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超声在创伤气道、呼吸、循环、残疾和暴露方面的兽医重点评估:对64例犬创伤患者的前瞻性观察研究。

Veterinary-focused assessment with sonography for trauma-airway, breathing, circulation, disability and exposure: a prospective observational study in 64 canine trauma patients.

作者信息

Armenise A, Boysen R S, Rudloff E, Neri L, Spattini G, Storti E

机构信息

Ospedale Veterinario Santa Fara, Bari 70124, Italy.

Faculty of Veterinary Medicine, University of Calgary, Calgary T2N 1N4, Canada.

出版信息

J Small Anim Pract. 2019 Mar;60(3):173-182. doi: 10.1111/jsap.12968. Epub 2018 Dec 13.

Abstract

OBJECTIVE

To describe the technique and findings of the 'veterinary focused assessment with sonography for trauma-airway, breathing, circulation, disability and exposure' protocol in dogs suffering from trauma.

MATERIALS AND METHODS

Prospective observational study on a new point-of-care ultrasound protocol on 64 dogs suffering from trauma and comparison of findings with radiology.

RESULTS

Comparison of the results of this new ultrasound protocol for trauma patients with radiography findings for pneumothorax, pleural effusion, alveolar-interstitial syndrome and abdominal effusion revealed positive agreement of 89, 83, 100 and 87% and negative agreement of 76, 83, 76 and 92%, respectively. Novel findings of the 'veterinary focused assessment with sonography for trauma-airway, breathing, circulation, disability and exposure' exam, which were not previously reported for dogs undergoing focused assessment with sonography for trauma, included alveolar-interstitial syndrome (suggestive of pulmonary contusions), diaphragmatic hernia, retroperitoneal effusion and tracheal injury. Our new technique may also help identify increased intracranial pressure via changes in optic nerve sheath diameter and haemodynamic instability through the evaluation of the caudal vena cava and cardiac function.

CLINICAL SIGNIFICANCE

The described ultrasound examination protocol can be rapidly performed on dogs suffering from trauma during resuscitation and it may detect injuries previously undetectable using other veterinary point-of-care ultrasound protocols.

摘要

目的

描述针对创伤犬的“创伤超声重点评估——气道、呼吸、循环、残疾与暴露情况”方案的技术及检查结果。

材料与方法

对64只创伤犬采用一种新的即时超声检查方案进行前瞻性观察研究,并将检查结果与放射学检查结果进行比较。

结果

将这种针对创伤患者的新超声检查方案的结果与针对气胸、胸腔积液、肺泡间质综合征和腹腔积液的放射学检查结果进行比较,发现阳性一致性分别为89%、83%、100%和87%,阴性一致性分别为76%、83%、76%和92%。“创伤超声重点评估——气道、呼吸、循环、残疾与暴露情况”检查的新发现,此前在接受创伤超声重点评估的犬中未见报道,包括肺泡间质综合征(提示肺挫伤)、膈疝、腹膜后积液和气管损伤。我们的新技术还可能通过评估视神经鞘直径的变化来帮助识别颅内压升高,并通过评估尾腔静脉和心脏功能来识别血流动力学不稳定情况。

临床意义

所描述的超声检查方案可在创伤犬复苏过程中快速实施,并且可能检测出使用其他兽医即时超声检查方案之前无法检测到的损伤。

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