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非诺多泮用于患有急性肾损伤的危重症小动物患者:28只犬和34只猫(2008 - 2012年)

Administration of fenoldopam in critically ill small animal patients with acute kidney injury: 28 dogs and 34 cats (2008-2012).

作者信息

Nielsen Lindsey K, Bracker Kiko, Price Lori Lyn

机构信息

Angell Animal Medical Center, Boston, MA.

Biostatistics Research Center, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA.

出版信息

J Vet Emerg Crit Care (San Antonio). 2015 May-Jun;25(3):396-404. doi: 10.1111/vec.12303. Epub 2015 Apr 8.

Abstract

OBJECTIVE

To describe the clinical features and outcomes of critically ill dogs and cats with acute kidney injury (AKI) receiving fenoldopam infusions compared to patients with AKI that did not receive fenoldopam.

DESIGN

Retrospective clinical study from May 1, 2008 until June 1, 2012.

SETTING

Private emergency and specialty referral hospital.

ANIMALS

Client-owned dogs (28) and cats (34) with AKI that received fenoldopam compared with similar patients with AKI (30 dogs and 30 cats) that did not.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

The medical records of 62 critically ill dogs and cats with AKI that received fenoldopam were reviewed. Presenting clinical signs, physical examination findings, and primary and secondary disease processes were identified in all patients. The mean number of days on fenoldopam was 1.5 days (range 0.3-4.0 days) for dogs and 1.9 days (range 1.0-4.0 days) for cats. Eleven of 28 (39%) dogs survived to discharge and 13 of 34 (38%) of the cats survived to discharge. Of the animals in the group receiving fenoldopam that died, the majority (84%) were euthanized. Potential adverse reactions were evaluated, with hypotension being the most commonly encountered adverse effect (7% of fenoldopam group [FG] dogs and 23% of FG cats). When compared with patients with AKI that did not receive fenoldopam, no significant differences were found between the groups with regards to survival, length of hospital stay, adverse effects, or changes in creatinine, BUN, or sodium concentrations except that patients receiving fenoldopam were significantly more likely to have received other renally active medications.

CONCLUSIONS

In this study of patients with AKI, fenoldopam administration at 0.8 μg/kg/min in dogs and 0.5 μg/kg/min in cats appeared relatively safe but was not associated with improvement in survival to discharge, length of hospital stay, or improvement in renal biochemical parameters when compared to patients with AKI not receiving fenoldopam.

摘要

目的

描述接受非诺多泮输注的急性肾损伤(AKI)重症犬猫的临床特征及预后,并与未接受非诺多泮的AKI患者进行比较。

设计

2008年5月1日至2012年6月1日的回顾性临床研究。

地点

私立急诊及专科转诊医院。

动物

28只接受非诺多泮治疗的客户-owned犬和34只接受非诺多泮治疗的猫,与未接受治疗的类似AKI患者(30只犬和30只猫)进行比较。

干预措施

无。

测量指标及主要结果

回顾了62只接受非诺多泮治疗的AKI重症犬猫的病历。确定了所有患者的临床表现、体格检查结果以及原发性和继发性疾病过程。犬使用非诺多泮的平均天数为1.5天(范围0.3 - 4.0天),猫为1.9天(范围1.0 - 4.0天)。28只犬中有11只(39%)存活至出院,34只猫中有13只(38%)存活至出院。在接受非诺多泮治疗且死亡的动物中,大多数(84%)实施了安乐死。评估了潜在的不良反应,低血压是最常见的不良反应(非诺多泮组[FG]犬中有7%,FG猫中有23%)。与未接受非诺多泮的AKI患者相比,两组在生存率、住院时间、不良反应或肌酐、尿素氮或钠浓度变化方面无显著差异,只是接受非诺多泮的患者更有可能接受其他肾活性药物治疗。

结论

在这项针对AKI患者的研究中,犬以0.8μg/kg/min、猫以0.5μg/kg/min的剂量使用非诺多泮似乎相对安全,但与未接受非诺多泮的AKI患者相比,在出院生存率、住院时间或肾脏生化参数改善方面并无关联。

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