Use of aortic flow indexes derived from transthoracic echocardiography to evaluate response to a fluid challenge in anesthetized dogs
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.1016/j.vaa.2020.12.006 http://hdl.handle.net/11449/207229 |
Resumo: | Objective: To evaluate the ability of transthoracic echocardiographic aortic flow measurements to discriminate response to a fluid challenge (FC) in healthy anesthetized dogs. Study design: Prospective experimental study. Animals: A total of 48 isoflurane-anesthetized dogs (14.2–35.0 kg) undergoing elective surgery. Methods: Fluid responsiveness was evaluated before surgery by FC (lactated Ringer's 10 mL kg–1 intravenously over 5 minutes). Percentage increases in transpulmonary thermodilution stroke volume (ΔSVTPTD) >15% from values recorded before FC defined responders to volume expansion. A group of 24 animals were assigned as nonresponders (ΔSVTPTD ≤15%). When ΔSVTPTD was >15% after the first FC, additional FC were administered until ΔSVTPTD was ≤15%. Final fluid responsiveness status was based on the response to the last FC. Percentage increases after FC in aortic flow indexes [velocity time integral (ΔVTIFC) and maximum acceleration (ΔVmaxFC)] and in mean arterial pressure (ΔMAPFC) were compared with ΔSVTPTD. Results: After one FC, 24 animals were responders. For nonresponders, ΔSVTPTD was ≤15% after one, two and three FCs in eight/24, 15/24 and one/24 animals, respectively. The FC that defined responsiveness increased ΔSVTPTD by 29 (18–53)% in responders and by 8 (–3 to 15)% in nonresponders [mean (range)]. The area under the receiver operating characteristics curve (AUROC) of ΔVTIFC (0.901) was larger than the AUROCs of ΔVmaxFC (0.774, p = 0.041) and ΔMAPFC (0.519, p < 0.0001). ΔMAPFC did not predict responsiveness (p = 0.826). Best cut-off thresholds for discriminating responders, with respective zones of diagnostic uncertainty (gray zones) were >14.7 (10.8–17.6)% for ΔVTIFC and >8.6 (–0.3 to 14.7)% for ΔVmaxFC. Animals within the gray zone were 17% (ΔVTIFC) and 50% (ΔVmaxFC). Conclusions and clinical relevance: Changes in VTI induced by FC can determine responsiveness with reasonable accuracy in dogs and could play an important role in goal-directed fluid therapy. |
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Use of aortic flow indexes derived from transthoracic echocardiography to evaluate response to a fluid challenge in anesthetized dogsfluid responsivenessgoal-directed fluid therapyvelocity time integralObjective: To evaluate the ability of transthoracic echocardiographic aortic flow measurements to discriminate response to a fluid challenge (FC) in healthy anesthetized dogs. Study design: Prospective experimental study. Animals: A total of 48 isoflurane-anesthetized dogs (14.2–35.0 kg) undergoing elective surgery. Methods: Fluid responsiveness was evaluated before surgery by FC (lactated Ringer's 10 mL kg–1 intravenously over 5 minutes). Percentage increases in transpulmonary thermodilution stroke volume (ΔSVTPTD) >15% from values recorded before FC defined responders to volume expansion. A group of 24 animals were assigned as nonresponders (ΔSVTPTD ≤15%). When ΔSVTPTD was >15% after the first FC, additional FC were administered until ΔSVTPTD was ≤15%. Final fluid responsiveness status was based on the response to the last FC. Percentage increases after FC in aortic flow indexes [velocity time integral (ΔVTIFC) and maximum acceleration (ΔVmaxFC)] and in mean arterial pressure (ΔMAPFC) were compared with ΔSVTPTD. Results: After one FC, 24 animals were responders. For nonresponders, ΔSVTPTD was ≤15% after one, two and three FCs in eight/24, 15/24 and one/24 animals, respectively. The FC that defined responsiveness increased ΔSVTPTD by 29 (18–53)% in responders and by 8 (–3 to 15)% in nonresponders [mean (range)]. The area under the receiver operating characteristics curve (AUROC) of ΔVTIFC (0.901) was larger than the AUROCs of ΔVmaxFC (0.774, p = 0.041) and ΔMAPFC (0.519, p < 0.0001). ΔMAPFC did not predict responsiveness (p = 0.826). Best cut-off thresholds for discriminating responders, with respective zones of diagnostic uncertainty (gray zones) were >14.7 (10.8–17.6)% for ΔVTIFC and >8.6 (–0.3 to 14.7)% for ΔVmaxFC. Animals within the gray zone were 17% (ΔVTIFC) and 50% (ΔVmaxFC). Conclusions and clinical relevance: Changes in VTI induced by FC can determine responsiveness with reasonable accuracy in dogs and could play an important role in goal-directed fluid therapy.Department of Veterinary Surgery and Animal Reproduction Faculdade de Medicina Veterinária e Zootecnia Universidade Estadual Paulista (UNESP)Department of Anesthesiology Faculdade de Medicina Universidade Estadual Paulista (UNESP)Department of Veterinary Surgery and Animal Reproduction Faculdade de Medicina Veterinária e Zootecnia Universidade Estadual Paulista (UNESP)Department of Anesthesiology Faculdade de Medicina Universidade Estadual Paulista (UNESP)Universidade Estadual Paulista (Unesp)de Oliveira, Guillermo C.V. [UNESP]Teixeira-Neto, Francisco J. [UNESP]Dalmagro, Tábata L. [UNESP]Alfonso, Angélica [UNESP]Celeita-Rodríguez, Nathalia [UNESP]Lobo, César P.C. [UNESP]Lourenço, Maria L.G. [UNESP]2021-06-25T10:51:07Z2021-06-25T10:51:07Z2021-03-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article187-197http://dx.doi.org/10.1016/j.vaa.2020.12.006Veterinary Anaesthesia and Analgesia, v. 48, n. 2, p. 187-197, 2021.1467-29951467-2987http://hdl.handle.net/11449/20722910.1016/j.vaa.2020.12.0062-s2.0-85100379841Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengVeterinary Anaesthesia and Analgesiainfo:eu-repo/semantics/openAccess2024-09-09T14:06:17Zoai:repositorio.unesp.br:11449/207229Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestrepositoriounesp@unesp.bropendoar:29462024-09-09T14:06:17Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Use of aortic flow indexes derived from transthoracic echocardiography to evaluate response to a fluid challenge in anesthetized dogs |
title |
Use of aortic flow indexes derived from transthoracic echocardiography to evaluate response to a fluid challenge in anesthetized dogs |
spellingShingle |
Use of aortic flow indexes derived from transthoracic echocardiography to evaluate response to a fluid challenge in anesthetized dogs de Oliveira, Guillermo C.V. [UNESP] fluid responsiveness goal-directed fluid therapy velocity time integral |
title_short |
Use of aortic flow indexes derived from transthoracic echocardiography to evaluate response to a fluid challenge in anesthetized dogs |
title_full |
Use of aortic flow indexes derived from transthoracic echocardiography to evaluate response to a fluid challenge in anesthetized dogs |
title_fullStr |
Use of aortic flow indexes derived from transthoracic echocardiography to evaluate response to a fluid challenge in anesthetized dogs |
title_full_unstemmed |
Use of aortic flow indexes derived from transthoracic echocardiography to evaluate response to a fluid challenge in anesthetized dogs |
title_sort |
Use of aortic flow indexes derived from transthoracic echocardiography to evaluate response to a fluid challenge in anesthetized dogs |
author |
de Oliveira, Guillermo C.V. [UNESP] |
author_facet |
de Oliveira, Guillermo C.V. [UNESP] Teixeira-Neto, Francisco J. [UNESP] Dalmagro, Tábata L. [UNESP] Alfonso, Angélica [UNESP] Celeita-Rodríguez, Nathalia [UNESP] Lobo, César P.C. [UNESP] Lourenço, Maria L.G. [UNESP] |
author_role |
author |
author2 |
Teixeira-Neto, Francisco J. [UNESP] Dalmagro, Tábata L. [UNESP] Alfonso, Angélica [UNESP] Celeita-Rodríguez, Nathalia [UNESP] Lobo, César P.C. [UNESP] Lourenço, Maria L.G. [UNESP] |
author2_role |
author author author author author author |
dc.contributor.none.fl_str_mv |
Universidade Estadual Paulista (Unesp) |
dc.contributor.author.fl_str_mv |
de Oliveira, Guillermo C.V. [UNESP] Teixeira-Neto, Francisco J. [UNESP] Dalmagro, Tábata L. [UNESP] Alfonso, Angélica [UNESP] Celeita-Rodríguez, Nathalia [UNESP] Lobo, César P.C. [UNESP] Lourenço, Maria L.G. [UNESP] |
dc.subject.por.fl_str_mv |
fluid responsiveness goal-directed fluid therapy velocity time integral |
topic |
fluid responsiveness goal-directed fluid therapy velocity time integral |
description |
Objective: To evaluate the ability of transthoracic echocardiographic aortic flow measurements to discriminate response to a fluid challenge (FC) in healthy anesthetized dogs. Study design: Prospective experimental study. Animals: A total of 48 isoflurane-anesthetized dogs (14.2–35.0 kg) undergoing elective surgery. Methods: Fluid responsiveness was evaluated before surgery by FC (lactated Ringer's 10 mL kg–1 intravenously over 5 minutes). Percentage increases in transpulmonary thermodilution stroke volume (ΔSVTPTD) >15% from values recorded before FC defined responders to volume expansion. A group of 24 animals were assigned as nonresponders (ΔSVTPTD ≤15%). When ΔSVTPTD was >15% after the first FC, additional FC were administered until ΔSVTPTD was ≤15%. Final fluid responsiveness status was based on the response to the last FC. Percentage increases after FC in aortic flow indexes [velocity time integral (ΔVTIFC) and maximum acceleration (ΔVmaxFC)] and in mean arterial pressure (ΔMAPFC) were compared with ΔSVTPTD. Results: After one FC, 24 animals were responders. For nonresponders, ΔSVTPTD was ≤15% after one, two and three FCs in eight/24, 15/24 and one/24 animals, respectively. The FC that defined responsiveness increased ΔSVTPTD by 29 (18–53)% in responders and by 8 (–3 to 15)% in nonresponders [mean (range)]. The area under the receiver operating characteristics curve (AUROC) of ΔVTIFC (0.901) was larger than the AUROCs of ΔVmaxFC (0.774, p = 0.041) and ΔMAPFC (0.519, p < 0.0001). ΔMAPFC did not predict responsiveness (p = 0.826). Best cut-off thresholds for discriminating responders, with respective zones of diagnostic uncertainty (gray zones) were >14.7 (10.8–17.6)% for ΔVTIFC and >8.6 (–0.3 to 14.7)% for ΔVmaxFC. Animals within the gray zone were 17% (ΔVTIFC) and 50% (ΔVmaxFC). Conclusions and clinical relevance: Changes in VTI induced by FC can determine responsiveness with reasonable accuracy in dogs and could play an important role in goal-directed fluid therapy. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-06-25T10:51:07Z 2021-06-25T10:51:07Z 2021-03-01 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1016/j.vaa.2020.12.006 Veterinary Anaesthesia and Analgesia, v. 48, n. 2, p. 187-197, 2021. 1467-2995 1467-2987 http://hdl.handle.net/11449/207229 10.1016/j.vaa.2020.12.006 2-s2.0-85100379841 |
url |
http://dx.doi.org/10.1016/j.vaa.2020.12.006 http://hdl.handle.net/11449/207229 |
identifier_str_mv |
Veterinary Anaesthesia and Analgesia, v. 48, n. 2, p. 187-197, 2021. 1467-2995 1467-2987 10.1016/j.vaa.2020.12.006 2-s2.0-85100379841 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Veterinary Anaesthesia and Analgesia |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
187-197 |
dc.source.none.fl_str_mv |
Scopus reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
repositoriounesp@unesp.br |
_version_ |
1810021351838187520 |