جستجوی مقالات مرتبط با کلیدواژه "hydroxyethyl starch" در نشریات گروه "دامپزشکی"

It has been documented that hemodynamic disturbances occur in hypovolemic patients. Therefore, the early management of hypovolemia is essential to achieve optimal outcomes. Blood gas, which changes rapidly during hemodynamic instability, can be used as a diagnostic approach for monitoring emergency patients. The objective of the current study was to evaluate the results of resuscitation with hydroxyethyl starch (HES) or lactated Ringer's solution (LR) on venous and arterial blood gas. In addition, the difference between venous and arterial blood gas parameters is investigated to assess the possibility of using venous blood gas analysis as a successor for arterial blood gas analysis in the resuscitation of hypovolemic dogs. Venous and arterial pH, PO2, PCO2, HCO3-, and base excess were analyzed at the end of each study stage as follow: 1) Establishment of anesthesia, 2) Blood collection to an arterial mean pressure of 40-50 mm Hg, 3) Maintaining dogs in a hypovolemic state, 4) Resuscitation with LR (group A) or HES (group B) in four steps, and 5) One hour after the final resuscitation step. Hypovolemia decreased the studied parameters, except venous PCO2, which showed a significant increase (p < 0.05). Fluid resuscitation returned the studied parameters to the control values as venous PCO2 in group A and HCO3- in group B showed a significant change in comparison with the control values (p < 0.05). We found that venous pH, HCO3-, and PCO2 can be used as less invasive and safer alternatives to similar arterial parameters to monitor the fluid resuscitation of hypovolemic dogs.

GReliable prediction of patient response to fluid resuscitation is a crucial issue in the management of hemorrhagic shock.

This study was designed to investigate vertebral heart score (VHS) variation in fluid resuscitation of hemorrhagic shock patients and the feasibility of this method in determining resuscitation endpoint. 

VHS values were assessed using previously published standard method in left to right lateral view. After induction of anesthesia (control assessments), hemorrhagic shock was induced by blood withdrawal to a mean arterial pressure of 40 to 50 mmHg within 30 minutes and then maintained in hypovolemic situation for an additional 30 minutes (second and third stages of assessments). Afterward, the dogs were randomly assigned to two groups which received 20 ml/kg lactated Ringer’s solution or 5 ml/kg Hydroxyethyl starch, in four consecutive 15 minute intervals (fourth stage of assessments). One hour after the last resuscitation step, final radiographic assessments were performed. 

Hemorrhagic shock caused significant decrease in VHS values to a mean of 7.7 vertebrae (P<0.05). Following the fluid resuscitation VHS increased and returned to pre-shock values in both groups.

This study confirms that the breed-specific VHS assessment can be a useful method in monitoring of patient’s response to fluid therapy and determination of resuscitation endpoint in dogs with hemorrhagic shock.