Developments in surgical fluid therapy rates in veterinary medicine

  • Kristina Naden Unitec Institute of Technology

Published:

2020-07-09

Share
Open Access Logo

DOI

https://doi.org/10.18849/ve.v5i3.299

Abstract

PICO question

Is there sufficient evidence to show surgical fluid therapy delivered at the recommended 3 mL/kg/hour for cats and 5 mL/kg/hour for dogs leads to a better outcome compared with widely accepted rates of 10 mL/kg/hour for both cats and dogs?

 

Clinical bottom line

Category of research question

Treatment

The number and type of study designs reviewed

Five studies were appraised. Two of these were opinion pieces, with one non-comparative prospective study, one randomised controlled trial, and one case control study.

Strength of evidence

Weak

Outcomes reported

Currently there is limited evidence to show that the surgical fluid therapy recommendations made by the 2013 Journal of the American Animal Hospital Association guidelines (Davis et al., 2013) for cats and dogs lead to a better outcome than accepted fluid therapy rates used. Fluid overload in humans can cause long-term adverse effects, however the same effects have yet to be shown specifically in veterinary patients

Conclusion

No evidence was found that provides strong, conclusive evidence that the 2013 recommendations by the American Animal Hospital Association and American Association of Feline Practitioners leads to a better outcome for both cats and dogs. The resulting research outlined below identifies a need to conduct clinical studies on the effects of fluid therapy on cats and dogs, and identify clear monitoring protocols to minimise and ideally avoid, fluid overload. When adequate, valid clinical studies have been carried out, this will provide sufficient information for the development of evidence-based recommended rates of fluid therapy for veterinary medicine, in a range of contexts

 

How to apply this evidence in practice

The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.

Knowledge Summaries are a resource to help reinforce or inform decision-making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.

 

Open Access Peer Reviewed

References

Borland, K. & Bennett, R. C. (2018). Perianaesthetic fluid therapy: an update. Companion Animal, 23(7), 406–411. DOI: https://doi.org/http://dx.doi.org/10.12968/coan.2018.23.7.406

Brodbelt, D. (2010). Feline anesthetic deaths in veterinary practice. Topics in Companion Animal Medicine. DOI: https://doi.org/10.1053/j.tcam.2010.09.007

Brodbelt, D. C., Pfeiffer, D. U., Young, L. E. & Wood, J. L. N. (2007). Risk factors for anaesthetic-related death in cats: results from the confidential enquiry into perioperative small animal fatalities (CEPSAF). British Journal of Anaesthesia, 99, 617–623. DOI: https://doi.org/10.1093/bja/aem229

Celeita-Rodríguez, N., Teixeira-Neto, F. J., Garofalo, N. A., Dalmagro, T. L., Girotto, C. H., Oliveira, G. C. V. & Santos, I. F. (2019). Comparison of the diagnostic accuracy of dynamic and static preload indexes to predict fluid responsiveness in mechanically ventilated, isoflurane anesthetized dogs. Veterinary Anaesthesia and Analgesia. DOI: https://doi.org/10.1016/j.vaa.2018.12.004

Coeckelenbergh, S., Delaporte, A., Ghoundiwal, D., Bidgoli, J., Fils, J. F., Schmartz, D. & Van Der Linden, P. (2019). Pleth variability index versus pulse pressure variation for intraoperative goal-directed fluid therapy in patients undergoing low-to-moderate risk abdominal surgery: A randomized controlled trial. BMC Anesthesiology, 19(1), 1–7. DOI: https://doi.org/10.1186/s12871-019-0707-9

Davis, H., Jensen, T., Johnson, A., Knowles, P., Meyer, R., Rucinsky, R. & Shafford, H. (2013). 2013 AAHA/AAFP Fluid Therapy Guidelines for Dogs and Cats. Journal of the American Animal Hospital Association. DOI: https://doi.org/10.5326/JAAHA-MS-5868

den Boogert, W. J., van Elteren, H. A., Goos, T. G., Reiss, I. K. M., de Jonge, R. C. J. & van den Berg, V. J. (2018). Reproducibility of the Pleth Variability Index in premature infants. Journal of Clinical Monitoring and Computing, 32(3), 457–464. DOI: https://doi.org/10.1007/s10877-017-0058-3

Doherty, M. & Buggy, D. J. (2012). Intraoperative fluids: How much is too much? British Journal of Anaesthesia, 109(1), 69–79. DOI: https://doi.org/10.1093/bja/aes171

Driessen, B. & Brainard, B. (2006). Fluid therapy for the traumatized patient. Journal of Veterinary Emergency and Critical Care. DOI: https://doi.org/10.1111/j.1476-4431.2006.00184.x

Drozdzynska, M. J., Chang, Y.-M., Stanzani, G. & Pelligand, L. (2018). Evaluation of the dynamic predictors of fluid responsiveness in dogs receiving goal-directed fluid therapy. Veterinary Anaesthesia and Analgesia, 45(1), 22–30. DOI: https://doi.org/10.1016/j.vaa.2017.06.001

Fantoni, D. & Shih, A. C. (2017). Perioperative Fluid Therapy. The Veterinary Clinics of North America. Small Animal Practice, 47(2), 423–434. DOI: https://doi.org/10.1016/j.cvsm.2016.11.004

Fantoni, D. T., Ida, K. K., Gimenes, A. M., Mantovani, M. M., Castro, J. R., Patricio, G. C. F., Ambrósio, A. M. & Otsuki, D. A. (2017). Pulse pressure variation as a guide for volume expansion in dogs undergoing orthopedic surgery. Veterinary Anaesthesia and Analgesia, 44(4), 710–718. DOI: https://doi.org/http://dx.doi.org/10.1016/j.vaa.2016.11.011

Gonçalves, L. A., Otsuki, D. A., Pereira, M. A., Nagashima, J. K., Ambrósio, A. M. & Fantoni, D. T. (2020). Comparison of pulse pressure variation versus echocardiography-derived stroke volume variation for prediction of fluid responsiveness in mechanically ventilated anesthetized dogs. Veterinary Anaesthesia and Analgesia, 47(1), 28–37. DOI: https://doi.org/10.1016/j.vaa.2019.08.047

Gurney, M. (2018). A procedure-specific approach to recovery after surgery.

Hopper, K., Garcia Rojas, A. & Barter, L. (2018). An Online Survey of Small Animal Veterinarians Regarding Current Fluid Therapy Practices in Dogs and Cats. Journal of the American Veterinary Medical Association, 252(5), 553–559. DOI: https://doi.org/10.2460/javma.252.5.553

Kehlet, H. (1997). Multimodal approach to control postoperative pathophysiology and rehabilitation. British Journal of Anaesthesia, 78(5), 606–617. DOI: https://doi.org/10.1093/bja/78.5.606

Kehlet, H. (2015). Enhanced Recovery After Surgery (ERAS): good for now, but what about the future? Canadian Journal of Anesthesia, 62(2), 99–104. DOI: https://doi.org/10.1007/s12630-014-0261-3

Licker, M., Triponez, F., Ellenberger, C. & Karenovics, W. (2016). Fluid therapy in thoracic surgery: A zero-balance target is always best! Turk Anesteziyoloji ve Reanimasyon Dernegi Dergisi, 44(5), 227–229. DOI: https://doi.org/10.5152/TJAR.2016.006

Lunn, K. F. (2011). The kidney in critically ill small animals. Veterinary Clinics of North America - Small Animal Practice, 41(4), 727–744. DOI: https://doi.org/10.1016/j.cvsm.2011.03.020

Marshall, K., Thomovsky, E., Johnson, P. & Brooks, A. (2016). A review of available techniques for cardiac output monitoring. Topics in Companion Animal Medicine, 31(3), 100–108. DOI: https://doi.org/10.1053/j.tcam.2016.08.006

McDermid, R. C., Raghunathan, K., Romanovsky, A., Shaw, A. D. & Bagshaw, S. M. (2014). Controversies in fluid therapy: Type, dose and toxicity. World Journal of Critical Care Medicine, 3(1), 24. DOI: https://doi.org/10.5492/wjccm.v3.i1.24

Myburgh, J. A. & Mythen, M. G. (2013). Resuscitation Fluids. New England Journal of Medicine, 369(13), 1243–1251. DOI: https://doi.org/10.1056/NEJMra1208627

O’Dwyer, L. (2011). How to perform central venous pressure measurement. The Veterinary Nurse, 2(10), 600–603.

Ostermann, M., Straaten, H. M. O. & Forni, L. G. (2015). Fluid overload and acute kidney injury: cause or consequence? Critical Care (London, England), 19, 443. DOI: https://doi.org/10.1186/s13054-015-1163-7

Sano, H., Barker, K., Odom, T., Lewis, K., Giordano, P., Walsh, V. & Chambers, J. P. (2018). A Survey of Dog and Cat Anaesthesia in a Sample of Veterinary Practices in New Zealand. New Zealand Veterinary Journal. DOI: https://doi.org/10.1080/00480169.2017.1413959

Siemionow, K., Cywinski, J., Kusza, K. & Lieberman, I. (2012). Intraoperative Fluid Therapy and Pulmonary Complications. Orthopedics, 35(2), 184–191. DOI: https://doi.org/10.3928/01477447-20120123-06

Silverstein, D. C., Cozzi, E. M., Hopkins, A. S. & Keefe, T. J. (2014). Microcirculatory effects of intravenous fluid administration in anesthetized dogs undergoing elective ovariohysterectomy. American Journal of Veterinary Research, 75(9), 809–817. DOI: https://doi.org/10.2460/ajvr.75.9.809

Stanzani, G. & Chan, D. L. (2010). Controversies in Fluid Therapy. European Journal of Companion Animal Practice, 24(2), 14–23.

Thomovsky, E., Brooks, A. & Johnson, P. (2016). Fluid Overload in Small Animal Patients. Topics in Companion Animal Medicine, 31(3), 94–99. DOI: https://doi.org/10.1053/j.tcam.2016.08.007

Valverde, A., Gianotti, G., Rioja-Garcia, E. & Hathway, A. (2012). Effects of high-volume, rapid-fluid therapy on cardiovascular function and hematological values during isoflurane-induced hypotension in healthy dogs. Canadian Journal of Veterinary Research (Revue Canadienne de Recherche Veterinaire), 76(2), 99–108.

Voldby, A. W. & Brandstrup, B. (2016). Fluid therapy in the perioperative setting-A clinical review. Journal of Intensive Care, 4(1). DOI: https://doi.org/10.1186/s40560-016-0154-3

Wang, N., Jiang, L., Zhu, B., Wen, Y. & Xi, X.-M. (2015). Fluid balance and mortality in critically ill patients with acute kidney injury: a multicenter prospective epidemiological study The Beijing Acute Kidney Injury Trial (BAKIT) Workgroup. Critical Care (London, England), 19(371). DOI: https://doi.org/10.1186/s13054-015-1085-4

Yozova, I. D., Howard, J., Sigrist, N. E. & Adamik, K.-N. (2017). Current Trends in Volume Replacement Therapy and the Use of Synthetic Colloids in Small Animals-An Internet-Based Survey (2016). Frontiers in Veterinary Science, 4, 140. DOI: https://doi.org/10.3389/fvets.2017.00140

Similar Articles

You may also start an advanced similarity search for this article.

4,514

Save

4,931

View

Vol. 5 No. 3 (2020): The third issue of 2020

Section: Knowledge Summaries

Categories :  Small Animal  /  Dogs  /  Cats  /  Rabbits  /  Production Animal  /  Cattle  /  Sheep  /  Pig  /  Equine  /