J Am Vet Med Assoc. 2024 Feb 14;262(7):1-6. doi: 10.2460/javma.23.12.0671. Print 2024 Jul 1.
To compare complications between central and peripheral administration of high-osmolarity (approx 700 to 1,000 mOsm/L) amino acid (± lipid) infusions.
18 client-owned dogs diagnosed with aminoaciduric canine hypoaminoacidemic hepatopathy syndrome or superficial necrolytic dermatitis receiving parenteral amino acid ± lipid infusions.
In this retrospective case series, medical records were reviewed for administration route (central vs peripheral), catheter details and infusion characteristics (product osmolarity, concurrent lipid administration, infusion volume, duration, and rate), and complications for each infusion.
18 dogs received 277 infusions (median, 8.5; range, 1 to 84). Effective infusion osmolarities were 683 mOsm/L in 22% of infusions, 791 mOsm/L in 8%, 802 mOsm/L in 2%, 837 mOsm/L in 45%, and 998 mOsm/L in 23% (65% peripheral, 35% central). Most (n = 230 [83%]) infusions were given peripherally. The osmolarities of solutions administered by each route (P = .53), the infusion rate indexed to body weight (P = .17), or the lipid infusion rates indexed to body weight (P = .89) did not differ. One dog suffered 2 complications in 63 infusions-1 mild, 1 severe-both occurring with peripheral infusions. Thus, the overall complication rate was 2 of 277 (0.9%) infusions.
Short-term peripherally administered amino acid ± lipid infusions < 1,000 mOsm/L confer little risk compared to centrally administered infusions. Additional studies are needed to determine the safety of infusions with longer durations. Due to the relative ease of peripheral catheterization, clinicians should consider this route for medically managing aminoaciduric canine hypoaminoacidemic hepatopathy syndrome and superficial necrolytic dermatitis in dogs.
比较中心和外周给予高渗透压(约 700 至 1000mOsm/L)氨基酸(± 脂质)输注的并发症。
18 只被诊断为氨基酸尿性犬低氨基酸血症性肝性脑病综合征或浅表性坏死性皮炎并接受肠外氨基酸±脂质输注的患犬。
在这项回顾性病例系列研究中,对输注途径(中心 vs 外周)、导管细节和输注特征(产品渗透压、同时给予的脂质、输注量、持续时间和速度)以及每次输注的并发症进行了回顾性病历审查。
18 只犬接受了 277 次输注(中位数 8.5;范围 1 至 84)。有效输注渗透压为 683mOsm/L 的输注占 22%,791mOsm/L 的占 8%,802mOsm/L 的占 2%,837mOsm/L 的占 45%,998mOsm/L 的占 23%(65%外周,35%中心)。大多数(n=230[83%])输注是外周给予的。每条途径给予的溶液渗透压(P=.53)、按体重指数(P=.17)或按体重指数给予的脂质输注率(P=.89)没有差异。1 只犬在 63 次输注中发生了 2 次并发症-1 次轻度,1 次重度-均发生在外周输注时。因此,总的并发症发生率为 277 次输注中的 2 次(0.9%)。
与中心给予的输注相比,<1000mOsm/L 的短期外周给予氨基酸±脂质输注风险较小。需要进一步研究以确定输注时间更长的安全性。由于外周置管相对容易,临床医生应考虑在患有氨基酸尿性犬低氨基酸血症性肝性脑病综合征和浅表性坏死性皮炎的犬中使用这种途径进行医学管理。