Peterson Katherine L, Hardy Brian T, Hall Kelly
Department of Veterinary Clinical Sciences, University of Minnesota, College of Veterinary Medicine, St Paul, MN, 55108.
J Vet Emerg Crit Care (San Antonio). 2013 Sep-Oct;23(5):545-50. doi: 10.1111/vec.12090. Epub 2013 Aug 23.
To compare the shock index (SI) in a population of healthy dogs to a population of dogs with confirmed hemorrhagic shock.
Retrospective analysis of data collected prospectively from 2 previous studies.
University teaching hospital.
Seventy-eight healthy control dogs enrolled in a study to establish a reference interval for a tissue oxygen monitor; 38 dogs with confirmed hemorrhagic shock enrolled in a study to evaluate the tissue oxygen monitor in hemorrhagic shock. The heart rate and systolic blood pressure obtained during the respective studies were used to calculate the SI.
None.
Shock index was significantly higher in the hemorrhage group (median 1.37, range 0.78-4.35) than the control group (median 0.91, range 0.57-1.53); 92% of the dogs in hemorrhagic shock had an SI of >0.91. Compared with controls, dogs in hemorrhagic shock had significantly lower body temperatures (median 38.3°C, range 35.6-39.9°C versus median 38.7°C, range 37.5-39.9°C), higher heart rates (median 150/min, range 120-220/min versus median 110/min range 80-150/min), lower systolic blood pressures (mean 112 mm Hg, SD ±35.8 mm Hg versus mean 125 mm Hg, SD ±21.5 mm Hg), higher lactate concentrations (median 0.51 mmol/L, range 0.078-1.41 mmol/L versus median 0.11 mmol/L, range 0.033-0.33 mmol/L), and lower hemoglobin concentrations (median 81 g/L, range 56-183 g/L versus median 162.5 g/L, range 133-198 g/L).
Shock index is a simple and easy calculation that can be used as an additional triage tool and should prompt further investigation for hemorrhage if the values are >0.9.
比较健康犬群体与确诊为失血性休克犬群体的休克指数(SI)。
对先前两项前瞻性研究收集的数据进行回顾性分析。
大学教学医院。
78只健康对照犬参与一项旨在建立组织氧监测仪参考区间的研究;38只确诊为失血性休克的犬参与一项旨在评估失血性休克中组织氧监测仪的研究。在各自研究过程中获得的心率和收缩压用于计算SI。
无。
出血组的休克指数(中位数1.37,范围0.78 - 4.35)显著高于对照组(中位数0.91,范围0.57 - 1.53);92%的失血性休克犬SI>0.91。与对照组相比,失血性休克犬的体温显著更低(中位数38.3°C,范围35.6 - 39.9°C,而对照组中位数38.7°C,范围37.5 - 39.9°C),心率更高(中位数150次/分钟,范围120 - 220次/分钟,而对照组中位数110次/分钟,范围80 - 150次/分钟),收缩压更低(平均112 mmHg,标准差±35.8 mmHg,而对照组平均125 mmHg,标准差±21.5 mmHg),乳酸浓度更高(中位数0.51 mmol/L,范围0.078 - 1.41 mmol/L,而对照组中位数0.11 mmol/L,范围0.033 - 0.33 mmol/L),血红蛋白浓度更低(中位数81 g/L,范围56 - 183 g/L,而对照组中位数162.5 g/L,范围133 - 198 g/L)。
休克指数是一种简单易算的指标,可作为一种额外的分诊工具,如果数值>0.9,应促使对出血情况进行进一步检查。