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Impact of preanaesthetic echocardiography on the planned anaesthetic management of cats.
Veterinary Anaesthesia and Analgesia ( IF 1.4 ) Pub Date : 2020-04-18 , DOI: 10.1016/j.vaa.2020.04.003
Louise Clark 1 , Julie A Kavanagh 2 , Daniel S J Pang 3 , Matt A Gurney 4 , Carl A Bradbrook 1 , Sarah M Gibson 1 , Pedro Oliveira 1
Affiliation  

Objective

To assess the impact of preanaesthetic echocardiography on the subsequent intended anaesthetic management plan in cats with incidental clinical findings that may indicate cardiac disease.

Study design

Clinical study involving cats undergoing echocardiography and subsequent anaesthesia.

Animals

A total of 40 client-owned cats.

Methods

Echocardiography was performed in conscious cats and the information was used to plan anaesthesia or sedation. An information sheet including relevant history, temperament, body condition score, clinical examination findings, current medication and results of any relevant tests such as haematology, biochemistry or Doppler blood pressure measurement was sent to three specialist anaesthetists and virtual case management plans were designed for each cat in two steps: step 1) anaesthetists were unaware of echocardiography results; and step 2) anaesthetists were aware of echocardiography results. In the second step the anaesthetists documented any changes to their original management plan, as either ‘step-up’ or ‘step-down’.

Results

Of the 40 cats, 26 had murmurs, four had a gallop rhythm, four had both findings and six had other findings. Pathology of potential haemodynamic significance was found on echocardiography in 23 cats, 17 of which anaesthetists had correctly identified as having disease before echocardiography. A proportion of cats with murmurs were subsequently deemed to have no significant pathology after echocardiography. Echocardiography findings in these cases were: dynamic left ventricular outflow tract obstruction (DLVOTO) without hypertrophy; DLVOTO without hypertrophy + dynamic right ventricular outflow tract obstruction (DRVOTO); DRVOTO; valvular dysplasia; normal. In a median of 26/40 (range 16–38) of cases, the anaesthetic plan was changed after provision of further information; in 15/40 (8–20) cases, this was a ‘step-up’ in care and in eight/40 (6–23) it was a ‘step-down’ in care. In cases with atrial enlargement (left atrium to aortic ratio of >1.6) and deemed at risk of cardiac failure, alpha-2 agonist use changed considerably with availability of echocardiography findings.

Conclusion

and clinical relevance Where there are abnormal cardiac findings on clinical examination in cats, echocardiography is required to accurately assess anaesthetic risk . The availability of echocardiographic information positively influences anaesthetic management.



中文翻译:

麻醉前超声心动图对计划麻醉猫的影响。

目的

评估麻醉前超声心动图对猫的后续预期麻醉管理计划的影响,并附带可能表明心脏病的临床发现。

学习规划

涉及猫接受超声心动图检查和随后麻醉的临床研究。

动物

共有40只客户拥有的猫。

方法

对有意识的猫进行超声心动图检查,并将该信息用于计划麻醉或镇静。将包括相关病史,气质,身体状况评分,临床检查结果,当前用药以及任何相关测试结果(如血液学,生物化学或多普勒血压测量)的信息表发送给三位专科麻醉师,并为每位专家设计虚拟病例管理计划猫分两个步骤:步骤1)麻醉师未意识到超声心动图检查的结果;步骤2)麻醉师了解超声心动图检查结果。在第二步中,麻醉师记录对原始管理计划的任何更改,即“逐步”或“逐步”。

结果

在40只猫中,有26只具有杂音,四只具有奔腾的节奏,四只同时具有发现,六只具有其他发现。通过超声心动图检查发现了23只猫的潜在血液动力学意义病理,其中有17位麻醉师在超声心动图检查之前已正确识别出患有疾病。超声心动图检查后,随后将一部分带有杂音的猫视为无明显病理。在这些情况下,超声心动图检查的结果是:无肥大的动态左室流出道梗阻(DLVOTO);DLVOTO无肥大+动态右室流出道梗阻(DRVOTO); DRVOTO;瓣膜发育不良 正常。在中位数为26/40(范围为16-38)的病例中,在提供更多信息后改变了麻醉计划。在15/40(8–20)的情况下,这是护理方面的“提升”,而在八分之四十(6-23)中则是护理方面的“降低”。在心房扩大(左心房与主动脉比例> 1.6)并被认为有心力衰竭的风险的情况下,随着超声心动图检查结果的可用性,α-2激动剂的使用发生了很大变化。

结论

与临床相关性如果猫的临床检查发现心脏异常,则需要超声心动图以准确评估麻醉风险。超声心动图信息的可用性对麻醉管理产生积极影响。

更新日期:2020-04-18
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