Evaluation of oesophageal Doppler-derived variables and plethysmographic variability index to predict fluid responsiveness in mechanically ventilated healthy dogs

IF 1.9 2区农林科学 Q2 VETERINARY SCIENCES

Veterinary anaesthesia and analgesia Pub Date : 2025-05-01 DOI:10.1016/j.vaa.2025.03.003

Ignacio Sández , Rocío Bustamante , Pablo A. Donati , Daniel Torralbo , Maria Soto , Aitor Fernández-Novo , Eva Rioja

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引用次数: 0

Abstract

Objective

To evaluate the plethysmography variability index (PVI) and oesophageal Doppler (OD)-derived dynamic variables [stroke distance variation (StDV) and aortic flow peak velocity variation (PVV)] as predictors of fluid responsiveness.

Study design

A prospective cohort, diagnostic test study.

Animals

A group of 30 client-owned dogs undergoing general anaesthesia.

Methods

Dogs received dexmedetomidine (3 μg kg^-1) and methadone (0.3 mg kg^-1), intramuscularly. Anaesthesia was induced with propofol and maintained with isoflurane. Volume-controlled ventilation was instituted with tidal volume 10 mL kg^-1, inspiratory-to-expiratory ratio 1:2. Heart rate (HR) and mean arterial pressure (MAP) were monitored. An OD probe was inserted to measure stroke distance (StD). Once surgery finished, PVV, StDV and PVI were recorded before (T0) and after (T1) the administration of 3 mL kg^-1 bolus of hydroxyethyl starch 6% over 5 minutes. Dogs were classified as fluid-responders (R; StD increased ≥ 15%) or non-fluid-responders (NR). Receiver operating characteristic (ROC) curves were plotted for PVV, StDV and PVI.

Results

Of the 30 animals, eight were classified as R and 22 as NR. The areas under the ROC curves for PVV, StDV and PVI were 0.87 [confidence interval (CI) 0.82–1], 0.84 (CI 0.67–1) and 0.78 (CI 0.62–1), respectively. The best cut-offs (positive–negative predictive values) were 9% (54–94%) for PVV (sensitivity, 88%; specificity, 73%), 12% (58–94%) for StDV (sensitivity, 88%; specificity, 77%) and 15% (60–90%) for PVI (sensitivity, 75%; specificity, 82%). No statistical differences were found between R and NR, nor between T0 and T1, for MAP or HR.

Conclusions and clinical relevance

OD-derived values of PVV, StDV and PVI are reasonable predictors of fluid responsiveness in client-owned dogs undergoing general anaesthesia and mechanical ventilation.

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评价食管多普勒衍生变量和体积脉搏变异性指数预测机械通气健康犬的液体反应。

目的：评价容积谱变异性指数（PVI）和食管多普勒（OD）衍生的动态变量[卒中距离变化（StDV）和主动脉血流峰值速度变化（PVV）]对液体反应性的预测作用。研究设计：前瞻性队列诊断试验研究。动物：一组30只接受全身麻醉的宠物狗。方法：犬肌肉注射右美托咪定（3 μg kg-1）和美沙酮（0.3 mg kg-1）。麻醉由异丙酚诱导，异氟醚维持。采用量控通气，潮气量10ml kg-1，吸气呼气比1:2。监测心率（HR）和平均动脉压（MAP）。插入外径探头测量行程距离（StD）。手术结束后，分别在给药前（T0）和后（T1） 5分钟内给予3ml kg-1剂量的6%羟乙基淀粉，记录PVV、StDV和PVI。狗被分类为液体反应(R；StD升高≥15%)或无液体反应（NR）。绘制PVV、StDV和PVI的受试者工作特征（ROC）曲线。结果：30只动物中，R 8只，NR 22只，PVV、StDV、PVI的ROC曲线下面积分别为0.87[置信区间（CI） 0.82-1]、0.84 （CI 0.67-1）、0.78 （CI 0.62-1）。PVV的最佳截断值（阳性-阴性预测值）为9%(54-94%)(敏感性为88%；特异性，73%),12%（58-94%）的StDV(敏感性，88%；特异性为77%)，PVI为15%(60-90%)(敏感性为75%；特异性,82%)。MAP和HR在R和NR之间无统计学差异，在T0和T1之间无统计学差异。结论及临床意义：PVV、StDV和PVI的od衍生值是客户拥有的接受全身麻醉和机械通气的狗的液体反应性的合理预测指标。

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

Veterinary anaesthesia and analgesia 农林科学-兽医学

CiteScore

3.10

自引率

17.60%

发文量

审稿时长

97 days

期刊介绍： Veterinary Anaesthesia and Analgesia is the official journal of the Association of Veterinary Anaesthetists, the American College of Veterinary Anesthesia and Analgesia and the European College of Veterinary Anaesthesia and Analgesia. Its purpose is the publication of original, peer reviewed articles covering all branches of anaesthesia and the relief of pain in animals. Articles concerned with the following subjects related to anaesthesia and analgesia are also welcome: the basic sciences; pathophysiology of disease as it relates to anaesthetic management equipment intensive care chemical restraint of animals including laboratory animals, wildlife and exotic animals welfare issues associated with pain and distress education in veterinary anaesthesia and analgesia. Review articles, special articles, and historical notes will also be published, along with editorials, case reports in the form of letters to the editor, and book reviews. There is also an active correspondence section.