Principles of shock and fluid therapy in special species

Marla Lichtenberger DVM, DACVECC
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引用次数: 47

Abstract

Increasing numbers of exotic animals are being kept as pets, and owners want to receive high-quality medical care for these pets. Treatment of hypovolemic shock and critical care monitoring in exotic pets are complicated by small patient size, physiological diversity, and lack of research and clinical data on their response to therapy. Despite these impediments, the same principles and techniques of monitoring used in domestic animals can be applied to the exotic patient. The goal of this article is to provide an in-depth presentation on the principles and pathophysiology of shock, types of fluids, monitoring techniques, and shock resuscitation methods for use in rabbits, ferrets, small mammals, and birds. An understanding by the veterinarian of the patient’s cardiovascular state and the characteristics of crystalloid and colloid fluids available is necessary for establishing a fluid therapy plan. Arterial blood pressure measurement is an important tool in the management of the critically ill pet. The message of clinical importance is that fixed fluid regimens (eg, Lactated Ringers), fixed volumes (eg, mL/kg) and rules of thumb are in most instances outdated, inappropriate and often times inadequate. Appropriate fluid therapy, combined with frequent patient evaluation and periodic blood pressure monitoring techniques, can produce astounding and at times miraculous results.

特殊物种休克及体液治疗原理
越来越多的外来动物被当作宠物饲养,主人希望这些宠物能得到高质量的医疗照顾。外来宠物低血容量性休克的治疗和重症监护监测由于患者体积小、生理多样性以及缺乏对治疗反应的研究和临床数据而变得复杂。尽管存在这些障碍,但在家畜中使用的相同监测原则和技术可以应用于外来患者。本文的目的是深入介绍休克的原理和病理生理学、液体类型、监测技术以及用于兔子、雪貂、小型哺乳动物和鸟类的休克复苏方法。兽医必须了解患者的心血管状态以及可用的晶体和胶体液体的特性,才能制定液体治疗计划。动脉血压测量是危重宠物管理的重要工具。临床重要性的信息是,固定的液体方案(如乳酸林格)、固定的体积(如mL/kg)和经验法则在大多数情况下是过时的、不适当的,而且往往是不充分的。适当的液体疗法,结合频繁的病人评估和定期血压监测技术,可以产生惊人的,有时是奇迹般的结果。
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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