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

Abstract

The purpose of the present study was to evaluate the changes in macrovascular and microvascular parameters in survivors (Sv) and non-survivors (non-Sv) dogs with severe sepsis and septic shock (SS&SS) 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 SS&SS were used. NE was given to 10 hypotensive dogs, despite one bolus of fluid therapy, at a constant infusion rate of 1.5 µg/kg/min for 2 h. If the clinical response was inadequate after 2 h, the rate of NE infusion was doubled (3.0 µg/kg/min). 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. In cases that do not result in an adequate clinical response in 2 h a doubling of the DT infusion (10 µg/kg/min) was administered. Macrovascular and microvascular parameters, PW-TDI septal mitral annulus systolic (S’) and early diastolic (E’) velocities, and DT applications did not show significant difference between the Sv and non-Sv groups. 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. An overall mortality rate was 25.7%. In conclusion, the effects of DT and NE in dogs with SS&SS is limited in veterinary medicine. Further studies are necessary in dogs with SS&SS to establish evidence-based guidelines.