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  • Author or Editor: Eric R. Schertel x
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Objective—

To compare the efficacy of 7% NaCI solution (hypertonic saline) in 6% dextran 70 solution (HSD) with that of lactated Ringer's solution (LRS) for treatment of dogs in traumatic shock.

Design—

Prospective, randomized, clinical study.

Animals—

16 traumatized adult dogs with clinical signs of shock.

Procedure—

Physical, hemodynamic, blood gas, and clinical chemistry measurements were performed prior to treatment. Initial treatment consisted of HSD (n = 8) or LRS (n = 8) administered as a bolus (5 ml/kg of body weight, IV) over a 3-minute period, followed by administration of additional LRS and other treatments to restore hemodynamic and physical criteria to within reference limits. Measurements were repeated for 3 hours after initial treatment. The volumes of LRS and HSD administered were recorded hourly. Degree of injury was scored by using a trauma severity index.

Results—

Dogs responded similarly to the treatments, and all but 3 dogs survived to be discharged. The amount of fluid administered to dogs in the HSD group over the final 2 hours of the study was significantly less than that administered to the dogs in the LRS group. Serum sodium concentration and osmolality of the dogs in the HSD group were not significantly greater than those values in the LRS group. Bradyarrhythmias were observed in 2 dogs in the HSD group.

Clinical Implications—

Hypertonic sodium chloride/ dextran solution is safe and effective for resuscitating dogs in traumatic shock. Seven percent NaCI in 6% dextran 70 may reduce the need for isotonic fluids in the hours after initial resuscitation. (J Am Vet Med Assoc 1996;208:366-370)

Free access
in Journal of the American Veterinary Medical Association

SUMMARY

We investigated small-volume (5 ml/kg) 7% NaCl in 6% dextran 70 (HS/D70) as an alternative to large-volume (60 ml/kg) 0.9% NaCl for treatment of experimentally induced canine gastric dilatation-volvulus (gdv) shock. The stomach was surgically displaced and then distended with an intragastric balloon in 11 dogs anesthetized with pentobarbital. All dogs were subjected to gdv for 180 minutes before partial decompression and resuscitation. Hemodynamic values, blood gas values, and plasma volume were measured during control, shock, and resuscitation periods. Resuscitation started with 1 group (n = 6) receiving 5 ml of HS/D70/kg, iv, over 5 minutes, and the other group (n = 5) receiving 60 ml of 0.9% NaCl/kg, iv, over 60 minutes. Both groups received a surgical maintenance dosage (20 ml/kg/h) of 0.9% NaCl after initial resuscitation. Resuscitative effects of small-volume HS/D70 were similar to large-volume 0.9% NaCl during the first hour of treatment; however, cardiac output was significantly higher in the HS/D70 group for the last 2 hours of resuscitation. Changes in heart rate, left ventricular pressure change, and systemic vascular resistance appeared to be responsible for improved perfusion. Mixed venous oxygen partial pressure data supported improved perfusion in the HS/D70 group. Packed cell volume remained higher in the HS/D70 group, indicating less hemodilution and improved oxygen delivery. Resuscitation of this gdv-induced shock model was better sustained with small-volume HS/D70, compared with conventional large-volume 0.9% NaCl.

Free access
in American Journal of Veterinary Research

Objective

To evaluate factors associated with perioperative mortality in dogs with gastric dilatation-volvulus and to determine the influence of treatment differences between university and private specialty practices on outcome.

Design

Retrospective analysis of medical records.

Animals

137 dogs with gastric dilatation-volvulus.

Procedure

Signalment; frequency of preoperative and postoperative treatments and complications; intraoperative findings; surgical technique; and hematologic, serum biochemical, and electrocardiographic results were recorded, evaluated for association with mortality, and compared between institutions.

Results

Mortality did not differ between institutions, and overall mortality was 18% (24/137). Surgical techniques differed between institutions, but were not associated with mortality. Gastric necrosis was associated with significantly higher mortality (46%; 13/28). When partial gastrectomy or splenectomy was performed, mortality (35 and 32% or 8/23 and 10/31, respectively) was significantly increased. Splenectomy was performed in 11 of 23 dogs requiring partial gastrectomy, and when both procedures were performed, mortality (55%; 6/11) was significantly increased. Preoperative cardiac arrhythmias were associated with significantly higher mortality (38%; 6/16). Mortality in dogs > 10 years old was not significantly greater than that in younger dogs.

Clinical Implications

Patient management differences between practices did not seem to influence survival in dogs with surgically managed gastric dilatation-volvulus. Signalment, including age, did not influence mortality. Gastric necrosis, gastric resection, splenectomy, and preoperative cardiac arrhythmias were associated with mortality > 30%. (J Am Vet Med Assoc 1996;208:1855-1858)

Free access
in Journal of the American Veterinary Medical Association

Objective

To test the hypothesis that small volumes of hypertonic saline-dextran (HSD) solution can be used to effectively resuscitate dogs in shock induced by gastric dilatation-volvulus (GDV). and, compared with administration of large volumes of lactated Ringer's solution (LRS), can be used to limit the overall volume of fluid needed for resuscitation.

Design

Prospective, clinical study.

Animals

15 dogs with GDV-induced shock.

Procedure

Initially, HSD solution (5 ml/kg of body weight) or LRS (60 to 90 ml/kg) was administered. All dogs then received a maintenance administration (20 ml/kg/h) of LRS. Cardiorespiratory, blood gas, and serum biochemical analyses were performed over a 4-hour period after initiation of treatment.

Results

Systolic arterial and central venous pressures and plasma volume increased more rapidly in dogs in the HSD + LRS group. The cumulative dose of fluids administered to dogs in the HSD + LRS group was significantly less than that administered to dogs in the LRS group. Serum sodium and chloride concentrations and osmolality increased significantly in dogs in the HSD + LRS group, but not in dogs in the LRS group. Ventricular arrhythmias were detected in both groups of dogs, but did not appear to be induced by either form of fluid therapy.

Clinical Implications

Administration of HSD rapidly restored cardiorespiratory function and induced resuscitation equivalent to administration of large volumes of LRS. Use of HSD solutions to treat dogs in GDV-induced shock may be more efficient than use of isotonic fluids. Administration of HSD solution was not associated with noticeable complications.

Free access
in Journal of the American Veterinary Medical Association