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剖宫产分娩新生犬脐血气参数与阿氏评分的评估

Umbilical Cord Blood Gas Parameters and Apgar Scoring in Assessment of New-Born Dogs Delivered by Cesarean Section.

作者信息

Antończyk Agnieszka, Ochota Małgorzata, Niżański Wojciech

机构信息

Wrocław University of Environmental and Life Sciences, Department and Clinic of Surgery, 50-366 Wrocław, Poland.

Wrocław University of Environmental and Life Sciences, Department of Reproduction and Clinic of Farm Animals, 50-366 Wrocław, Poland.

出版信息

Animals (Basel). 2021 Mar 4;11(3):685. doi: 10.3390/ani11030685.

Abstract

The article presents the results of the clinical evaluation (Apgar scores, AS) and umbilical cord blood gas analysis (UCBGA) obtained from clamped umbilical cords of newborn pups delivered by the elective Caesarean section. The study was planned as a controlled clinical study, the newborns were allocated into one of the groups, I-critical neonates (severe distress, AS ≤ 3), II-weak neonates (moderate distress, AS 4-6) and III-healthy neonates (no distress, AS ≥ 7). The following parameters were evaluated: pH (pH units), carbon dioxide partial pressure (pCO; mmHg), oxygen partial pressure (pO; mmHg), actual bicarbonate (cHCO; mmol/L), total carbon dioxide (cTCO; mmol/L), base excess of extracellular fluid (BE(ecf); mmol/L), base excess of blood (BE(b); mmol/L), oxygen saturation (csO; %), lactate (Lac; mg/dL), hematocrit (Hct; %PCV), hemoglobin (cHgb; g/dL), glucose (Glu; mg/dL), ions (Na, K, Ca, Cl). The majority of puppies had low AS at birth (AS 4-6 in 38.1% and AS ≤ 3 in 57.1% of the neonates), but most of them (85.7%) improved by the 20th min. reaching AS of 7 and more. Moreover, puppies with lower AS (≤ 3) were at higher risk of death within the first 24h (20.8% did not survive). The positive correlation was found between Apgar score measured at 0 min and pH (r = 0.46, = 0.01), and between Apgar score (at 0 min) and base excess in whole blood measured [BE(b)] r = 0.36, = 0.03). Whereas, a negative correlation was detected between Apgar score at 0 and 5th min and glycemia (r = -0.42, = 0.05, r = -0.34, = 0.02 respectively. Overall, the puppies with higher glucose levels had lower Apgar scores and were at higher risk of death. Furthermore, in our study, the newborn puppies had mild acidemia with elevated pCO levels and the HCO at the lower range of normal limits, suggesting the mixed component in the acidemic state. Adaptation to extra-uterine life is crucial and any practical improvement in neonatal diagnostics and care would be beneficial for newborn puppy survival.

摘要

本文呈现了对择期剖宫产分娩的新生幼犬钳夹脐带进行临床评估(阿氏评分,AS)和脐血血气分析(UCBGA)的结果。该研究计划为对照临床研究,将新生儿分为以下几组:I组为危重新生儿(严重窘迫,AS≤3),II组为虚弱新生儿(中度窘迫,AS 4 - 6),III组为健康新生儿(无窘迫,AS≥7)。评估了以下参数:pH(pH单位)、二氧化碳分压(pCO;mmHg)、氧分压(pO;mmHg)、实际碳酸氢盐(cHCO;mmol/L)、总二氧化碳(cTCO;mmol/L)、细胞外液碱剩余(BE(ecf);mmol/L)、全血碱剩余(BE(b);mmol/L)、氧饱和度(csO;%)、乳酸(Lac;mg/dL)、血细胞比容(Hct;%PCV)、血红蛋白(cHgb;g/dL)、葡萄糖(Glu;mg/dL)、离子(Na、K、Ca、Cl)。大多数幼犬出生时阿氏评分较低(38.1%的新生儿AS为4 - 6,57.1%的新生儿AS≤3),但其中大多数(85.7%)在第20分钟时情况改善,阿氏评分达到7及以上。此外,阿氏评分较低(≤3)的幼犬在出生后24小时内死亡风险更高(20.8%未存活)。在出生0分钟时测得的阿氏评分与pH之间发现正相关(r = 0.46,P = 0.01),以及在出生0分钟时的阿氏评分与全血碱剩余[BE(b)]之间发现正相关(r = 0.36,P = 0.03)。然而,在出生0分钟和5分钟时的阿氏评分与血糖之间检测到负相关(分别为r = -0.42,P = 0.05;r = -0.34,P = 0.02)。总体而言,血糖水平较高的幼犬阿氏评分较低,死亡风险更高。此外,在我们的研究中,新生幼犬存在轻度酸血症,pCO水平升高,HCO处于正常范围下限,提示酸血症状态存在混合成分。适应宫外生活至关重要,新生儿诊断和护理方面的任何实际改进都将有利于新生幼犬存活。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a98/8000146/6bc4c7fcff91/animals-11-00685-g001.jpg

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