Changes in tissue perfusion parameters in dogs with severe sepsis/septic shock in response to goal-directed hemodynamic optimization at admission to ICU and the relation to outcome

• Published in: Journal of veterinary emergency and critical care (San Antonio, Tex. : 2000) Vol. 22; no. 4; pp. 409 - 418
• Main Authors: Conti-Patara, Andreza, de Araújo Caldeira, Juliana, de Mattos-Junior, Ewaldo, de Carvalho, Haley da Silva, Reinoldes, Adriane, Pedron, Bruno Gregnanin, Patara, Marcelo, Francisco Talib, Mariana Semião, Faustino, Marcelo, de Oliveira, Clair Motos, Cortopassi, Silvia Renata Gaido
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.08.2012
• Subjects: Animals; Anti-Bacterial Agents - therapeutic use; base deficit; Biomarkers; central venous oxygen saturation; Cephalothin - therapeutic use; Dog Diseases - etiology; Dog Diseases - mortality; Dog Diseases - therapy; Dogs; Dopamine - pharmacology; Female; Fluid Therapy; Intensive Care Units; lactate; Metronidazole - therapeutic use; Oxygen - blood; Pyometra - complications; Pyometra - veterinary; Resuscitation; Sepsis - mortality; Sepsis - therapy; Sepsis - veterinary; septicemia; Shock, Septic - mortality; Shock, Septic - therapy; Shock, Septic - veterinary; Treatment Outcome
• ISSN: 1479-3261; 1476-4431
• DOI: 10.1111/j.1476-4431.2012.00769.x

Objective To evaluate the changes in tissue perfusion parameters in dogs with severe sepsis/septic shock in response to goal‐directed hemodynamic optimization in the ICU and their relation to outcome. Design Prospective observational study. Setting ICU of a veterinary university medical center. Animals Thirty dogs with severe sepsis or septic shock caused by pyometra who underwent surgery and were admitted to the ICU. Measurements and Main Results Severe sepsis was defined as the presence of sepsis and sepsis‐induced dysfunction of one or more organs. Septic shock was defined as the presence of severe sepsis plus hypotension not reversed with fluid resuscitation. After the presumptive diagnosis of sepsis secondary to pyometra, blood samples were collected and clinical findings were recorded. Volume resuscitation with 0.9% saline solution and antimicrobial therapy were initiated. Following abdominal ultrasonography and confirmation of increased uterine volume, dogs underwent corrective surgery. After surgery, the animals were admitted to the ICU, where resuscitation was guided by the clinical parameters, central venous oxygen saturation (ScvO2), lactate, and base deficit. Between survivors and nonsurvivors it was observed that the ScvO2, lactate, and base deficit on ICU admission were each related independently to death (P = 0.001, P = 0.030, and P < 0.001, respectively). ScvO2 and base deficit were found to be the best discriminators between survivors and nonsurvivors as assessed via receiver operator characteristic curve analysis. Conclusion Our study suggests that ScvO2 and base deficit are useful in predicting the prognosis of dogs with severe sepsis and septic shock; animals with a higher ScvO2 and lower base deficit at admission to the ICU have a lower probability of death.