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猫全胃肠外营养给药相关并发症及预后因素的评估:75例病例(1994 - 2001年)

Evaluation of complications and prognostic factors associated with administration of total parenteral nutrition in cats: 75 cases (1994-2001).

作者信息

Pyle Sally C, Marks Stanley L, Kass Philip H

机构信息

Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.

出版信息

J Am Vet Med Assoc. 2004 Jul 15;225(2):242-50. doi: 10.2460/javma.2004.225.242.

Abstract

OBJECTIVE

To determine frequency and types of complications, prognostic factors, and primary diseases affecting clinical outcome associated with administration of total parenteral nutrition (TPN) in cats.

DESIGN

Retrospective study.

ANIMALS

75 cats that received TPN for > or = 12 hours.

PROCEDURE

Medical records were reviewed, and information was obtained on signalment, history, problems at initial evaluation, physical examination findings, weight and changes in weight while receiving TPN, duration in the hospital before initiation of TPN, the type of TPN catheter used, duration of TPN administration, and final diagnosis. Laboratory results obtained immediately prior to TPN and at 24 and 96 hours following initiation of TPN administration were compared.

RESULTS

Reports of weight loss at initial evaluation, hyperglycemia at 24 hours, or diagnosis of chronic renal failure were significantly associated with increased mortality rate. Greater serum albumin concentrations prior to and at 96 hours following TPN administration were significantly associated with decreased mortality rate. Mechanical and septic complications were infrequent and not associated with increased mortality rate. Most cats had multiple diseases. The overall mortality rate was 52%; among 75 cats, 36 recovered, 23 were euthanatized, and 16 died as a result of their primary illness or complications associated with their illness.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated high mortality rate in cats maintained onTPN that had multiple concurrent diseases associated with a poor prognosis. Indicators of poor prognosis included a history of weight loss, hyperglycemia at 24 hours following TPN administration, hypoalbuminemia, and chronic renal failure.

摘要

目的

确定猫接受全胃肠外营养(TPN)时并发症的发生率及类型、预后因素以及影响临床结局的原发性疾病。

设计

回顾性研究。

动物

75只接受TPN≥12小时的猫。

方法

查阅病历,获取有关特征、病史、初次评估时的问题、体格检查结果、接受TPN期间的体重及体重变化、开始TPN前的住院时间、所用TPN导管类型、TPN给药持续时间以及最终诊断的信息。比较TPN给药前以及给药后24小时和96小时即刻获得的实验室结果。

结果

初次评估时体重减轻、24小时时血糖升高或诊断为慢性肾衰竭的报告与死亡率增加显著相关。TPN给药前及给药后96小时血清白蛋白浓度较高与死亡率降低显著相关。机械性和感染性并发症较少见,且与死亡率增加无关。大多数猫患有多种疾病。总体死亡率为52%;75只猫中,36只康复,23只实施安乐死,16只因原发性疾病或与其疾病相关的并发症死亡。

结论及临床意义

结果表明,患有多种并发疾病且预后不良的猫接受TPN时死亡率较高。预后不良的指标包括体重减轻史、TPN给药后24小时血糖升高、低白蛋白血症和慢性肾衰竭。

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