Multicenter retrospective evaluation of norepinephrine extravasation in dogs and cats (2015–2021): 14 cases

IF 1.1 3区农林科学 Q3 VETERINARY SCIENCES

Journal of veterinary emergency and critical care Pub Date : 2025-02-17 DOI:10.1111/vec.13442

Maria P. Vasquez DVM, Meredith Daly VMD, DACVECC, Corrin J. Boyd BSc, BVMS(Hons), GradDipEd MVetClinStud, MANZCVS, DACVECC, Dawn E. Crandell DVM, DVSc, DACVECC, Kelly E. Hall DVM, MS, DACVECC, Erin Long Mays DVM, DACVECC, Tandi Ngwenyama DVM, DACVECC, Jennifer Ortolani DVM, DACVECC, M. Ryan Smith DVM, DACVECC, Sabrina N. Hoehne Dr med vet, DACVECC, DECVECC, Linda Martin DVM, MS, DACVECC, Elizabeth B. Davidow DVM, DACVECC

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引用次数: 0

Abstract

Objective

To document clinical complications and intervention options associated with norepinephrine (NE) extravasation in dogs and cats.

Design

Cases were identified between 2015 and 2021. Because this is an uncommon complication, the findings are compiled as a descriptive retrospective study.

Setting

Cases were provided from 4 universities and 2 private practice groups in the United States, Canada, and Australia.

Animals

Fourteen patients (13 dogs, 1 cat) that experienced extravasation events (16 total).

Interventions

Small animal patients were included where extravasation of a NE constant rate infusion (CRI) was documented. Records were reviewed for information, including suspected underlying condition, description of the interventions pursued after identification of extravasation, clinical signs after extravasation, and survival to discharge or reason for patient death or euthanasia. When available, information was collected pertaining to the NE dose, dilution, total duration of CRI, and duration of CRI before extravasation was recognized.

Measurements and Main Results

The most commonly reported clinical signs after extravasation of NE were skin necrosis (n = 9 [64.3%]) and swelling (n = 6 [42.9%]). In 10 of 16 events (62.5%), discontinuation of the NE CRI and/or application of a warm compress to the extravasation site were performed; these were the most common nonpharmacological rescue measures. Two patients received subcutaneous phentolamine, and 1 patient underwent hyperbaric oxygen therapy. While surgical intervention was recommended for 4 dogs, 2 improved without surgical debridement. The overall survival rate from underlying disease processes was 57% (n = 8), with only 1 patient (7%) euthanized due to an injury from the extravasation.

Conclusions

Severe lesions can result from NE extravasation in dogs and cats, leading to euthanasia. Although phentolamine remains the treatment of choice, lesions may heal with alternative supportive measures.

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目的记录与猫狗去甲肾上腺素 (NE) 外渗相关的临床并发症和干预方案。设计 2015 年至 2021 年间发现的病例。由于这种并发症并不常见，因此研究结果以描述性回顾研究的形式进行汇编。背景病例来自美国、加拿大和澳大利亚的 4 所大学和 2 个私人诊所。动物 14 名患者（13 只狗、1 只猫）发生了外渗事件（共 16 例）。记录了NE恒速输注（CRI）外渗的小动物患者被纳入干预范围。对记录中的信息进行审查，包括疑似潜在病情、确定发生外渗后所采取干预措施的描述、外渗后的临床症状、患者出院后的存活情况或患者死亡或安乐死的原因。在有条件的情况下，还收集了有关 NE 剂量、稀释度、CRI 总持续时间以及确认外渗前 CRI 持续时间的信息。测量和主要结果 NE外渗后最常见的临床症状是皮肤坏死（9 例 [64.3%]）和肿胀（6 例 [42.9%]）。在 16 例事件中，有 10 例（62.5%）停止使用 NE CRI 和/或对外渗部位进行热敷；这是最常见的非药物抢救措施。两名患者接受了皮下注射酚妥拉明，一名患者接受了高压氧治疗。虽然建议对 4 只狗进行手术治疗，但其中 2 只狗在未进行手术清创的情况下病情有所好转。从潜在疾病过程中存活的总比率为 57%（n = 8），只有 1 名患者（7%）因外渗造成的伤害而安乐死。结论 NE 外渗可导致猫狗严重损伤，从而导致安乐死。尽管酚妥拉明仍是首选治疗方法，但采用其他辅助措施也可使病变痊愈。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of veterinary emergency and critical care 农林科学-兽医学

CiteScore

2.50

自引率

15.40%

发文量

121

审稿时长

18-36 weeks

期刊介绍： The Journal of Veterinary Emergency and Critical Care’s primary aim is to advance the international clinical standard of care for emergency/critical care patients of all species. The journal’s content is relevant to specialist and non-specialist veterinarians practicing emergency/critical care medicine. The journal achieves it aims by publishing descriptions of unique presentation or management; retrospective and prospective evaluations of prognosis, novel diagnosis, or therapy; translational basic science studies with clinical relevance; in depth reviews of pertinent topics; topical news and letters; and regular themed issues. The journal is the official publication of the Veterinary Emergency and Critical Care Society, the American College of Veterinary Emergency and Critical Care, the European Veterinary Emergency and Critical Care Society, and the European College of Veterinary Emergency and Critical Care. It is a bimonthly publication with international impact and adheres to currently accepted ethical standards.