Retrospective evaluation of fluid overload and relationship to outcome in critically ill dogs
Retrospective evaluation of fluid overload and relationship to outcome in critically ill dogs
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DOI：
10.1111/vec.12477
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发表时间：
2016-07-01
影响因子：
1.3
通讯作者：
Hansen, Bernard D.
中科院分区：
文献类型：
--
作者：
Cavanagh, Amanda A.;Sullivan, Lauren A.;Hansen, Bernard D.
目的-确定危重犬在住院期间液体过载（FO）的风险是否比病情较轻的犬高，并确定FO是否与住院期间死亡率增加有关。设计：观察性病例对照研究。设置-大学教学医院。动物：34只危重犬和15只相对健康的术后稳定的神经骨科疾病犬。干预措施——无。测量和主要结果-记录的数据包括入院时的基础疾病、体重和APPLE（快速）评分、住院期间的单日和综合APPLE（完整）评分、给予的总液体体积(L)、总液体体积输出(L)和结局。液体体积百分比（%FO）的计算公式为100 ×（[给液量-失液量]/1000 mL/L） -（入院时脱水百分比），液体体积表示为mL/kg基线体重。与术后病情稳定的犬相比，危重犬在住院期间出现了更高的%FO (12.1 +/- 11.7% vs 0.5 +/- 5.2%, P = 0.001)，并且有一半（16只狗中有8只）的%FO （bb0 = 12%）死亡。综合APPLE（完整）分数与%FO呈弱正相关，而入院时记录的APPLE（快速）和单日APPLE（完整）分数与%FO无显著正相关。住院期间FO每增加一个百分点，死亡的优势比为1.08（95%置信限1.012-1.59,P = 0.02）。结论：危重犬在住院期间FO的风险增加，并且FO百分比、疾病严重程度和死亡率之间存在微弱但显著的关联。需要前瞻性研究来证实本回顾性研究的结果。
Objective - To determine if critically ill dogs have an increased risk of fluid overload (FO) during hospitalization compared to less ill dogs, and to determine if FO is associated with increased mortality during hospitalization.Design - Observational, case-control study.Setting - University teaching hospital.Animals - Thirty-four critically ill dogs and 15 comparatively healthy stable postoperative dogs with neuro-orthopedic disease.Interventions - None.Measurements and Main Results - Data recorded included underlying disease, body weight, and APPLE(fast) score at admission, single-day and composite APPLE(full) scores during hospitalization, total fluid volume administered (L), total fluid volume output (L), and outcome. Percent FO (%FO) was calculated using the equation 100 x ([fluid volume administered - fluid volume lost]/1000 mL/L) - (% dehydration at admission), with fluid volume expressed as mL/kg of baseline body weight. Critically ill dogs developed greater %FO during hospitalization compared to stable postoperative dogs (12.1 +/- 11.7% vs 0.5 +/- 5.2%, P = 0.001), and half (8 out of 16) of the dogs with %FO >= 12% died. Composite APPLE(full) scores were weakly positively correlated with %FO, whereas APPLE(fast) and single-day APPLE(full) scores recorded at admission were not. The odds ratio for death was 1.08 for every percent increase in FO during hospitalization (95% confidence limits 1.012-1.59, P = 0.02).Conclusions - Critically ill dogs are at increased risk for FO during hospitalization, and a weak but significant association exists between %FO, illness severity, and mortality. Prospective studies are warranted to confirm the findings of this retrospective study.