs showed that a 90 mL/kg of isotonic crystalloid fluids provided as a bolus could increase median plasma NT‐proBNP concentrations to 797 pmol/L (range: 250‐985 pmol/L) 12 hours after fluid administration 46 …”

Section: Discussionmentioning

confidence: 99%

Cardiovascular abnormalities in dogs with acute pancreatitis

Cridge

Langlois

Steiner

et al. 2022

Veterinary Internal Medicne

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Background The prevalence and clinical importance of cardiac abnormalities in dogs with acute pancreatitis (AP) is unknown. Animals Twelve dogs with AP and 60 archived serum samples from dogs with suspected AP. Methods Two‐phase study. Phase I: Analysis of archived serum samples from dogs with clinical signs of AP and high Spec cPL concentrations. High sensitivity troponin I (TnIH) and N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) concentrations were measured in achieved serum samples. Phase II: Prospective observational study. Dogs with AP underwent echocardiography and Holter monitoring. Serum cardiac troponin I (cTnI) and plasma NT‐proBNP concentrations were measured. Previously described disease severity indices were calculated for each dog. Results Phase I: 41 of 60 dogs suspected of having AP had abnormally high TnIH concentrations and 13 of 60 had abnormally high serum NT‐proBNP concentrations. Higher TnIH concentrations were observed in dogs with Spec cPL concentration >2000 μg/L as compared to those with concentrations of 1000‐2000 μg/L. Phase II: 11 of 12 dogs diagnosed with pancreatitis had abnormal cTnI concentrations (median: 0.384 ng/mL, range: 0.041‐2.966 ng/mL, RI: ≤0.06 ng/mL) and 7 of 12 dogs had plasma NT‐proBNP concentrations above the reference interval (median: 971 pmol/L, range: 250‐2215 pmol/L, RI: ≤900 pmol/L). Supraventricular and ventricular ectopic beats occurred in 3 dogs. Echocardiographic abnormalities were detected in 5 dogs. Cardiovascular variables were not associated with indices of disease severity. Conclusions and Clinical Importance Myocardial injury is common in dogs with AP, but clinical consequences appeared to be uncommon in our small cohort. Cardiac biomarkers should be interpreted with caution in dogs with AP.

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“…Likewise, there is a lack of consensus regarding appropriate endpoints of resuscitation, with principles of goal‐directed therapy remaining controversial as well 8–11 . There is similar uncertainty and limited definitive recommendations for FBT available in published guidelines for administration of fluid therapy to dogs and cats by the American Animal Hospital Association 12–16 …”

Section: Introductionmentioning

confidence: 99%

A survey of emergency and critical care veterinarians regarding IV fluid bolus therapy and monitoring practices in small animals

Harris¹,

Hofmeister

Gicking³

2021

J Vet Emergen Crit Care

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Objective To determine how veterinary emergency and critical care clinicians define IV fluid bolus therapy (FBT) and what constitutes a positive response to a fluid bolus. Design Online survey of 222 emergency and critical care veterinarians between December 17, 2018, and March 1, 2019. Interventions An online survey was provided to diplomates of the American College of Veterinary Emergency and Critical Care (ACVECC), residents of ACVECC‐approved training programs, as well as house officers and emergency clinicians of a corporate multicenter emergency and specialty care veterinary hospital. The survey investigated the administration of various crystalloid, colloid, and blood products for FBT, as well as expected physiological responses. Measurements and Main Results The majority of respondents considered balanced isotonic crystalloids appropriate for FBT (220/222 [99.1%]). Respondents showed greater variability in acceptance of 0.9% sodium chloride (105/222 [47.30%]), hypertonic (3‐7%) sodium chloride (131/222 [59.01%]), and hydroxyethyl starch solutions (90/222 [40.54%]). Most respondents did not consider physiological plasma (44/222 [19.82%]) an appropriate choice. The most commonly used parameters for monitoring FBT responses were heart rate (220/222 [99.10%]), blood pressure (217/222 [97.75%]), capillary refill time (192/222 [86.49%]), lactate (181/222 [81.53%]), pulse pressure (151/222 [68.02%]), and rectal temperature (145/222 [65.32%]). The majority of respondents perceived that 0–20% (165/222 [74.32%]) of hypotensive patients are nonresponsive to FBT. Conclusions Small animal emergency and critical care clinicians favored balanced isotonic electrolyte solutions and hypertonic sodium chloride solutions for FBT over other options. When monitoring responses to FBT, heart rate, blood pressure, capillary refill time, and plasma lactate were among the most commonly monitored parameters, and there was a lack of familiarity with others. Despite the widespread use of FBT, these findings outline the need for further prospective clinical trials regarding the ideal fluid type and rate, as well as the appropriate responses to FBT.

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Effect of three resuscitative fluid therapy strategies on NT‐proBNP concentration in healthy dogs

Cited by 4 publications

References 10 publications

N‐terminal brain natriuretic peptide, cardiactroponin‐I, and point‐of‐care ultrasound in dogs with cardiac and noncardiac causes of nonhemorrhagic ascites

N‐terminal brain natriuretic peptide, cardiactroponin‐I, and point‐of‐care ultrasound in dogs with cardiac and noncardiac causes of nonhemorrhagic ascites

Cardiovascular abnormalities in dogs with acute pancreatitis

A survey of emergency and critical care veterinarians regarding IV fluid bolus therapy and monitoring practices in small animals

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