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在接受择期手术或肠手术麻醉的马中,使用舌下微循环侧流暗场视频显微镜进行评估。

Evaluation of the sublingual microcirculation with sidestream dark field video microscopy in horses anesthetized for an elective procedure or intestinal surgery.

机构信息

From the APCSe Unit UPSP 2016.A101, VetAgro Sup, University of Lyon, 69280 Marcy-l'Étoile, France.

From the Department of Pharmacology, Faculty of Agronomy and Veterinary Medicine, Lebanese University, Beirut, Lebanon.

出版信息

Am J Vet Res. 2021 Jul;82(7):574-581. doi: 10.2460/ajvr.82.7.574.

Abstract

OBJECTIVE

To compare the sublingual microcirculation between healthy horses anesthetized for elective procedures and horses with colic anesthetized for abdominal surgery and to determine the effect of mean arterial blood pressure (MAP) on the microcirculation.

ANIMALS

9 horses in the elective group and 8 horses in the colic group.

PROCEDURES

Sublingual microcirculation was assessed with sidestream dark field video microscopy. Videos were captured at 3 time points during anesthesia. Recorded microvasculature parameters were De Backer score (DBS), total density of perfused vessels (PVD) and small vessels (PVD-S), total proportion of perfused vessels (PPV) and small vessels (PPV-S), vascular flow index (MFI), and heterogeneity index (HI). Blood pressure during hypotensive (MAP < 60 mm Hg) and normotensive (MAP ≥ 60 mm Hg) episodes was also recorded.

RESULTS

During normotensive episodes, the elective group had significantly better PPV and PPV-S versus the colic group (median PPV, 76% vs 50%; median PPV-S, 73% vs 51%). In both groups, PPV decreased during anesthesia (elective group, -29%; colic group, -16%) but significantly improved in the elective group 15 minutes before the end of anesthesia (59%). During hypotensive episodes, PVD-S was better preserved in the colic group (11.1 vs 3.8 mm/mm). No differences were identified for the microcirculatory parameters between normo- and hypotensive episodes in the colic group.

CONCLUSIONS AND CLINICAL RELEVANCE

Sublingual microcirculation was better preserved in healthy horses anesthetized for elective procedures than in horses with colic anesthetized for abdominal surgery despite resuscitation maneuvers. Results indicated that the macrocirculation and microcirculation in critically ill horses may be independent.

摘要

目的

比较择期手术麻醉的健康马与腹部手术麻醉的腹痛马的舌下微循环,并确定平均动脉血压(MAP)对微循环的影响。

动物

择期组 9 匹马,腹痛组 8 匹马。

程序

采用侧流暗场视频显微镜评估舌下微循环。在麻醉期间的 3 个时间点采集视频。记录的微血管参数包括德贝克评分(DBS)、总灌注血管密度(PVD)和小血管(PVD-S)、总灌注血管比例(PPV)和小血管(PPV-S)、血管血流指数(MFI)和异质性指数(HI)。还记录了低血压(MAP < 60mmHg)和正常血压(MAP ≥ 60mmHg)期间的血压。

结果

在正常血压期,择期组的 PPV 和 PPV-S 明显优于腹痛组(中位 PPV,76%比 50%;中位 PPV-S,73%比 51%)。在两组中,PPV 在麻醉期间下降(择期组下降 29%;腹痛组下降 16%),但在麻醉结束前 15 分钟,择期组显著改善(59%)。在低血压期,腹痛组的 PVD-S 保存得更好(11.1 比 3.8mm/mm)。在腹痛组中,正常血压期和低血压期的微循环参数没有差异。

结论和临床相关性

尽管有复苏措施,但在择期手术麻醉的健康马中,舌下微循环的保存明显优于腹部手术麻醉的腹痛马。结果表明,危重病马的大循环和微循环可能是独立的。

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