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Markers of tissue perfusion and their relation to mortality in dogs with blunt trauma

Objective To evaluate admission Animal Trauma Triage (ATT) score, shock index (SI), and markers of perfusion, including base excess (BE), plasma lactate, and lactate clearance in dogs with blunt trauma. Design Prospective observational clinical study from 2013 to 2015. Setting Private veterinary ref...

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Published in:Journal of veterinary emergency and critical care (San Antonio, Tex. : 2000) Tex. : 2000), 2023-01, Vol.33 (1), p.16-21
Main Authors: Poirier, Maude, Stillion, Jenefer R., Boysen, Søren R.
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Stillion, Jenefer R.
Boysen, Søren R.
description Objective To evaluate admission Animal Trauma Triage (ATT) score, shock index (SI), and markers of perfusion, including base excess (BE), plasma lactate, and lactate clearance in dogs with blunt trauma. Design Prospective observational clinical study from 2013 to 2015. Setting Private veterinary referral and emergency center. Animals Forty‐four client‐owned dogs hospitalized following blunt trauma. Intervention Within 1 hour of presentation and prior to fluid administration an initial hematocrit, total plasma protein, blood glucose, plasma lactate, blood gas, and electrolytes were obtained for analysis. Plasma lactate concentrations were also measured 4 and 8 hours following initial measurement, and a 4‐hour lactate clearance was calculated if patients had an increased admission plasma lactate. ATT score and SI were calculated for each patient based on admission data. Outcome was defined as survival to hospital discharge. Measurements and Main Results Twenty‐nine dogs survived, 14 were euthanized, and 1 died. Nonsurviving dogs had a lower mean pH (7.28 ± 0.03 vs 7.36 ± 0.01, P = 0.006), lower median HCO3 (15.7 vs 18.8 mmol/L, P = 0.004), lower median admission BE (–11.0 vs –7.0 mmol/L, P = 0.004), and higher median admission lactate (3.1 vs 2.4 mmol/L, P = 0.036) than those who survived. Median ATT was significantly higher in nonsurvivors (5 vsF 2, P 
doi_str_mv 10.1111/vec.13249
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Design Prospective observational clinical study from 2013 to 2015. Setting Private veterinary referral and emergency center. Animals Forty‐four client‐owned dogs hospitalized following blunt trauma. Intervention Within 1 hour of presentation and prior to fluid administration an initial hematocrit, total plasma protein, blood glucose, plasma lactate, blood gas, and electrolytes were obtained for analysis. Plasma lactate concentrations were also measured 4 and 8 hours following initial measurement, and a 4‐hour lactate clearance was calculated if patients had an increased admission plasma lactate. ATT score and SI were calculated for each patient based on admission data. Outcome was defined as survival to hospital discharge. Measurements and Main Results Twenty‐nine dogs survived, 14 were euthanized, and 1 died. Nonsurviving dogs had a lower mean pH (7.28 ± 0.03 vs 7.36 ± 0.01, P = 0.006), lower median HCO3 (15.7 vs 18.8 mmol/L, P = 0.004), lower median admission BE (–11.0 vs –7.0 mmol/L, P = 0.004), and higher median admission lactate (3.1 vs 2.4 mmol/L, P = 0.036) than those who survived. Median ATT was significantly higher in nonsurvivors (5 vsF 2, P &lt; 0.001). The SI was not significantly different between survivors and nonsurvivors (P = 0.41). There was no difference in median 4‐hour lactate (P = 0.34), median 8‐hour lactate (P = 0.19), or 4‐hour lactate clearance (P = 0.83) in survivors compared to nonsurvivors. No other statistically significant differences were noted between groups. Conclusion Dogs hospitalized following blunt trauma with a lower admission pH, HCO3, and BE and a higher admission plasma lactate were less likely to survive to hospital discharge. Median ATT score was also significantly higher in nonsurvivors. Although lactate clearance was not predictive of survival, the sample size was small, and additional studies with a larger study population are warranted.</description><identifier>ISSN: 1479-3261</identifier><identifier>EISSN: 1476-4431</identifier><identifier>DOI: 10.1111/vec.13249</identifier><identifier>PMID: 36286596</identifier><language>eng</language><publisher>United States</publisher><subject>Animals ; base excess ; blunt trauma ; Dog Diseases ; Dogs ; Electrolytes ; hypoperfusion ; lactate ; Lactic Acid ; mortality ; Prospective Studies ; Retrospective Studies ; Wounds, Nonpenetrating - veterinary</subject><ispartof>Journal of veterinary emergency and critical care (San Antonio, Tex. : 2000), 2023-01, Vol.33 (1), p.16-21</ispartof><rights>Veterinary Emergency and Critical Care Society 2022.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2559-c51a0835742a4934087a845441ae7f49d180a2d66daedced68ab4ebe901e137d3</citedby><cites>FETCH-LOGICAL-c2559-c51a0835742a4934087a845441ae7f49d180a2d66daedced68ab4ebe901e137d3</cites><orcidid>0000-0001-8271-4514 ; 0000-0002-0936-4834</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36286596$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Poirier, Maude</creatorcontrib><creatorcontrib>Stillion, Jenefer R.</creatorcontrib><creatorcontrib>Boysen, Søren R.</creatorcontrib><title>Markers of tissue perfusion and their relation to mortality in dogs with blunt trauma</title><title>Journal of veterinary emergency and critical care (San Antonio, Tex. : 2000)</title><addtitle>J Vet Emerg Crit Care (San Antonio)</addtitle><description>Objective To evaluate admission Animal Trauma Triage (ATT) score, shock index (SI), and markers of perfusion, including base excess (BE), plasma lactate, and lactate clearance in dogs with blunt trauma. Design Prospective observational clinical study from 2013 to 2015. Setting Private veterinary referral and emergency center. Animals Forty‐four client‐owned dogs hospitalized following blunt trauma. Intervention Within 1 hour of presentation and prior to fluid administration an initial hematocrit, total plasma protein, blood glucose, plasma lactate, blood gas, and electrolytes were obtained for analysis. Plasma lactate concentrations were also measured 4 and 8 hours following initial measurement, and a 4‐hour lactate clearance was calculated if patients had an increased admission plasma lactate. ATT score and SI were calculated for each patient based on admission data. Outcome was defined as survival to hospital discharge. Measurements and Main Results Twenty‐nine dogs survived, 14 were euthanized, and 1 died. Nonsurviving dogs had a lower mean pH (7.28 ± 0.03 vs 7.36 ± 0.01, P = 0.006), lower median HCO3 (15.7 vs 18.8 mmol/L, P = 0.004), lower median admission BE (–11.0 vs –7.0 mmol/L, P = 0.004), and higher median admission lactate (3.1 vs 2.4 mmol/L, P = 0.036) than those who survived. Median ATT was significantly higher in nonsurvivors (5 vsF 2, P &lt; 0.001). The SI was not significantly different between survivors and nonsurvivors (P = 0.41). There was no difference in median 4‐hour lactate (P = 0.34), median 8‐hour lactate (P = 0.19), or 4‐hour lactate clearance (P = 0.83) in survivors compared to nonsurvivors. No other statistically significant differences were noted between groups. Conclusion Dogs hospitalized following blunt trauma with a lower admission pH, HCO3, and BE and a higher admission plasma lactate were less likely to survive to hospital discharge. Median ATT score was also significantly higher in nonsurvivors. Although lactate clearance was not predictive of survival, the sample size was small, and additional studies with a larger study population are warranted.</description><subject>Animals</subject><subject>base excess</subject><subject>blunt trauma</subject><subject>Dog Diseases</subject><subject>Dogs</subject><subject>Electrolytes</subject><subject>hypoperfusion</subject><subject>lactate</subject><subject>Lactic Acid</subject><subject>mortality</subject><subject>Prospective Studies</subject><subject>Retrospective Studies</subject><subject>Wounds, Nonpenetrating - veterinary</subject><issn>1479-3261</issn><issn>1476-4431</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp1kLtOwzAUQC0EouUx8APIIwxpbcdx4hFV5SEVsVDWyIlvqCGJi-1Q9e9Jm8KGl2tdHR3pHoSuKJnQ_k2_oZzQmHF5hMaUpyLiPKbH-7-MYiboCJ15_0EIlTJhp2gUC5aJRIoxWj4r9wnOY1vhYLzvAK_BVZ03tsWq1TiswDjsoFZhtwoWN9YFVZuwxabF2r57vDFhhYu6awMOTnWNukAnlao9XB7mOVrez19nj9Hi5eFpdreISpYkMioTqkgWJylnisuYkyxVGU84pwrSiktNM6KYFkIr0CVokamCQwGSUKBxquNzdDN4185-deBD3hhfQl2rFmznc5YySVja39qjtwNaOuu9gypfO9Mot80pyXcV875ivq_Ys9cHbVc0oP_I32w9MB2Ajalh-78pf5vPBuUPnON8LQ</recordid><startdate>202301</startdate><enddate>202301</enddate><creator>Poirier, Maude</creator><creator>Stillion, Jenefer R.</creator><creator>Boysen, Søren R.</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8271-4514</orcidid><orcidid>https://orcid.org/0000-0002-0936-4834</orcidid></search><sort><creationdate>202301</creationdate><title>Markers of tissue perfusion and their relation to mortality in dogs with blunt trauma</title><author>Poirier, Maude ; Stillion, Jenefer R. ; Boysen, Søren R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2559-c51a0835742a4934087a845441ae7f49d180a2d66daedced68ab4ebe901e137d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Animals</topic><topic>base excess</topic><topic>blunt trauma</topic><topic>Dog Diseases</topic><topic>Dogs</topic><topic>Electrolytes</topic><topic>hypoperfusion</topic><topic>lactate</topic><topic>Lactic Acid</topic><topic>mortality</topic><topic>Prospective Studies</topic><topic>Retrospective Studies</topic><topic>Wounds, Nonpenetrating - veterinary</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Poirier, Maude</creatorcontrib><creatorcontrib>Stillion, Jenefer R.</creatorcontrib><creatorcontrib>Boysen, Søren R.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of veterinary emergency and critical care (San Antonio, Tex. : 2000)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Poirier, Maude</au><au>Stillion, Jenefer R.</au><au>Boysen, Søren R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Markers of tissue perfusion and their relation to mortality in dogs with blunt trauma</atitle><jtitle>Journal of veterinary emergency and critical care (San Antonio, Tex. : 2000)</jtitle><addtitle>J Vet Emerg Crit Care (San Antonio)</addtitle><date>2023-01</date><risdate>2023</risdate><volume>33</volume><issue>1</issue><spage>16</spage><epage>21</epage><pages>16-21</pages><issn>1479-3261</issn><eissn>1476-4431</eissn><abstract>Objective To evaluate admission Animal Trauma Triage (ATT) score, shock index (SI), and markers of perfusion, including base excess (BE), plasma lactate, and lactate clearance in dogs with blunt trauma. Design Prospective observational clinical study from 2013 to 2015. Setting Private veterinary referral and emergency center. Animals Forty‐four client‐owned dogs hospitalized following blunt trauma. Intervention Within 1 hour of presentation and prior to fluid administration an initial hematocrit, total plasma protein, blood glucose, plasma lactate, blood gas, and electrolytes were obtained for analysis. Plasma lactate concentrations were also measured 4 and 8 hours following initial measurement, and a 4‐hour lactate clearance was calculated if patients had an increased admission plasma lactate. ATT score and SI were calculated for each patient based on admission data. Outcome was defined as survival to hospital discharge. Measurements and Main Results Twenty‐nine dogs survived, 14 were euthanized, and 1 died. Nonsurviving dogs had a lower mean pH (7.28 ± 0.03 vs 7.36 ± 0.01, P = 0.006), lower median HCO3 (15.7 vs 18.8 mmol/L, P = 0.004), lower median admission BE (–11.0 vs –7.0 mmol/L, P = 0.004), and higher median admission lactate (3.1 vs 2.4 mmol/L, P = 0.036) than those who survived. Median ATT was significantly higher in nonsurvivors (5 vsF 2, P &lt; 0.001). The SI was not significantly different between survivors and nonsurvivors (P = 0.41). There was no difference in median 4‐hour lactate (P = 0.34), median 8‐hour lactate (P = 0.19), or 4‐hour lactate clearance (P = 0.83) in survivors compared to nonsurvivors. No other statistically significant differences were noted between groups. Conclusion Dogs hospitalized following blunt trauma with a lower admission pH, HCO3, and BE and a higher admission plasma lactate were less likely to survive to hospital discharge. Median ATT score was also significantly higher in nonsurvivors. Although lactate clearance was not predictive of survival, the sample size was small, and additional studies with a larger study population are warranted.</abstract><cop>United States</cop><pmid>36286596</pmid><doi>10.1111/vec.13249</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0001-8271-4514</orcidid><orcidid>https://orcid.org/0000-0002-0936-4834</orcidid></addata></record>
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subjects Animals
base excess
blunt trauma
Dog Diseases
Dogs
Electrolytes
hypoperfusion
lactate
Lactic Acid
mortality
Prospective Studies
Retrospective Studies
Wounds, Nonpenetrating - veterinary
title Markers of tissue perfusion and their relation to mortality in dogs with blunt trauma
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