Vasoactive use in early goal-directed therapy in dogs with severe sepsis and septic shock

Abstract

The goal of this study was to see how to evaluate the changes in macrovascularand microvascular parameters in survivors (Sv) and non-survivors (non-Sv) dogs with severe sepsis and septic shock (SEVS & SEPS) in response to goal-directed hemodynamic optimization at the intensive care unit (ICU), and to evaluate norepinephrine (NE) and dobutamine (DT) ICU applications, and their effectiveness for predicting death. Thirty-five dogs with SEVS & SEPS were used. NE was given to 10 hypotensive dogs, despite receiving a single bolus of fluid therapy, at a constant infusion rate of 1.5 µg/kg/min for 2 h. The rate of NE infusion was doubled (3.0 µg/kg/min) if the clinical response was insufficient after 2 hours. DT was administered to 5 dogs with left ventricular systolic dysfunction (LVSD) (LVS’<7.5 cm/s) at a constant infusion rate of 5 µg/kg/min for 2 h. The Sv and non-Sv groups had no major differences in macrovascular and microvascular characteristics, PW-TDI septal mitral annulus systolic (S') and early diastolic (E') velocities, or DT applications. The only difference was the use of NE applications. non-Sv received a greater amount of NE, while Sv received a smaller amount of NE. In contrast, more Sv received a greater amount of DT applications. Total mortality rate was 25.7%. In conclusion, the effects of DT and NE in dogs with SEVS & SEPS are limited. To provide evidence-based guidelines for dogs with SEVS & SEPS, more research is needed.

Keywords

• dobutamine
• early goal-directed therapy
• norepinephrine
• septic shock
• severe sepsis

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