Risk factors, characteristics, and outcomes of acute respiratory distress syndrome in dogs and cats: 54 cases
Risk factors, characteristics, and outcomes of acute respiratory distress syndrome in dogs and cats: 54 cases
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DOI：
10.1111/vec.12819
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发表时间：
2019-03-01
影响因子：
1.3
通讯作者：
Borchers, Angela
中科院分区：
文献类型：
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作者：
Boiron, Ludivine;Hopper, Kate;Borchers, Angela
目的探讨犬猫急性呼吸窘迫综合征（ARDS）的临床特点、危险因素及预后。本研究还旨在通过临床诊断标准与尸检结果的比较，评价目前兽医诊断ARDS的标准。设计回顾性研究。54只客户拥有的动物，46只狗和8只猫。干预措施：根据先前公布的临床标准或尸检诊断，回顾了诊断为ARDS的患者的医疗记录。记录信号、临床表现和结果。根据临床或尸检诊断将动物分组：43/54（80%）根据临床标准诊断为ARDS（1组），11/54（20%）仅根据尸检诊断为ARDS（2组）。1组尸检22/43(51%),12/22（54%）确诊ARDS。狗的直接（肺）原因比间接原因更常见，而猫的直接和间接原因发生率相似。犬类中最常见的危险因素是吸入性肺炎（42%）、全身炎症反应综合征（SIRS）（29%）和休克（29%）。所有临床诊断为ARDS的猫都有伴有或不伴有败血症的SIRS。在临床诊断为ARDS的动物中，49%接受了机械通气，58%接受了24小时或更长时间的治疗（有或没有机械通气）。狗和猫的总病死率分别为84%和100%。正如人类文献所述，肺炎是狗患ARDS最常见的危险因素，而猫则是SIRS。高死亡率和临床诊断与尸检结果之间的差异可能突出了狗和猫ARDS诊断和治疗的临床标准的局限性。
Objective To characterize the clinical features of the acute respiratory distress syndrome (ARDS), risk factors, and outcome in dogs and cats. The study also aimed to evaluate the current veterinary criteria for the diagnosis of ARDS by comparison of clinical diagnostic criteria with necropsy findings.Design Retrospective study.Animals Fifty-four client-owned animals, 46 dogs and 8 cats.Interventions Medical records were reviewed for patients with the diagnosis of ARDS based on previously published clinical criteria or necropsy diagnosis. Signalment, clinical findings, and outcome were recorded.Measurements and Main Results Animals were grouped according to a clinical or necropsy diagnosis: 43/54 (80%) were diagnosed with ARDS based on clinical criteria (group 1) and 11/54 (20%) were diagnosed with ARDS based on necropsy only (group 2). In group 1, 22/43 (51%) had a necropsy, which confirmed ARDS in 12/22 (54%). Direct (pulmonary) causes of ARDS were more common than indirect causes in dogs, while cats had a similar occurrence of direct and indirect causes. The most common risk factors identified in dogs were aspiration pneumonia (42%), systemic inflammatory response syndrome (SIRS) (29%), and shock (29%). All cats diagnosed clinically with ARDS had SIRS with or without sepsis. Of the animals with a clinical diagnosis of ARDS, 49% received mechanical ventilation and 58% received treatment (with or without mechanical ventilation) for 24 hours or longer. The overall case fatality rate was 84% in dogs and 100% in cats.Conclusions and Clinical Relevance As described in human literature, pneumonia was the most common risk factor in dogs with ARDS, whereas it was SIRS for the cat population. The high mortality rate and discrepancy between the clinical diagnosis and necropsy findings may highlight limitations in the clinical criteria for the diagnosis of ARDS and treatment in dogs and cats.