Foster Hospital for Small Animals, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, USA.
Center for Resuscitation Science, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
J Vet Emerg Crit Care (San Antonio). 2024 Jan-Feb;34(1):49-56. doi: 10.1111/vec.13341. Epub 2023 Nov 21.
To determine the normal reference interval (RI) for thiamine concentrations in healthy dogs and investigate the prevalence of thiamine deficiency in critically ill dogs with and without sepsis.
Prospective, observational, multicenter study, conducted between 2019 and 2021.
Two veterinary university teaching hospitals.
A total of 109 dogs were enrolled into 3 groups: 40 healthy dogs, 33 dogs with suspected or confirmed sepsis and evidence of tissue hypoperfusion (Doppler blood pressure ≤90 mm Hg or plasma lactate ≥3 mmol/L), and 36 dogs with other critical illnesses and evidence of tissue hypoperfusion.
For each dog, CBC, serum biochemistry, plasma lactate concentration, whole-blood thiamine concentration, blood pressure, vital parameters, Acute Patient Physiologic and Laboratory Evaluation (APPLE) score, and clinical outcomes were recorded, alongside basic patient parameters and dietary history. Whole-blood thiamine pyrophosphate (TPP) concentrations were measured using high-performance liquid chromatography.
The RI for whole-blood TPP in healthy dogs was 70.9-135.3 μg/L. Median TPP concentrations were significantly lower in septic dogs compared to healthy controls (P = 0.036). No significant difference in median TPP concentrations was found between septic dogs and nonseptic critically ill dogs, or between healthy dogs and nonseptic critically ill dogs. TPP concentrations were below the normal RI in 27.3% of septic dogs, compared to 19.4% of nonseptic critically ill dogs (P = 0.57). No correlations were found between TPP concentrations and lactate concentrations, age, body condition scores, time since last meal, RBC count, serum alanine aminotransferase, APPLE scores, or patient outcomes.
TPP concentrations were significantly lower in septic dogs compared to healthy controls, with an absolute thiamine deficiency found in 27.3% of septic dogs. The established TPP RI allows for further investigation of thiamine deficiency in critically ill dogs.
确定健康犬体内硫胺素浓度的正常参考区间(RI),并调查伴有和不伴有脓毒症的重症犬中硫胺素缺乏的患病率。
前瞻性、观察性、多中心研究,于 2019 年至 2021 年进行。
两所兽医大学教学医院。
共纳入 109 只犬,分为 3 组:40 只健康犬、33 只疑似或确诊脓毒症且存在组织低灌注证据(多普勒血压≤90mmHg 或血浆乳酸≥3mmol/L),以及 36 只患有其他危重病且存在组织低灌注证据的犬。
记录每只犬的全血细胞计数、血清生化、血浆乳酸浓度、全血硫胺素浓度、血压、生命体征、急性患者生理和实验室评估(APPLE)评分和临床结局,以及基本患者参数和饮食史。使用高效液相色谱法测量全血硫胺素焦磷酸盐(TPP)浓度。
健康犬全血 TPP 的 RI 为 70.9-135.3μg/L。与健康对照组相比,脓毒症犬的 TPP 浓度中位数明显较低(P=0.036)。脓毒症犬与非脓毒症重症犬之间,或健康犬与非脓毒症重症犬之间,TPP 浓度中位数无显著差异。27.3%的脓毒症犬 TPP 浓度低于正常 RI,而非脓毒症重症犬为 19.4%(P=0.57)。未发现 TPP 浓度与乳酸浓度、年龄、体况评分、上次进食后时间、红细胞计数、血清丙氨酸氨基转移酶、APPLE 评分或患者结局之间存在相关性。
与健康对照组相比,脓毒症犬的 TPP 浓度明显较低,27.3%的脓毒症犬存在绝对硫胺素缺乏。所建立的 TPP RI 可进一步调查重症犬中的硫胺素缺乏情况。