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利用生理和动脉血气变量预测大结肠扭转马匹的短期生存情况。

Use of physiologic and arterial blood gas variables to predict short-term survival in horses with large colon volvulus.

作者信息

Kelleher Maureen E, Brosnan Robert J, Kass Philip H, le Jeune Sarah S

机构信息

William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616, USA.

出版信息

Vet Surg. 2013 Jan;42(1):107-13. doi: 10.1111/j.1532-950X.2012.01081.x. Epub 2012 Dec 5.

Abstract

OBJECTIVE

To determine if preoperative physical examination and blood work values, intraoperative physiologic variables, and intraoperative treatments can be correlated with survival to anesthetic recovery and short-term survival to hospital discharge in horses that undergo exploratory celiotomy for large colon volvulus (LCV) with and without colon resection.

STUDY DESIGN

Retrospective case series.

ANIMALS

Horses (n = 156) undergoing exploratory celiotomy for correction of LCV ≥ 360(ο) .

METHODS

Medical records (January 2000-December 2009) of horses that had surgical correction of LCV ≥ 360(ο) were reviewed. Data collection included signalment, preoperative physical examination variables and hematologic values as well as intraoperative physiologic variables, intraoperative treatments, and arterial blood gas values. Risk factors for survival to anesthetic recovery and hospital discharge were determined using exact logistic regression.

RESULTS

High preoperative heart rate and packed cell volume were associated with not surviving to anesthetic recovery or hospital discharge. A low intraoperative total serum protein concentration was associated with not surviving to anesthetic recovery or to hospital discharge. Intraoperative tachycardia and hypercapnia were associated with not surviving to hospital discharge. Intraoperative hypotension was a negative predictor of survival to anesthetic recovery. There was no increase in death for horses in which a resection and anastomosis was performed compared with those having manual correction.

CONCLUSIONS

Several hematologic and cardiorespiratory variables that are easily measured preoperatively and intraoperatively show good correlation with postanesthetic survival in horses undergoing surgical correction of LCV. These measurements might be useful for prognosticating survival in horses admitted for correction of LCV ≥ 360(ο) .

摘要

目的

确定术前体格检查和血液检查值、术中生理变量以及术中治疗是否与接受大结肠扭转(LCV)探查性剖腹术且有或无结肠切除术的马匹麻醉恢复存活及出院短期存活相关。

研究设计

回顾性病例系列研究。

动物

156匹因矫正≥360°的LCV而接受探查性剖腹术的马匹。

方法

回顾2000年1月至2009年12月间接受LCV≥360°手术矫正的马匹的病历。数据收集包括特征、术前体格检查变量和血液学值以及术中生理变量、术中治疗和动脉血气值。使用精确逻辑回归确定麻醉恢复存活和出院存活的危险因素。

结果

术前心率高和红细胞压积与麻醉恢复或出院未存活相关。术中总血清蛋白浓度低与麻醉恢复或出院未存活相关。术中心动过速和高碳酸血症与出院未存活相关。术中低血压是麻醉恢复存活的负性预测指标。与手动矫正的马匹相比,进行切除吻合术的马匹死亡率没有增加。

结论

术前和术中易于测量的几个血液学和心肺变量与接受LCV手术矫正的马匹麻醉后存活具有良好相关性。这些测量可能有助于预测因矫正≥360°的LCV而入院的马匹的存活情况。

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