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Comparison of H b‐200 and 6% hetastarch 450/0.7 during initial fluid resuscitation of 20 dogs with gastric dilatation‐volvulus
Author(s) -
Haak Carol E.,
Rudloff Elke,
Kirby Rebecca
Publication year - 2012
Publication title -
journal of veterinary emergency and critical care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.886
H-Index - 47
eISSN - 1476-4431
pISSN - 1479-3261
DOI - 10.1111/j.1476-4431.2012.00726.x
Subject(s) - medicine , resuscitation , hetastarch , anesthesia , capillary refill , blood pressure , surgery
Objective To compare the use of polymerized stroma‐free bovine hemoglobin ( H b‐200) and 6% hetastarch 450/0.7 ( HES 450/0.7) in 0.9% saline during fluid resuscitation of dogs with gastric dilatation‐volvulus ( GDV ). Design Prospective, randomized clinical case series. Setting Private specialty and referral clinic. Animals Twenty client‐owned dogs presenting with GDV . Interventions Dogs presenting with GDV and abnormal perfusion parameters first received rapid IV infusion of a buffered isotonic replacement crystalloid (15 mL/kg) and IV opioids. Patients were then randomized to receive either H b‐200 ( N = 10) or HES 450/0.7 ( N = 10). Balanced isotonic replacement crystalloids (10–20 mL/kg IV ) were rapidly infused along with either H b‐200 or HES in 5 mL/kg IV aliquots to meet resuscitation end points. Measurements and Main Results Resuscitation was defined as meeting at least 2 of 3 criteria: (1) capillary refill time 1–2 seconds, pink mucous membrane color, strong femoral pulse quality; (2) heart rate ( HR ) ≤ 150/min; or (3) indirect arterial systolic blood pressure ( SBP ) > 90 mm H g. HR , SBP , packed cell volume, hemoglobin, glucose, venous p H , bicarbonate, base excess, anion gap, and colloid osmotic pressure were compared at hospital entry and within 30 minutes post‐resuscitation. Compared to the HES group, the H b‐200 group required significantly less colloid (4.2 versus 18.4 mL/kg) and crystalloid (31.3 versus 48.1 mL/kg) to reach resuscitation end points ( P = 0.001). Time to resuscitation was significantly shorter in the H b‐200 group (12.5 versus 52.5 min). Conclusions Dogs with GDV receiving H b‐200 during initial resuscitation required smaller volumes of both crystalloid and colloid fluids and reached resuscitation end points faster than dogs receiving HES 450/0.7 ( P = 0.02).