首页 | 本学科首页   官方微博 | 高级检索  
相似文献
 共查询到20条相似文献，搜索用时 31 毫秒
1.
Objective: To provide evidence that naturally occurring sepsis in dogs provides a unique opportunity to test new therapies in clinically relevant settings. Data sources: Human and veterinary literature. Human data synthesis: Sepsis is a devastating condition responsible for most intensive care unit deaths. Most clinical trials targeting inflammatory mediators of sepsis have failed to improve outcome in clinical patients despite promising results in laboratory animal models. Animal models of sepsis fail to reproduce the clinical syndrome and therefore lead to conclusions that may not be relevant to clinical care. Veterinary data synthesis: Sepsis is recognized but not well‐characterized in companion animal species. Despite some species variability, the cardiopulmonary response to sepsis in dogs is similar to humans. Additionally, inflammatory and coagulation changes that accompany canine sepsis are consistent with those documented in humans. Sepsis secondary to canine parvoviral infection offers the advantages of relative population homogeneity, predictable course, and easy early diagnosis. The disadvantages of canine parvovirus are that it affects a predominantly young and healthy population and results in low mortality with aggressive supportive care. Septic peritonitis and pneumonia have high mortality but can be challenging to diagnose, have a variable course, and affect a heterogeneous population, which can be an advantage or a disadvantage. Conclusions: Similar to trials currently being performed in canine cancer patients, veterinary clinical trials of new sepsis therapeutics may provide a unique opportunity to advance the treatment of sepsis in dogs, humans, and other species. Spontaneous sepsis from canine parvovirus, peritonitis, and pneumonia are common clinical conditions in which therapeutics can be tested.  相似文献   

2.
Objective: To review the current understanding of mechanisms involved in normal hemostasis and to describe the changes associated with pro‐inflammatory disease processes such as sepsis. Data sources: Original research articles and scientific reviews. Human data synthesis: Organ damage caused by sepsis is created in part by the interdependent relationship between hemostasis and inflammation. Markers of coagulation have been found to have prognostic value in human patients with sepsis and there are both experimental and clinical investigations of the therapeutic potential of modulating the hemostatic system in sepsis. Improvement of 28‐day all‐cause mortality in severe sepsis by treatment with recombinant human activated Protein C strongly supports the interdependence of hemostasis and inflammation in the pathophysiology of sepsis. Veterinary data synthesis: Publications reporting clinical evaluation of the hemostatic changes occurring in septic dogs or cats are minimal. Experimental animal models of sepsis reveal significant similarity between human and animal sepsis and may provide relevance to clinical veterinary medicine until prospective clinical evaluations are published. Conclusions: It is now apparent that inflammation and the coagulation system are intimately connected. Understanding this relationship provides some insight into the pathogenesis of the hemostatic changes associated with sepsis. This new updated view of hemostasis may lead to the development of novel therapeutic approaches to sepsis and disseminated intravascular coagulation in veterinary medicine.  相似文献   

3.
Evaluation of a score designed to predict sepsis in foals   总被引：1，自引：1，他引：0  
Objective: To evaluate the accuracy of a published score designed to predict sepsis in foals in a clinical setting and to evaluate the association of clinical and clinicopathological variables with sepsis. Design: Observational study. Retrospective for data from 1998. Prospective in 1999–2001. Setting: Foal intensive care unit of a university hospital. Animals: Client‐owned foals of less than 10 days of age, presenting from 1998 to 2001. Interventions: None. Measurements and main results: Data from the history and physical examination, together with admission hematology, biochemistry and arterial blood gas analysis were used to generate the published sepsis scores. The same data were investigated for their statistical relationship with sepsis. The presence or absence of sepsis was determined from blood culture, culture of sites of suspected local infection, clinical course and/or post‐mortem examination. The modified sepsis score was calculated for 168 foals, which were classified as septic (86), non‐septic (45) or not possible to classify (37). The modified sepsis score correctly predicted sepsis in 58 out of 86 foals and non‐sepsis in 34 out of 45 foals, resulting in a sensitivity of 67%, a specificity of 76%, a positive predictive value of 84% and a negative predictive value of 55%. Abnormal neutrophil cytology, an immunoglobulin concentration of less than 400 mg/dl, and low blood glucose concentration had the strongest association with sepsis. Conclusions: The low negative predictive value of the sepsis score limited its clinical utility. The sepsis score should not be used to define sepsis in clinical studies, unless previously validated in the study center.  相似文献   

4.
Neonatal sepsis is a serious and often fatal disease of the foal. Research has documented that the clinical syndrome which results from bacterial infection of the neonate is the result of a widespread and florid inflammatory response which is termed the systemic inflammatory response syndrome (SIRS). Successful treatment of affected individuals is possible, and an important component of the treatment is the proper use of antimicrobials. Proper selection of antimicrobials requires the consideration of several important factors including the infecting organism, toxicity, and route of administration, cost, and metabolism of the antimicrobial. In most cases, antimicrobial treatment can be discontinued when localizing signs of infection are absent, and the temperature and complete blood cell count have been normal for 72 hours.  相似文献   

5.
Four groups of 8 horses each had 1 midcarpal joint injected with 33 colony-forming units (CFU) of viable Staphylococcus aureus plus: 1 ml of saline solution (group 1, control), 250 mg of polysulfated glycosaminoglycan (PSGAG, group 2), 100 mg of methylprednisolone acetate (group 3), or 20 mg of sodium hyaulronate (group 4). Horses were euthanatized, and samples were obtained on the basis of clinical signs of septic arthritis that were nonresponsive to phenylbutazone administration. One group-1 horse, all 8 group-2 horses, 3 group-3 horses, and 4 group-4 horses were culture-positive for S aureus and had clinical signs, results of synovial fluid analysis, and histopathologic findings that were consistent with sepsis. The addition of 250 mg of PSGAG increased the development of sepsis significantly (P = 0.001), compared with results in control horses. Differences in the development of sepsis between horses injected with methylprednisolone acetate or sodium hyaluronate and control horses were not significant.  相似文献   

6.
鸭大肠杆菌病是由致病性大肠杆菌引起的多病型疾病的总称。临床病型众多,其中以雏鸭或小鸭败血症和产蛋母鸭的卵黄性腹膜炎(蛋子瘟)危害最为严重,该病是目前对养鸭业危害较大的传染病。2012年3月,盘锦市某大型养鸭场饲养2000多只樱桃谷鸭,从186日龄开始陆续发病,主要表现为产蛋率迅速下降,病鸭精神萎顿,食欲减退,下痢,发病后期病鸭的腹部膨大、下垂,病死率约为4%。通过临床观察、病理剖检及实验室检查,确诊为鸭大肠杆菌病。根据药敏试验结果,选用极度敏感的丁胺卡那霉素治疗并采取综合性措施,迅速控制了病情。  相似文献   

7.
Foals may present to a referral hospital with the primary diagnosis of uroperitoneum (UP), or they may develop UP while hospitalized for other reasons. Historical, physical, laboratory, and diagnostic variables of foals presenting with UP were compared to those developing UP while hospitalized. Emphasis was placed on the presence of electrolyte abnormalities, evidence of sepsis or infection, and development of anesthetic complications during surgical correction of the defect. Foals developing UP while in the hospital frequently had a history of dystocia and presented at a very young age (< 48 hours) with primary clinical signs compatible with intrauterine compromise or presumed hypoxic or ischemic insult with or without sepsis. Foals referred with suspected UP often had additional problems unrelated to the urinary system. These foals had hyponatremia and hyperkalemia on presentation, whereas foals receiving intravenous fluid therapy consisting of a balanced electrolyte solution did not develop the classical pattern of electrolyte abnormalities, yet a similar increase in serum creatinine and, frequently, decreasing urine production were noted. Infection was present in 63% of the foals, and 78% of foals revealed signs suggestive of sepsis or infection. Intrauterine compromise, presumed hypoxia or ischemia, and sepsis may predispose foals to development of UP. Anesthetic complications occurred in 16% of the foals undergoing surgical correction of the defect, although hyperkalemia was only present in half of the foals with anesthetic complications.  相似文献   

8.
Pulmonary thromboembolism in dogs: 47 cases (1986-1987)   总被引：4，自引：0，他引：4  
Medical records of 47 dogs with pulmonary thromboembolism were reviewed. Middle-aged to older dogs predominated and dyspnea and arterial hypoxemia were consistent clinical findings. Thoracic radiographic findings were variable. Cardiac disease, neoplasia, hyperadrenocorticism, disseminated intravascular coagulation, and sepsis were identified most frequently. Multiple disease processes were identified in 64% of the dogs.  相似文献   

9.
广西荷斯坦奶牛胎衣不下的病因、发病规律及防制措施   总被引：2，自引：1，他引：1  
奶牛胎衣不下常会引起奶牛子宫内膜炎,降低产奶量,延长产犊周期甚至引起败血症,给奶牛养殖业造成巨大的经济损失。作者针对广西奶牛胎衣不下发生原因、发病规律及综合防制措施进行调查分析,总结一些有效的预防和治疗胎衣不下的措施,旨在为南方地区奶牛业全面降低胎衣不下发病率提供参考资料。  相似文献   

10.
BACKGROUND: There is limited literature on neonatal bacterial sepsis in New World (NW) camelids. HYPOTHESIS: Bacterial culture-positive crias have clinical differences based on the specific bacterial genera isolated. ANIMALS: Bacterial culture-positive NW camelid crias <21 days of age from 1990 to 2005 were included. METHODS: Historic physical examination and cliniopathologic data were retrieved from medical records as were the identity and antibiograms of bacterial isolates. Cases were categorized by outcome (survival versus nonsurvival) and type of sepsis (gram-negative or gram-positive). Kruskal-Wallis and chi-square testing were used to evaluate differences between groups. RESULTS: Twenty-one crias met the inclusion criteria. Median age was 2 days. Failure of passive transfer was common. There were few differences identified on the basis of outcome or type of sepsis. Crias without gastrointestinal or central nervous system involvement survived in greater numbers. Forty-six percent of isolates were gram-positive. The most common isolates were the following: Escherichia coli, Enterococcus spp., Listeria monocytogenes, and Citrobacter spp. Overall survival was 67% (14/21). CONCLUSIONS AND CLINICAL IMPORTANCE: Crias with sepsis do not appear to present with major biochemical, hematologic, or blood gas abnormalities, potentially complicating diagnosis. Affected crias may not have localizing signs at presentation and are not usually febrile, although hypothermia, tachypnea, and tachycardia are relatively common. Total protein concentration was not a substitute for immunoglobulin G measurement in septic crias in this study. Familiarity with the clinical presentation and common pathogens isolated should improve early recognition and treatment and ultimately outcome of crias with sepsis.  相似文献   

11.
Objective – To review the human and veterinary literature on histamine physiology and pathophysiology and potential applications for clinical use in veterinary critical care. Data Sources – Human and veterinary clinical studies, reviews, texts, and recent research in histamine receptor and antagonist therapy. Human Data Synthesis – Recent progress in molecular biology has led to a more complete understanding of the enzymes involved in histamine metabolism and histamine receptor physiology. The past decade of research has confirmed the role of histamine in the classical functions (contraction of smooth muscle, increase in vascular permeability, and stimulation of gastric acid secretion) and has also elucidated newer ones that are now under investigation. Data on the roles of histamine in angiogenesis, circadian rhythm, bone marrow regeneration, bacterial eradication, and cancer are emerging in the literature. Newer histamine antagonists are currently in drug trials and are expected to advance the clinical field in treatment of allergic, gastrointestinal, and cognitive disorders. Veterinary Data Synthesis – Veterinary histamine research is directed at identifying the effects of certain pharmacological agents on blood histamine concentrations and establishing the relevance in clinical disease states. Research demonstrates important species differences in regards to histamine receptor physiology and tissue response. Studies in the area of trauma, sepsis, anaphylaxis, allergy, and gastrointestinal disorders have direct applications to clinical veterinary medicine. Conclusions – Histamine plays a key role in the morbidity and mortality associated with allergy, asthma, gastric ulcers, anaphylaxis, sepsis, hemorrhagic shock, anesthesia, surgery, cardiovascular disease, cancer, CNS disorders, and immune‐mediated disease. Histamine antagonism has been in common use to block its adverse effects. With recent advances in the understanding of histamine receptor physiology, pharmaceutical agents targeting these receptors have increased the therapeutic options.  相似文献   

12.
Background: Neonatal foals with isoerythrolysis (NI) often die, but the risk factors for death have not been identified.
Objectives: To identify factors associated with outcome in foals with NI and to identify factors associated with death from liver failure or kernicterus in the same population.
Animals: Seventy-two foals with NI examined at referral institutions.
Methods: Retrospective case series. Information on signalment, clinical examination findings, laboratory testing, treatment, complications, outcome, and necropsy results were obtained.
Results: The overall survival rate was 75% (54 of 72). Liver failure (n = 7), kernicterus (n = 6), and complications related to bacterial sepsis (n = 3) were the 3 most common reasons for death or euthanasia. The number of transfusions with blood products was the factor most strongly associated with nonsurvival in a multivariate logistic regression model. The odds of liver failure developing in foals receiving a total volume of blood products ≥ 4.0 L were 19.5 (95% confidence intervals [CI]: 2.13–178) times higher than that of foals receiving a lower volume ( P = .009). The odds of kernicterus developing in foals with a total bilirubin ≥ 27.0 mg/dL were 17.0 (95% CI: 1.77–165) times higher than that of foals with a lower total bilirubin ( P = .014).
Conclusions and Clinical Importance: Development of liver failure, kernicterus, and complications related to bacterial sepsis are the most common causes of death in foals with NI. Foals administered a large volume of blood products are at greater risk for developing liver failure.  相似文献   

13.
Cardiac output, wedge pressure, and oxygen delivery.   总被引：1，自引：0，他引：1  
The primary goal of the intensive care clinician can be said to be to optimize global DO2. This approach is the primary means by which the greatest killers of the critically ill patient (sepsis, SIRS, multiple organ dysfunction syndrome) may be addressed at present. Optimizing DO2 means delivering just enough to meet the patient's needs, because therapeutic measures taken to increase DO2 are all associated with some degree of risk. When used correctly, the PAC can allow the clinician to determine if DO2 is optimal and, if not, what steps might be best suited to improve on it. Newer generations of PACs are becoming available and can provide valuable additional insights into a patient's cardiovascular status. Nearly all attempts to increase DO2 address one or more of a relatively short list of variables. The specific endpoints of therapy need to be tailored to the individual patient but include clinical, metabolic, organ function, and hemodynamic markers. As clinicians expand our understanding of the key elements found in survivors of critical illness, it is hoped that this knowledge translates into better outcomes.  相似文献   

14.
Sepsis is defined as an exaggerated, systemic inflammatory response to infection and is a common condition in horses. Systemic inflammatory response syndrome (SIRS) associated with bacterial infection is a hallmark of sepsis. Sepsis in neonatal foals is a common sequela of failure of passive transfer and, in addition to development of SIRS, may be characterised by bacteraemia, pneumonia, enterocolitis, omphalophlebitis, meningoencephalitis or arthritis. Sepsis in mature horses is most commonly observed secondary to gastrointestinal lesions that result in disrupted mucosa and bacterial translocation into circulation (endotoxaemia). Pleuropneumonia and metritis may also cause sepsis in mature horses. Diagnosis of sepsis is based on SIRS criteria as well as suspected or confirmed infection. Due to the relatively low sensitivity of microbial culture and the subjectivity of sepsis scoring, many sepsis biomarkers are being studied for their usefulness in diagnosis and prognostication of sepsis in horses. Treatment of sepsis requires an intensive care approach that includes antimicrobial drug administration, fluid resuscitation and pressure support, and treatment for inflammation, endotoxaemia and coagulopathy. Early recognition of sepsis and prompt antimicrobial drug treatment are critical for a successful outcome. Multiple organ dysfunction syndrome may occur in severe cases of sepsis, with common manifestations including laminitis and coagulopathies. Although prognosis for septic mature horses depends highly on the primary disease process, the overall survival rate in septic neonatal foals ranges from 26 to 86%, with most studies indicating a survival rate of 45–60%.  相似文献   

15.
Background: Antibiotics generally are recommended to treat hemorrhagic gastroenteritis (HGE). Inappropriate use of antibiotics may promote risk of antimicrobial resistance and unnecessary adverse drug reactions. The necessity of antimicrobial therapy in dogs with HGE has not been demonstrated. Objective: The purpose of this prospective, placebo‐controlled, blinded study was to evaluate whether treatment with amoxicillin/clavulanic acid improves the clinical course and outcome of HGE in dogs that show no signs of sepsis. Animals: The study included 60 dogs diagnosed with HGE between 2007 and 2009 at the Clinic of Small Animal Medicine, LMU University of Munich, Germany. The inclusion criterion was the presence of acute hemorrhagic diarrhea (<3 days). Dogs pretreated with antibiotics, with signs of sepsis, or diagnosed with any disease known to cause bloody diarrhea were excluded from the study. Methods: Patients were randomly divided into treatment (amoxicillin/clavulanic acid for 7 days) and placebo groups. To evaluate treatment efficacy, severity of clinical signs (based on a newly developed HGE index), duration of hospitalization, and mortality rate were compared between the 2 groups. Results: Fifty‐three of 60 dogs completed the study. No significant difference between treatment groups concerning mortality rate, dropout rate, duration of hospitalization, or severity of clinical signs, either on any individual day or over the course of disease, was observed. Conclusions and Clinical Importance: In some dogs with HGE that show no signs of sepsis, antibiotics may not change the case outcome or time to recovery.  相似文献   

16.
The records of 16 dogs with left ventricular dysfunction associated with severe systemic illness were reviewed. The most common diagnoses in affected dogs were sepsis and cancer. Despite left ventricular dysfunction, no dog presented with signs of congestive heart failure. Fifteen dogs were presented with generalized weakness as a part of their clinical complaint. Twelve (75%) of 16 dogs died or were euthanized within 15 days of admission to the hospital. The average time until death was 3.6 days.  相似文献   

17.
This prospective study compared survival rates of critically ill and septic foals receiving 1 of 2 different types of commercial equine plasma and analyzed admission variables as possible predictors of survival. Standardized clinical, hematologic, biochemical, and hemostatic admission data were collected and foals received either conventional commercially available hyperimmune equine plasma or equine plasma specifically rich in antiendotoxin antibodies in a double-blinded, coded fashion. Sepsis was defined as true bacteremia or sepsis score >11. Overall survival rate to discharge was 72% (49/68). Foals that were nonbacteremic and demonstrated a sepsis score of < or = 11 at admission had a 95% (18/19) survival rate. The survival rate to discharge for septic foals was 28/49 (57%), with truly bacteremic foals having a survival rate of 58% (14/24), whereas that for nonbacteremic, septic foals was 56% (14/25). Sensitivity and specificity for sepsis score >11 as a predictor of bacteremia were 74 and 52%, respectively. For the entire study population, a higher survival rate to discharge was documented for those foals receiving hyperimmune plasma rich in antiendotoxin antibodies (P = .012, odds ratio [OR] 6.763, 95% confidence interval [CI]: 1.311, 34.903). Administration of plasma rich in antiendotoxin antibodies also was associated with greater survival in septic foals (P = .019, OR 6.267, 95% CI: 1.186, 33.109). Statistical analyses demonstrated that, among 53 clinical and clinicopathologic admission variables, high sepsis score (P < .001), low measured IgG concentration (P = .01), high fibrinogen concentration (P = .018), low segmented neutrophil count (P = .028), and low total red blood cell numbers (P = .048) were the most significant predictors of overall mortality.  相似文献   

18.
Sepsis develops in horses when the host response to the invading pathogens is not properly balanced according to the severity of the insult. Several clinical conditions frequently encountered in equine practice may be associated with the development of sepsis and have the potential to progress to more severe forms, such as severe sepsis, MODS, and septic shock. Consequently, it is important for equine practitioners to be aware of the manifestations,pathophysiology, and treatment of sepsis. Although enormous progress has been made in recent years in our understanding of the pathophysiology of sepsis. more work remains to be done in improving basic critical care guidelines and basic monitoring in equine intensive care units and in critically evaluating potential equine sepsis therapy. Fortunately, we can learn from the important advances made recently in the treatment of human sepsis patients;hence, rapid progress may be expected in a near future, especially as more and more veterinarians show interest in the discipline of equine critical care. With the completion of several genome projects and the availability of high-throughput genetic techniques, one hopes that we will further refine our understanding of the events underlying the development of severe sepsis and septic shock, which could lead to more appropriate therapeutic intervention targeted to each individual according to the state of the immune response in that horse.  相似文献   

19.
The case report by O'Sullivan et al. in this month's issue of EVE describes an unusual case of synovial sepsis raising interesting points on synovial infection in general and more specifically the implication of haematogenous spread of bacteria from a remote site in the mature horse. The identification of synovial sepsis in this location is challenging due to the complex and unfamiliar anatomy in the shoulder region. This clinical commentary reviews the anatomy in this region and discusses the unusual presentation of synovial sepsis secondary to haematogenous spread.  相似文献   

20.
A sepsis scoring system was developed and tested prospectively in a blind study of 190 neonatal foals admitted to the University of Florida Veterinary Medical Teaching Hospital's neonatal intensive care unit. The system used 14 readily available historical, clinical or laboratory variables and weighted each item to arrive at a sepsis score. The score was found to have a sensitivity of 93 per cent, a specificity of 86 per cent, positive accuracy rate of 89 per cent and negative accuracy rate of 92 per cent. The sepsis score was far more sensitive and specific for infection, even in very early cases, and had fewer false positive and false negative values than did any parameter taken individually.  相似文献   

设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号