1Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO.
2Department of Statistics, College of Natural Sciences, Colorado State University, Fort Collins, CO.
J Am Vet Med Assoc. 2023 Mar 3;261(6):874-880. doi: 10.2460/javma.22.11.0521. Print 2023 Jun 1.
To determine whether shock index (SI) positively correlates with percentage blood loss and negatively correlates with cardiac output (CO) in a canine hemorrhagic shock model and whether SI and metabolic markers may be used as end point targets for resuscitation.
8 healthy Beagles.
Between September and December 2021, dogs underwent general anesthesia for experimental induction of hypotensive shock, with the total volume of blood removed, CO, heart rate, systolic blood pressure, base excess, blood pH, and concentrations of hemoglobin, lactate, ionized calcium recorded, and SI calculated at 4 time points (TPs): after anesthetic induction when the dog had been stable for 10 minutes (TP1), 10 minutes after the mean arterial pressure stabilized to a target of 40 mm Hg following jugular removal of up to 60% blood volume to induce hemorrhagic shock (TP2), 10 minutes after autotransfusion of 50% of the removed blood (TP3), and 10 minutes after autotransfusion of the remaining 50% of the removed blood (TP4).
Mean SI increased between TP1 (1.08 ± 0.35) and TP2 (1.90 ± 0.73) and did not return to the prehemorrhage values for TP3 or TP4. SI correlated positively with percentage blood loss (r = 0.583) and negatively with CO (r = -0.543).
An increase in SI may support diagnosis of hemorrhagic shock; however, SI cannot be used as the sole end point of resuscitation. Significant differences in blood pH, base excess, and lactate concentration suggested they may be useful markers of hemorrhagic shock and need for blood transfusion.
在犬出血性休克模型中，确定休克指数（SI）是否与失血量百分比呈正相关，与心输出量（CO）呈负相关，以及 SI 和代谢标志物是否可作为复苏的终点目标。
8 只健康的比格犬。
2021 年 9 月至 12 月，犬接受全身麻醉，以实验性诱导低血压性休克，记录总出血量、CO、心率、收缩压、基础不足、血 pH 值以及血红蛋白、乳酸、离子钙浓度，并在 4 个时间点（TP）计算 SI：麻醉诱导后犬稳定 10 分钟时（TP1）、在颈静脉去除多达 60%的血液体积以诱导出血性休克后平均动脉压稳定至 40mmHg 目标 10 分钟时（TP2）、去除血液的 50%自体输血后 10 分钟（TP3）以及去除血液的剩余 50%自体输血后 10 分钟（TP4）。
平均 SI 在 TP1（1.08±0.35）和 TP2（1.90±0.73）之间增加，在 TP3 或 TP4 时未恢复到出血前的值。SI 与失血量百分比呈正相关（r=0.583），与 CO 呈负相关（r=-0.543）。
SI 的增加可能支持出血性休克的诊断；然而，SI 不能用作复苏的唯一终点。血液 pH 值、基础不足和乳酸浓度的显著差异表明它们可能是出血性休克和输血需求的有用标志物。
