Volume Resuscitation in the Acutely Hemorrhaging Patient: Historic Use to Current Applications
Acute hemorrhage in small animals results from traumatic and non-traumatic causes. This review seeks to describe current understanding of the resuscitation of the acutely hemorrhaging small animal (dog and cat) veterinary patient through evaluation of pre-clinical canine models of hemorrhage and res...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2021-07-01
|
| Series: | Frontiers in Veterinary Science |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fvets.2021.638104/full |
| _version_ | 1818433677632208896 |
|---|---|
| author | Kelly Hall Kenneth Drobatz |
| author_facet | Kelly Hall Kenneth Drobatz |
| author_sort | Kelly Hall |
| collection | DOAJ |
| description | Acute hemorrhage in small animals results from traumatic and non-traumatic causes. This review seeks to describe current understanding of the resuscitation of the acutely hemorrhaging small animal (dog and cat) veterinary patient through evaluation of pre-clinical canine models of hemorrhage and resuscitation, clinical research in dogs and cats, and selected extrapolation from human medicine. The physiologic dose and response to whole blood loss in the canine patient is repeatable both in anesthetized and awake animals and is primarily characterized clinically by increased heart rate, decreased systolic blood pressure, and increased shock index and biochemically by increased lactate and lower base excess. Previously, initial resuscitation in these patients included immediate volume support with crystalloid and/or colloid, regardless of total volume, with a target to replace lost vascular volume and bring blood pressure back to normal. Newer research now supports prioritizing hemorrhage control in conjunction with judicious crystalloid administration followed by early consideration for administration of platelets, plasma and red blood during the resuscitation phase. This approach minimizes blood loss, ameliorates coagulopathy, restores oxygen delivery and correct changes in the glycocalyx. There are many hurdles in the application of this approach in clinical veterinary medicine including the speed with which the bleeding source is controlled and the rapid availability of blood component therapy. Recommendations regarding the clinical approach to volume resuscitation in the acutely hemorrhaging veterinary patient are made based on the canine pre-clinical, veterinary clinical and human literature reviewed. |
| first_indexed | 2024-12-14T16:24:54Z |
| format | Article |
| id | doaj.art-6025b4c6785d4b28af783e7b1e3b59ed |
| institution | Directory Open Access Journal |
| issn | 2297-1769 |
| language | English |
| last_indexed | 2024-12-14T16:24:54Z |
| publishDate | 2021-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Veterinary Science |
| spelling | doaj.art-6025b4c6785d4b28af783e7b1e3b59ed2022-12-21T22:54:42ZengFrontiers Media S.A.Frontiers in Veterinary Science2297-17692021-07-01810.3389/fvets.2021.638104638104Volume Resuscitation in the Acutely Hemorrhaging Patient: Historic Use to Current ApplicationsKelly Hall0Kenneth Drobatz1Department of Clinical Sciences, Critical Care Services, Colorado State University, Fort Collins, CO, United StatesSection of Critical Care, Department of Clinical Studies, University of Pennsylvania, Philadelphia, PA, United StatesAcute hemorrhage in small animals results from traumatic and non-traumatic causes. This review seeks to describe current understanding of the resuscitation of the acutely hemorrhaging small animal (dog and cat) veterinary patient through evaluation of pre-clinical canine models of hemorrhage and resuscitation, clinical research in dogs and cats, and selected extrapolation from human medicine. The physiologic dose and response to whole blood loss in the canine patient is repeatable both in anesthetized and awake animals and is primarily characterized clinically by increased heart rate, decreased systolic blood pressure, and increased shock index and biochemically by increased lactate and lower base excess. Previously, initial resuscitation in these patients included immediate volume support with crystalloid and/or colloid, regardless of total volume, with a target to replace lost vascular volume and bring blood pressure back to normal. Newer research now supports prioritizing hemorrhage control in conjunction with judicious crystalloid administration followed by early consideration for administration of platelets, plasma and red blood during the resuscitation phase. This approach minimizes blood loss, ameliorates coagulopathy, restores oxygen delivery and correct changes in the glycocalyx. There are many hurdles in the application of this approach in clinical veterinary medicine including the speed with which the bleeding source is controlled and the rapid availability of blood component therapy. Recommendations regarding the clinical approach to volume resuscitation in the acutely hemorrhaging veterinary patient are made based on the canine pre-clinical, veterinary clinical and human literature reviewed.https://www.frontiersin.org/articles/10.3389/fvets.2021.638104/fullhemorrhageresuscitationtraumacoagulopathyshock |
| spellingShingle | Kelly Hall Kenneth Drobatz Volume Resuscitation in the Acutely Hemorrhaging Patient: Historic Use to Current Applications Frontiers in Veterinary Science hemorrhage resuscitation trauma coagulopathy shock |
| title | Volume Resuscitation in the Acutely Hemorrhaging Patient: Historic Use to Current Applications |
| title_full | Volume Resuscitation in the Acutely Hemorrhaging Patient: Historic Use to Current Applications |
| title_fullStr | Volume Resuscitation in the Acutely Hemorrhaging Patient: Historic Use to Current Applications |
| title_full_unstemmed | Volume Resuscitation in the Acutely Hemorrhaging Patient: Historic Use to Current Applications |
| title_short | Volume Resuscitation in the Acutely Hemorrhaging Patient: Historic Use to Current Applications |
| title_sort | volume resuscitation in the acutely hemorrhaging patient historic use to current applications |
| topic | hemorrhage resuscitation trauma coagulopathy shock |
| url | https://www.frontiersin.org/articles/10.3389/fvets.2021.638104/full |
| work_keys_str_mv | AT kellyhall volumeresuscitationintheacutelyhemorrhagingpatienthistoricusetocurrentapplications AT kennethdrobatz volumeresuscitationintheacutelyhemorrhagingpatienthistoricusetocurrentapplications |