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Investigation of biomarkers for impending fluid overload in a feline acute haemorrhage-resuscitation model

  • Gareth E. Zeiler
    Correspondence
    Correspondence: Gareth E Zeiler, Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Private Bag X04, Onderstepoort, 0110, South Africa.
    Affiliations
    Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa

    Section of Anaesthesia and Critical Care, Valley Farm Animal Hospital, Pretoria, South Africa

    Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
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  • Brighton T. Dzikiti
    Affiliations
    Clinical Sciences Department, Ross University School of Veterinary Medicine, Basseterre, St. Kitts and Nevis
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  • Peter Kamerman
    Affiliations
    Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
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  • Friederike Pohlin
    Affiliations
    Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa

    Section of Anaesthesia and Critical Care, Valley Farm Animal Hospital, Pretoria, South Africa
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  • Roxanne K. Buck
    Affiliations
    Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa
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  • Andrea Fuller
    Affiliations
    Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
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Published:August 20, 2021DOI:https://doi.org/10.1016/j.vaa.2021.04.011

      Abstract

      Objective

      To determine biomarkers for impending fluid overload during intravenous fluid administration in a feline haemorrhage-resuscitation model.

      Study design

      Randomized crossover study.

      Animals

      A group of six domestic cats (mean age and weight: 21 months; 4.9 kg, respectively).

      Methods

      The cats underwent three treatments, 2 months apart. They were anaesthetized and instrumented to measure a range of physiological, blood gas, haematological and biochemical variables over time. Samples were taken during a health check, before haemorrhage, after haemorrhage and then at 30 minute intervals during fluid resuscitation and 24 hours later. The three treatments were: 1) control, sham haemorrhage and resuscitation; 2) lactated Ringer’s solution (LRS); and 3) 6% tetrastarch 130/0.4 (Vol) where the cats underwent a controlled haemorrhage then resuscitation by administering LRS and Vol at 60 and 20 mL kg–1 hour–1, respectively, for 120 minutes. Fluid overload was identified by nasal discharge and radiographic evidence. Biomarkers were variables that exceeded the reference interval for cats during treatment. Potential biomarkers were analysed using receiver operating characteristic curves (p < 0.05).

      Results

      Mean ± standard deviation total blood loss was 10.2 ± 2.3, 29.3 ± 9.0 and 29.1 ± 6.3 mL kg–1 for control, LRS and Vol, respectively. The total volume of LRS and Vol administered was 120 and 40 mL kg–1, respectively. Haematocrit, albumin, magnesium, chloride-to-sodium ratio and sodium-chloride difference were identified as potential biomarkers. These variables exceeded the reference intervals from 30 minutes of resuscitation onwards. A chloride-to-sodium ratio > 0.84 was the most sensitive (90%) and specific (75%) of all potential biomarkers.

      Conclusions and clinical relevance

      Changes in physiological variables, haematocrit and albumin were poor biomarkers of impending fluid overload compared with electrolytes. Finding the ideal biomarker to identify impending fluid overload of commonly used intravenous fluids should improve the safety of their administration in cats.

      Keywords

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