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对于接受高血糖危象治疗的犬,钠校正因子为每 100mg/dL 葡萄糖升高 1.6mEq/L 的钠降低。

The sodium correction factor for dogs undergoing treatment for a hyperglycemic crisis is a 1.6-mEq/L decrease in sodium per 100-mg/dL increase in glucose.

出版信息

J Am Vet Med Assoc. 2024 Feb 27;262(8):1069-1075. doi: 10.2460/javma.23.11.0664. Print 2024 Aug 1.

Abstract

OBJECTIVE

To determine the sodium correction factor for clinical use in hyperglycemic diabetic dogs.

SAMPLE

Retrospective analysis of 76 hospitalization episodes from 67 different dogs presenting to the University of Georgia Veterinary Teaching Hospital between January 1, 2015, and January 1, 2023.

METHODS

For each hospitalization episode, paired blood sodium and glucose concentration measurements were recorded from the time of presentation until glucose concentration was ≤ 201 mg/dL. Therapies administered, primary diagnosis, and concurrent diseases were also recorded for each episode. A linear mixed model was used to determine the sodium correction factor per 100-mg/dL increase in glucose. Piecewise linear mixed models were also constructed for blood glucose measurements ≤ 400 mg/dL and > 400 mg/dL to explore potential correction factor differences between low and high glucose concentrations.

RESULTS

A sodium correction factor of a 1.6-mEq/L (95% CI, 1.3 to 1.9 mEq/L) decrease in sodium concentration per 100-mg/dL increase in blood glucose concentration was calculated. Differences in the correction factor between conditions of low and high glucose concentrations could not be determined due to a small sample size of blood glucose values > 400 mg/dL. Most dogs received similar treatments throughout the study period, including balanced isotonic crystalloids (97% [74/76]), electrolyte supplementation (84% [64/76]), and regular insulin (97% [74/76]). Almost all patients (93% [71/76]) had 1 or more concurrent diseases.

CLINICAL RELEVANCE

A sodium correction factor of 1.6 mEq/L (decrease in sodium per 100-mg/dL increase in glucose) is recommended for clinical use in hyperglycemic diabetic dogs.

摘要

目的

确定用于高血糖糖尿病犬临床的钠校正因子。

样本

2015 年 1 月 1 日至 2023 年 1 月 1 日期间,在佐治亚大学兽医教学医院就诊的 67 只不同犬的 76 例住院病例的回顾性分析。

方法

对于每例住院病例,从就诊时开始记录配对的血钠和血糖浓度测量值,直到血糖浓度≤201mg/dL。还记录了每例病例的治疗、主要诊断和合并症。使用线性混合模型确定每 100mg/dL 血糖升高时的钠校正因子。还构建了分段线性混合模型,用于血糖测量值≤400mg/dL 和>400mg/dL,以探索低和高血糖浓度之间潜在的校正因子差异。

结果

计算出血糖浓度每升高 100mg/dL,血钠浓度降低 1.6mEq/L(95%CI,1.3 至 1.9mEq/L)的钠校正因子。由于血糖值>400mg/dL 的样本量较小,无法确定高低血糖浓度条件下校正因子的差异。大多数犬在整个研究期间接受了类似的治疗,包括平衡等渗晶体液(97%[74/76])、电解质补充(84%[64/76])和常规胰岛素(97%[74/76])。几乎所有患者(93%[71/76])都有 1 种或多种合并症。

临床相关性

建议在高血糖糖尿病犬的临床中使用 1.6mEq/L(血糖每升高 100mg/dL 时钠的降低)的钠校正因子。

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Incidence and clinical relevance of hyperglycemia in critically ill dogs.危重病犬高血糖的发生率及临床相关性
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