Evaluation of the Sensitivity and Specificity of Diagnostic Criteria for Sepsis in Dogs

Hauptman, J. G.; Walshaw, Richard; Olivier, N. Bari

doi:10.1111/j.1532-950x.1997.tb01699.x

Cited by 265 publications

(303 citation statements)

References 7 publications

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“…Animals were classified as positive for SIRS when they had two or more of following four criteria: f > 20 breaths per minute, HR > 120 beats per minute, T < 38.1 or > 39.2 °C, total leukocyte count < 6 or > 16 x 10³/mm³ or percentage of band neutrophils > 3%. These criteria have 97% sensitivity in diagnosing patients with SIRS and have 64% specificity in classifying patients without SIRS (HAUPTMAN et al, 1997).…”

Section: Introductionmentioning

confidence: 99%

The importance of Gram positive bacteria as the cause of canine pyometra

anna

Trautwein

Pretto‐Giordano

et al. 2017

SCA

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E. coli is the main bacteria isolated from infected uterus and bacterial endotoxin can lead to fatal endotoxic shock. Systemic inflammatory response syndrome (SIRS) precedes the endotoxic shock. Thus, early recognition of SIRS is important for patient treatment and prognostic. In Brazil, Gram positive bacteria are responsible for approximately 20% of all pyometra cases, and there is limited information about pathophysiology of shock and tissue injury. The aim of this study was to investigate the capacity of Gram positive bacteria to cause SIRS in bitches with pyometra. A prospective follow-up of 67 bitches with pyometra was performed, which were classified as SIRS + and SIRS-on admission. All bitches were surgically treated (ovariohysterectomy), uterine contents were collected in a sterile manner and the material was submitted to microbiological evaluation. Were identified in 55.2% of bitches E. coli (G1), 23.9% other Gram negative bacteria (G2) and 20.9% Gram positive bacteria (G3). The leukocyte profile, serum biochemistry and prevalence of SIRS were similar between the groups. It is concluded that Gram positive bacteria have the capacity to promote tissue damage and can lead the patient to death after SIRS and shock, as well as by E. coli and other Gram negative. Key words: Bacteria etiology. Cystic endometrial hyperplasia. SIRS. ResumoA Escherichia coli é reportada como principal agente etiológico da piometra canina e as endotoxinas bacterianas podem desencadear choque endotóxico e óbito. A síndrome da resposta inflamatória sistêmica (SIRS) antecede o choque e sua identificação pode predizer o prognóstico do paciente. No Brasil, bactérias Gram positivas são responsáveis por aproximadamente 20% dos casos de piometra, e informações a respeito da fisiopatologia do choque ou da lesão tecidual nesses casos são escassos. Assim, o objetivo foi investigar a capacidade de bactérias Gram positivas desencadear SIRS em cadelas com piometra. Foram acompanhadas de maneira prospectiva 67 cadelas com piometra, que na admissão passaram por exame clínico, exames laboratoriais e foram classificadas como SIRS+ e SIRS-. Todos os animais foram tratados cirurgicamente (ovariohisterectomia), o conteúdo uterino foi coletado de forma estéril e o material foi submetido à avaliação microbiológica. Em 55,2% das cadelas foi identificada E. coli (G1), 23,9% outras bactérias Gram negativas (G2) e 20,9% Gram positivas (G3). O perfil leucocitário, a bioquímica sérica e a prevalência de SIRS foram semelhantes entre os grupos. Conclui-se

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Section: Introductionmentioning

confidence: 99%

The importance of Gram positive bacteria as the cause of canine pyometra

anna

Trautwein

Pretto‐Giordano

et al. 2017

SCA

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“…The SIRS classification was introduced to describe the clinical response to systemic inflammation and has been applied to patients with inflammatory disease 35, 36, 37. The SIRS classification is based on basic clinical and laboratory parameters.…”

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confidence: 99%

Serum Cardiac Troponin I Concentrations in Dogs with Systemic Inflammatory Response Syndrome

Hamacher¹,

Dörfelt²,

Müller³

et al. 2015

Veterinary Internal Medicne

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BackgroundMyocardial injury can be detected by cardiac troponin I (cTnI) concentration, which appears to be a predictor of short‐term death in critically ill patients. It is unknown if the best prognostic indicator of short‐term survival is cTnI measurement at admission or at later time points.Hypothesis/ObjectivesMeasuring cTnI with a high‐sensitivity (HS) test at different time points after admission may be a better short‐term prognostic indicator than a single cTnI measurement at admission in dogs with systemic inflammatory response syndrome (SIRS).AnimalsProspective, observational clinical study of 60 dogs with SIRS.MethodsCardiac troponin I concentration was measured in 133 serum samples, collected at days 1, 2, 3, and 5. Additionally, the acute patient physiologic and laboratory evaluation (APPLE) fast score was evaluated at admission. Prognostic capabilities of cTnI measurement and APPLE fast score for 28‐day mortality were assessed by receiver operating characteristic curve analysis.ResultsForty‐one dogs with SIRS that survived 28 days had significantly lower serum cTnI concentrations at admission (median, 0.09 ng/mL; P = .004) and at the peak time point (median, 0.23 ng/mL; P = .01) compared to 19 nonsurvivors (median at admission, 0.63 ng/mL; median at peak, 1.22 ng/mL). Area under the curve to predict survival, using cTnI was similar at admission (0.732) and at peak (0.708), and was 0.754 for the APPLE fast score.Conclusions and Clinical ImportanceIncreased cTnI concentration in dogs with SIRS is associated with poor outcome. Daily follow‐up measurement of cTnI concentration provides no additional prognostic information for short‐term mortality.

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“…To our knowledge, a scoring system to classify severity of sepsis has not been validated for use in veterinary patients, and the method used to diagnose systematic inflammatory response syndrome (ie, > 2 of 4 criteria present) is most frequently used to evaluate the severity of illness for dogs with septic peritonitis. 17 Unfortunately, the records for only a few dogs of the present study contained sufficient information for application of that method. Therefore, we decided to use ASA status prior to surgery as a surrogate measure of disease severity.…”

Section: Discussionmentioning

confidence: 78%

Effect of intraoperative constant rate infusion of lidocaine on short-term survival of dogs with septic peritonitis: 75 cases (2007–2011)

Bellini¹,

Seymour²

2016

javma

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The full details of the published version of the article are as follows: Small Animals S eptic peritonitis is associated with a high mortality rate, and it is a major cause of sepsis in dogs. The most common predisposing cause for septic peritonitis is the contamination of (or translocation into) the peritoneal cavity by microorganisms normally present in abdominal organs. 1,2 Endotoxins produced by bacteria cause the release of inflammatory cytokines, including interleukin, tumor necrosis factor, and prostanoids, which contribute to vasomotor paralysis and capillary occlusion with secondary leakage of fluid into the interstitium. [3][4][5][6][7] The clinical signs of septic peritonitis may be vague, but distributive shock fre- OBJECTIVETo investigate whether intraoperative administration of a lidocaine infusion to dogs with septic peritonitis was associated with short-term (48 hours) survival after surgery. DESIGN Retrospective case series.ANIMALS 75 dogs with septic peritonitis. PROCEDURESMedical records of dogs with septic peritonitis that underwent laparotomy between January 2007 and December 2011 at the Royal Veterinary College were reviewed. Select variables during the preoperative, intraoperative, and postoperative periods and short-term survival after surgery were compared between dogs that received an opioid only (group O; n = 33) and dogs that received lidocaine (50 µg/kg/min [22.7 µg/kg/min], IV; group L; 42) in addition to an opioid during surgery. RESULTSThe proportion of dogs that survived for 48 hours after surgery was significantly greater for group L (35/42) than for group O (20/33). Intraoperative infusion of lidocaine increased the odds of short-term survival (OR, 8.77; 95% CI, 1.94 to 39.57). No significant differences were observed between the 2 treatment groups for variables assessed during the preoperative and postoperative periods. During the intraoperative period, more dogs in group L received an IV bolus of a synthetic colloid than did dogs in group O, but the number of IV boluses administered was not associated with short-term survival. CONCLUSIONS AND CLINICAL RELEVANCEResults indicated that IV infusion of lidocaine might improve the short-term survival of dogs with septic peritonitis. Prospective clinical trials are necessary to determine the efficacy of lidocaine as a supportive treatment for dogs with septic peritonitis. (J Am Vet Med Assoc 2016;248:422-429)

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Evaluation of the Sensitivity and Specificity of Diagnostic Criteria for Sepsis in Dogs

Abstract: These criteria may be used for a sensitive, but nonspecific, diagnosis of sepsis in dogs.

Cited by 265 publications

References 7 publications

The importance of Gram positive bacteria as the cause of canine pyometra

The importance of Gram positive bacteria as the cause of canine pyometra

Serum Cardiac Troponin I Concentrations in Dogs with Systemic Inflammatory Response Syndrome

Effect of intraoperative constant rate infusion of lidocaine on short-term survival of dogs with septic peritonitis: 75 cases (2007–2011)

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