Descending thoracic aortic blood flow parameters during emergent surgery in anesthetized critically ill dogs

Authors

  • Richard J. Mills DVM,

    1. From the Animal Emergency Center, Glendale, WI (Mills, Lichtenberger, Kirby), and Iowa Methodist Medical Center, Surgery Education Department and Trauma Research, Des Moines, IA (Wall).
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  • Marla K. Lichtenberger DVM, DACVECC,

    1. From the Animal Emergency Center, Glendale, WI (Mills, Lichtenberger, Kirby), and Iowa Methodist Medical Center, Surgery Education Department and Trauma Research, Des Moines, IA (Wall).
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  • Piper L. Wall DVM, PhD,

    1. From the Animal Emergency Center, Glendale, WI (Mills, Lichtenberger, Kirby), and Iowa Methodist Medical Center, Surgery Education Department and Trauma Research, Des Moines, IA (Wall).
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  • Rebecca Kirby DVM, DACVECC, DACVIM

    1. From the Animal Emergency Center, Glendale, WI (Mills, Lichtenberger, Kirby), and Iowa Methodist Medical Center, Surgery Education Department and Trauma Research, Des Moines, IA (Wall).
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Dr Richard Mills, Animal Emergency Center, 2100 W. Silver Spring Drive, Glendale, WI 53209, Fax: (414) 540 6720.E-mail: DOC4DAWGS@msn.com

Abstract

Objective: To explore the potential value of transesophageally-determined descending thoracic aortic blood flow parameters in critically ill dogs undergoing surgery.

Design: Observational case series.

Setting: Private small animal referral hospital.

Animals: Ten anesthetized critically ill dogs that underwent emergent surgery.

Interventions: Placement of the ultrasonic transesophageal probe.

Measurements and main results: Transesophageally-determined descending thoracic aortic blood flow, stroke volume, blood velocity, blood acceleration, left ventricular ejection time interval, and heart rate parameters were recorded every minute. Systolic and mean arterial blood pressures were non-invasively determined and recorded at 1–5 minute intervals. The anesthetist and surgeon were blinded to the descending thoracic aortic blood flow parameters. All dogs received fluid challenges as part of their management, and 2 dogs received dopamine. The variability of the descending thoracic aortic blood flow parameters within each dog was greater than has been reported in non-critically ill anesthetized dogs. Consistent trends in descending thoracic aortic blood flow parameters after fluid challenges were not found. An escalating dopamine infusion was, however, accompanied by increasing aortic blood flow, stroke volume, acceleration, and peak velocity.

Conclusions: Descending thoracic aortic blood flow parameters may eventually be useful for evaluating the responses to and suggesting the need for cardiovascular interventions during emergent surgeries in anesthetized critically ill canine patients. For this to occur, more experience with this technology will be required.

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