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Tissue oxygen saturation in dogs with acute hemorrhage
Author(s) -
Gray Sarah L.,
Hall Kelly E.,
Powell Lisa L.,
Schildt Julie,
Brearley Ann M.,
Beilman Greg J.
Publication year - 2018
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/vec.12752
Subject(s) - medicine , shock (circulatory) , partial thromboplastin time , prothrombin time , pulse oximetry , anesthesia , confidence interval , oxygen saturation , arterial blood , population , cardiology , oxygen , coagulation , chemistry , organic chemistry , environmental health
Objective To evaluate initial tissue hemoglobin oxygen saturation (StO 2 ) in dogs presenting to an emergency room (ER) for acute hemorrhage. Design Prospective, observational study. Setting University veterinary teaching hospital. Animals Thirty‐eight dogs with acute hemorrhage were enrolled between July 2009 and October 2010. Seventy‐eight normal dogs from a previous observational study were included to represent healthy controls (“no shock”). Interventions Tissue oxygen saturation measurement was obtained at enrollment on dogs presented to the ER for acute hemorrhage. Baseline clinicopathologic (CBC, serum biochemical profile, prothrombin time, and activated partial thromboplastin time) and physiologic (plasma lactate concentration, venous blood gas, blood pressure, and hemoglobin oxygen saturation by pulse oximetry) data were recorded from all patients with hemorrhage. An ER clinician blinded to the StO 2 value guided patient management. Patient survival to discharge from the hospital in the study group was recorded. Once data collection was complete, 3 emergency and critical care clinicians blinded to the StO 2 data retrospectively classified patients into 1 of 4 shock categories (no shock, mild, moderate, or severe shock). Measurements and Main Results The historical group of healthy dogs had higher StO 2 concentrations compared to the dogs classified with shock at all 3 levels (mild, moderate, and severe, P = 0.0006, < 0.0001, and 0.0018, respectively); however, there was no statistical difference in StO 2 between the levels of shock. A cut‐off StO 2 value of 87.6% identified a patient as having shock (area under the curve: 0.824, 95% confidence interval 0.749, 0.899). Conclusions Dogs with hemorrhagic shock have lower StO 2 than a population of healthy dogs.