Markers of tissue perfusion, relation to mortality in dogs with blunt trauma
The aim of this study was to evaluate admission Animal Trauma Triage (ATT) score, shock index (SI), and markers of perfusion, including base excess (BE), plasma lactate and lactate clearance in dogs with blunt trauma.
In this prospective observational clinical study, researchers included 44 client-owned dogs hospitalized following blunt trauma.
Within one hour of presentation and prior to fluid administration an initial hematocrit, total plasma protein, blood glucose, plasma lactate, blood gas and electrolytes were obtained for analysis. Plasma lactate concentrations were also measured four and eight hours following initial measurement, and a four-hour lactate clearance was calculated if patients had an increased admission plasma lactate. ATT score and SI were calculated for each patient based on admission data. Outcome was defined as survival to hospital discharge.
Twenty-nine dogs survived, 14 were euthanized and one dog died. Animals that did not survive had a lower mean pH (7.28 ± 0.03 vs 7.36 ± 0.01, P = 0.006), lower median HCO3 (15.7 vs 18.8 mmol/L, P = 0.004), lower median admission BE (-11.0 vs -7.0 mmol/L, P = 0.004), and higher median admission lactate (3.1 vs 2.4 mmol/L, P = 0.036) than those who survived.
Median ATT was significantly higher in non-survivors (5 vsF 2, P < 0.001). The SI was not significantly different between survivors and non-survivors (P = 0.41). There was no difference in median 4-hour lactate (P = 0.34), median eight-hour lactate (P = 0.19), or four-hour lactate clearance (P = 0.83) in survivors compared to non-survivors. No other statistically significant differences were noted between groups.
In conclusion, dogs hospitalized following blunt trauma with a lower admission pH, HCO3 and BE and a higher admission plasma lactate were less likely to survive to hospital discharge. Median ATT score was also significantly higher for non-survivors. Although lactate clearance was not predictive of survival, the sample size was small and the research team said additional studies with a larger study population are warranted.
Maude Poirier, et al. “Markers of tissue perfusion and their relation to mortality in dogs with blunt trauma.” J Vet Emerg Crit Care (San Antonio). 2022 Oct 26. doi: 10.1111/vec.13249.
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