Shock/CPR articles Flashcards
Evaluation of the relationship between peripheral pulse palpation and Doppler systolic blood pressure in dogs presenting to an emergency service
Ateca et al JVECC 2018
Mean SBP not diff b/w femoral pulse but diff in dorsal metatarsal pulse group
Absent metatarsal pulse 7.6x times more likely to be hypotensive (SBP<90mmHg)
Retrospective evaluation of the prognostic utility of plasma lactate concentration, base deficit, pH, and anion gap in canine and feline emergency patients
Kohen JVECC 2018
Plasma lactate, BD and pH predicted mortality in dogs
Plasma lactate is an independent predictor of mortality inc cats
Mortality was highest for animals with lactic acidosis
Evaluation of pulse pressure variation and pleth variability index to predict fluid responsiveness in mechanically ventilated isoflurane-anesthetized dogs
Sano jvecc 2018
PPV and PVI increased consistently with decreased blood volume and decreased with volume expansion
More were more accurate than CVP
In mechanically ventilated dog:
Pulse pressure variation (PPV) at 11 was 79% Sn 80% Sp
Pleth variability index (PVI) of 9.3% was 86% Sn and 70% Sp
for predicting fluid responsiveness
Evaluation of end-tidal carbon dioxide as a predictor of return of spontaneous circulation in dogs and cats undergoing cardiopulmonary resuscitation
hogen jvecc 2018
ROSC patients had higher initial, peak, average, and delta PetCO2
Optimal cutoff PetCO2 is 18 mmHg at minute 2 of CPR was the strongest discriminator
34% achieved ROSC, more common for in-hospital CPA
(Hofmeister 2009: previous study: ETCO2 >15 mmHg in dogs and >20 mmHg in cats)
Tissue oxygen saturation in dogs with acute hemorrhage
gray jvecc 2018
Healthy dogs had higher tissue hemoglobin O2 saturation (StO2)
Measures Hb sat in microvasculature (rather than SpO2 = arterial blood)
StO2 cutoff of 87.6% can be used to identify patient being in shock
Spontaneous hemoperitoneum and anaphylactic shock associated with Hymenoptera envenomation in a dog
Dana J. Caldwell et al jvecc 2018
Anaphylaxis secondary to Hymenoptera envenomation –> spontaneous hemoperitoneum
No GB edema and ALT was only mildly elevated (198)
Evaluation of biomarkers of kidney injury following 4% succinylated gelatin and 6% hydroxyethyl starch 130/0.4 administration in a canine hemorrhagic shock model.
Boyd et al jvecc 2019
GELO was associated with greater magnitude increases in urine biomarkers of AKI (uNGAL, uCLUST, uCYSC, uKIM) and more frequent marked tubular microvesiculation
increased despite adequate glomerular filtration rate and tubular function
Evaluation of tissue oxygen saturation in naturally occurring canine shock patients.
Berg jvecc 2019
StO2 = indicative of venous hemoglobin oxygen saturation, surrogate for DO2
Dogs w/ naturally occurring shock had lower StO2 (65%)
Mod linear correlation to APPLE score
Development and validation of a hemangiosarcoma likelihood prediction model in dogs presenting with spontaneous hemoabdomen: The HeLP score.
Schick, et al jvecc 2019
nontraumatic hemoabdomen
Score based on BW, TP, plt count and TXR findings
low, medium, or high risk
AUROC 0.77
Investigation of percentage changes in pulse wave transit time induced by mini-fluid challenges to predict fluid responsiveness in ventilated dogs.
Sano jvecc 2019
PWTT was calculated as the time from the ECG R-wave peak to the rise point of the pulse oximeter plethysmography wave
- inversely proportional to SV and has a strong negative correlation with SV
- good trending ability to detect changes in SV measured by thermodilution technique
- 3 mL/kg = minimum amount
- Pulse wave transit time (PWTT%Δ) 2.5% accurately predicted fluid responsiveness.
A pilot study comparing bone marrow aspirates and venous blood for emergency point-of-care blood parameters in healthy dogs.
Ackert et al jvecc 2019
IO and IV difference: Na, Cl, BUN, K, HCT
K and HCT sig. different. K higher in IO
Retrospective evaluation of pericardial catheter placement in the management of pericardial effusion in dogs (2007-2015):18 cases.
Cook et al jvecc 2019
Done via modified seldinger technique
Main SE was arrhythmia and required tx more often (22 vs 13%)
Utility of admission lactate concentration, lactate variables, and shock index in outcome assessment in dogs diagnosed with shock.
Zollo et al jvecc 2019
Shorter duration of lac >2, greater lactate clearance, and smaller area under the lactate conc vs time curve
were found in survivor
admission SI and time to normalize SI was no diff.
Evaluation of the agreement between a point-of-care lactate meter and a handheld laboratory analyzer in cats treated in emergency practice
Mark J. Acierno et al jvecc 2020
New POC lactate meter is in agreement w/ handheld analyzer in CI cats
Lactate Plus machine (new machine) compared to iSTAT
Perception of small animal cardiopulmonary resuscitation of owners presenting to a small animal teaching clinic including a large first opinion service
Jennifer A. Oberholtzer et al jvecc 2020
The general public are interested in CPR
Retrospective evaluation of the influence of azotemia on plasma lactate concentrations in hypotensive dogs and cats (2008-2018): 337 cases
Wolf et al jvecc 2020
Hypotensive + severe azotemia (Cr >5) have LOWER lactate compared to hypotensive, non-azotemic
Suspect decreased cellular production of lactate or increased excretion of lactate
Differences in the clinical practice of small animal CPR before and after the release of the RECOVER guidelines: Results from two electronic surveys (2008 and 2017) in the United States and Canada
Donaldson et al jvecc 2020
Compliance was higher in 2017 than 2008
Incr in age = less compliance w/ BLS guidelines
Evaluation of the rectal-interdigital temperature gradient as a diagnostic marker of shock in dogs
Schaefer et al jvecc 2020
Dogs in shock were more likely to have sig. increased rectal-interdigital temp gradient (RITG)
RITG correlated to prolonged CRT, tachycardia, decreased DBP, and SI
RITG 8.5F to screen for shock and 11.6F indicate high suspicion (high Sp)
Caudal vena cava collapsibility index as a tool to predict fluid responsiveness in dogs
Pablo A. Donati et al, jvecc 2020
CI spontaneously breathing dogs
CVCCI = (max diameter-min diameter)/max diameter x 100
VTI >-15% = fluid responder
CVCCI accurately predicted fluid responsiveness w/ AUROC 0.96 with optimal cut-off at 27% (100% Sn and 83% Sp)
Owner-witnessed cardiopulmonary resuscitation in small animal emergency veterinary medicine
Lindsey M. Fejfar et al, javma 2018
78% opposed it
Respondents with <10 years experience less willing to allow owners be present
A pilot study evaluating adaptive closed-loop fluid resuscitation during states of absolute and relative hypovolemia in dogs
Behnood Gholami et al jvecc 2018
Closed-loop fluid admin based on IVF distribution and compartmental dynamical system can be used for GDFT during absolute or relative hypovolemia in ventilated dogs
-requires feedback signal (SVV-stroke volume variation) and a desired state (e.g. 13%) and it adjusts IVF rate as needed to maintain
Effect of three resuscitative fluid therapy strategies on NT-proBNP concentration in healthy dogs.
Alison Khoo, et al jvecc 2019
NT-proBNP didn’t incr beyond reported cutoffs to ddx cardiac vs noncardiac causes of resp signs after receiving balanced crystalloid solution, hypertonic saline, or a synthetic colloid
Retrospective evaluation of paired plasma creatinine and chloride concentrations following hetastarch administration in anesthetized dogs (2002-2015): 244 cases.
Kristin M Zersen, et al jvecc 2019
6 mL/kg HES lower Cr and increased Cl in post-ax dogs
NEJM 2018
PARAMEDIC2: Randomized trial of epi in out-of-hospital CPA
Use of epi resulted in higher rate of 30d survival compared to placebo but no diff in neuro outcome
Sonographic assessment of volaemia: development and validation of a new method in dogs
M. Cambournac et al JSAP 2018
CdVC:Aorta ratio is lower in hypovolemic dogs
CCM 2020
Alterations in Skin Blood Flow at the Fingertip Are Related to Mortality in Patients With Circulatory Shock
Alterations in fingertip skin blood flow can be evaluated using a laser Doppler thermal challenge technique in patients with circulatory shock and are directly related to outcome
(Survivors had: higher baseline skin BF, shorter CRT)
CCM 2020
Targeted Temperature Management at 33 Versus 36 Degrees: A Retrospective Cohort Study
Comatose, adult out-of-hospital cardiac arrest patients treated during the targeted temperature management 33°C period had higher odds of neurologically intact survival to hospital discharge
