Arterialbloodgasinazotemicdogshasnotbeenreported.AtpresentonlyfewstudieshavebeenreportedinVeterinaryMedicineaboutrespiratoryabnormalitiesinrenalfailure(1,2).Respiratorytractdiseaseindogswithkidneyfailurerangesfromalterationsinbreathingpatterntoprogressivedyspneaandacuterespiratorydistresssyndromewithamajorimpairmentingasexchangeandeventualcyanosis.Lunginvolvementinazotemicpatientsrepresentsaseverecomplicationcausingincreasedcasefatalitydependingontheseverityofrespiratorydistress.Arterialbloodgassampleistheonlytestthataccuratelymeasurethepartialpressureofoxygen(PaO2)andoxygensaturationwithaearlyrecognitionofoxygenimpairmentalsobycalculationofP[A−a]O2gradientandPaO2/FiO2ratio.Objective:Toevaluatearterialbloodgasparameters(Ph,PaO2,PaCO2,SO2PaO2/FiO2ratio,Alveolar-arterialP[A−a]O2gradientandbicarbonate)inazotemicdogsatadmissioninICU. Methods:Datawerecollectedretrospectively.Thirtydogswithsevereacuteazotemia(creatinine>5mg/dL)wereselected.Arterialbloodsamples(approx0.4mL)wereobtainedfromthedorsalpedalarteryforeachpatientatpresentationusing60IUbalancedheparinself-fillingsampler(safePICOSelf-fill®.RadiometerMedicalApS-Denmark-fig2)andrunimmediatelyinabloodgasanalyzer(ABL700seires,Radiometer-Copenhagen-fig1).Allmeasurementswereobtainedonroomairatsealevel(FiO221%).Alveolar-arterialoxygentensiongradient,andP/Fwereauthomaticallycalculatedbybloodgasanalyzer.Dogsweresubsequentlydividedintwogroupsaccordingtooutcome:survivors(S)andnotsurvivors(NS).NormaldistributionwasassessedusingtheShapiro-Wilktest.MannWhitneytestwasusedtocomparePh,PaCO2,PaO2,P[A−a]O2gradient,PaO2/FiO2andbicarbonateinsurvivorsversusnonsurvivors. Results:13/30dogssurvived(43.3%),17/30dogsdidnotsurvive(56.7%).(S)grouphadmeanvaluesofpH7.3(min7.1-max7.4),PaO297.0mmHg(min55.5-max112.0),PaCO229.4mmHg(min18.9-max36.5),PaO2/FiO2ratioof461.5mmHg(min264–max531.0),P[A−a]O2gradient25.8mmHg(min12.7-max61.2),SO299.3%(min86.5-max101.8)andHCO3-16.9mmol/l(min8.5-max22.4).(NS)grouphadameanvaluesofpH7.3(min7.1-max7.6),PaO285.5mmHg(min49.4-max116.0),PaCO231.3mmHg(min17,9-max40,1),PaO2/FiO2393.1mmHg(min235.0-max552.0),SO294.8%(min75.7-max101.7),P[A−a]O237.0mmHg(min15.2-max68.8),HCO3-16.1mmol/l(min5.5-max27.8). TheMann-Whitneytestrevealedasignificativeincrease(P<0.05)inmeanvaluesofPaO2(p=0.0287),PaO2/FiO2(p=0.0287)andSO2(p=0.0247)insurvivorsversusnon-survivors.WealsofoundthatthemeanAlveolar-arterialgradientvaluesresultedtobeincreasedinalldogs(>10.00mmHg)atadmissionwhilethemeanvalueofPaCO2(<37±3mmHg)andHCO3-(<21±2mmol/L)wasreducedinalldogs(Table1,Fig.3-4-5). Conclusion:Arterialbloodgasparametersindogswithrenalfailurehasnotbeenreportedbefore.StastisticallysignificancewasfoundforPaO2,PaO2/FiO2andSO2betweensurvivorsversusnon-survivor.AnincreasedvalueofmeanAlveolar-arterialoxygengradientinazotemicdogsrespectreferencevalueswasalsofound.Thiscouldresultfromimpaireddiffusionor,morecommonly,byventilation-perfusioninequalityofthe"shunting"variety.PaCO2andHCO3-wasreducedinalldogsenrolledrespectreferencevalues.Theutilityofarterialbloodgasshouldbeconsideredinordertoevaluatearterialgasexchangeinthesepatients.Theseresultssuggesttoevaluatearterialbloodgasalsoduringhospitalizationtobetterverifyanypossiblecorrelationwithoutcome.

ARTERIAL BLOOD GAS IN AZOTEMIC DOGS

CECCHERINI, GIANILA;PERONDI, FRANCESCA;LIPPI, ILARIA;MARCHETTI, VERONICA;GUIDI, GRAZIA
2016-01-01

Abstract

Arterialbloodgasinazotemicdogshasnotbeenreported.AtpresentonlyfewstudieshavebeenreportedinVeterinaryMedicineaboutrespiratoryabnormalitiesinrenalfailure(1,2).Respiratorytractdiseaseindogswithkidneyfailurerangesfromalterationsinbreathingpatterntoprogressivedyspneaandacuterespiratorydistresssyndromewithamajorimpairmentingasexchangeandeventualcyanosis.Lunginvolvementinazotemicpatientsrepresentsaseverecomplicationcausingincreasedcasefatalitydependingontheseverityofrespiratorydistress.Arterialbloodgassampleistheonlytestthataccuratelymeasurethepartialpressureofoxygen(PaO2)andoxygensaturationwithaearlyrecognitionofoxygenimpairmentalsobycalculationofP[A−a]O2gradientandPaO2/FiO2ratio.Objective:Toevaluatearterialbloodgasparameters(Ph,PaO2,PaCO2,SO2PaO2/FiO2ratio,Alveolar-arterialP[A−a]O2gradientandbicarbonate)inazotemicdogsatadmissioninICU. Methods:Datawerecollectedretrospectively.Thirtydogswithsevereacuteazotemia(creatinine>5mg/dL)wereselected.Arterialbloodsamples(approx0.4mL)wereobtainedfromthedorsalpedalarteryforeachpatientatpresentationusing60IUbalancedheparinself-fillingsampler(safePICOSelf-fill®.RadiometerMedicalApS-Denmark-fig2)andrunimmediatelyinabloodgasanalyzer(ABL700seires,Radiometer-Copenhagen-fig1).Allmeasurementswereobtainedonroomairatsealevel(FiO221%).Alveolar-arterialoxygentensiongradient,andP/Fwereauthomaticallycalculatedbybloodgasanalyzer.Dogsweresubsequentlydividedintwogroupsaccordingtooutcome:survivors(S)andnotsurvivors(NS).NormaldistributionwasassessedusingtheShapiro-Wilktest.MannWhitneytestwasusedtocomparePh,PaCO2,PaO2,P[A−a]O2gradient,PaO2/FiO2andbicarbonateinsurvivorsversusnonsurvivors. Results:13/30dogssurvived(43.3%),17/30dogsdidnotsurvive(56.7%).(S)grouphadmeanvaluesofpH7.3(min7.1-max7.4),PaO297.0mmHg(min55.5-max112.0),PaCO229.4mmHg(min18.9-max36.5),PaO2/FiO2ratioof461.5mmHg(min264–max531.0),P[A−a]O2gradient25.8mmHg(min12.7-max61.2),SO299.3%(min86.5-max101.8)andHCO3-16.9mmol/l(min8.5-max22.4).(NS)grouphadameanvaluesofpH7.3(min7.1-max7.6),PaO285.5mmHg(min49.4-max116.0),PaCO231.3mmHg(min17,9-max40,1),PaO2/FiO2393.1mmHg(min235.0-max552.0),SO294.8%(min75.7-max101.7),P[A−a]O237.0mmHg(min15.2-max68.8),HCO3-16.1mmol/l(min5.5-max27.8). TheMann-Whitneytestrevealedasignificativeincrease(P<0.05)inmeanvaluesofPaO2(p=0.0287),PaO2/FiO2(p=0.0287)andSO2(p=0.0247)insurvivorsversusnon-survivors.WealsofoundthatthemeanAlveolar-arterialgradientvaluesresultedtobeincreasedinalldogs(>10.00mmHg)atadmissionwhilethemeanvalueofPaCO2(<37±3mmHg)andHCO3-(<21±2mmol/L)wasreducedinalldogs(Table1,Fig.3-4-5). Conclusion:Arterialbloodgasparametersindogswithrenalfailurehasnotbeenreportedbefore.StastisticallysignificancewasfoundforPaO2,PaO2/FiO2andSO2betweensurvivorsversusnon-survivor.AnincreasedvalueofmeanAlveolar-arterialoxygengradientinazotemicdogsrespectreferencevalueswasalsofound.Thiscouldresultfromimpaireddiffusionor,morecommonly,byventilation-perfusioninequalityofthe"shunting"variety.PaCO2andHCO3-wasreducedinalldogsenrolledrespectreferencevalues.Theutilityofarterialbloodgasshouldbeconsideredinordertoevaluatearterialgasexchangeinthesepatients.Theseresultssuggesttoevaluatearterialbloodgasalsoduringhospitalizationtobetterverifyanypossiblecorrelationwithoutcome.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11568/804791
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