Hematologic changes in propofol-anesthetized dogs with or without tramadol administration

High carbohydrate is preferable to high lipid parenteral nutrition in healthy dogs undergoing prolonged sedation

Parenteral nutrition (PN) is commonly used in intensive care units (ICUs) and is associated with earlier hospital outcome. However, there is scarcity of information about the metabolic effects of PN caloric distribution for dogs. Considering the high tolerance of dogs to lipids and, also, that hospitalized animals usually present insulin resistance, PN formulation with high fat instead high glucose can provide metabolic benefits in this specie. This study evaluated two PN protocols, based on high lipid or high carbohydrate in 12 healthy dogs under sedation/ventilation during 24 h. For baseline data, blood samples were collected 24 h before the study beginning. After fasting, the dogs were anesthetized and put under mechanical ventilation without energy support for 12 h to obtain: daily energy expenditure (DEE), respiratory quotient (RQ), oxygen consumption (VO2), carbon dioxide production (VCO2), lactate, glucose, cholesterol, and triglycerides concentrations. After, the dogs were allocated into two groups: lipid-based energy group (LEG) and carbohydrate-based energy group (CEG). Both groups received the PN infusions at a rate of 3 mL/kg/h for 12 h. Blood tests were performed 12, 24, and 48 h after infusion's completion. VO2 increased after PN in LEG, increasing energy expenditure compared to CEG. RQ remained close to 1 in CEG, indicating carbohydrate preferential consumption. Triglycerides increased in both groups after propofol infusion, remaining higher in LEG until the end of the evaluation. Glycaemia increased in CEG compared to baseline. In conclusion, both PN protocols can be used in healthy animals undergoing prolonged sedation protocols. However, high lipid PN had higher VO2 and DEE, and resulted in higher triglycerides concentrations and lower glycaemia indexes than carbohydrate, making high carbohydrate PN preferable to high lipid PN. Therefore, for use in critically ill patients, the data obtained in this study should be extrapolated, taking into consideration the specificity of each case.

Effect of material tramadol on some blood components of laboratory rats

The current study deal with the effect of tramadol injections on body weight and some blood components in 40 male laboratory rats, divided into four groups. The first group, G1 represents the control group. The second group G2 and the third group G3 were injected with a concentration of 20 and 40 mg/100 g of body weight, respectively, and the fourth group G4 was injected at a concentration of 80 mg / 100 g of body weight for ten days respectively. The current study results showed a significant decrease in the weights of rats injected with tramadol compared to the control group. Also, there was a significant decrease in the numbers of RBC, PLT, MID#, and GRAN#, respectively. The concentrations of each of the following constants: HGB, HCT, MCV, MCH, and MCHC showed a significant decrease in their values; except for MCV, the decrease was not significant, and the results of this study also recorded a significant increase in the white blood cells count as well as the number of lymphocytes, and there was an increase in both RDW-CV & RDW-SD. Keywords. Body weight, tramadol, RBC, WBC, PLT.

Physiologic Effects of Prolonged Terminal Anesthesia in Sheep (Ovis gmelini aries)

The ruminant alimentary tract and its effects on blood homeostasis complicate prolonged terminal studies conducted under general anesthesia in sheep. We therefore studied 15 healthy female white alpine sheep that were undergoing prolonged anesthesia (> 30 h) for an unrelated terminal study. In the current study, all sheep developed a decreased hematocrit and hemoglobin concentration after induction of anesthesia, which fell further, along with a significant decrease in white blood cell count, over the course of anesthesia. Sheep also showed an initial hyponatremia, a persistent hypokalemia, hypocalcemia, and a progressive hyperchloremia. A significant drop in blood pH developed over time despite normal values of blood lactate and a marked decline in partial pressure of carbon dioxide over the course of the experiment. The latter consequently reduced the efficacy of mechanical ventilation, as reflected in a reduced oxygen partial pressure. A significant increase in lactate dehydrogenase and creatinine kinase was observed. Arterial blood pressure and heart rate significantly decreased over time, but remained within normotensive and normocardic limits. Central venous pressure rose significantly over the course of anesthesia. In conclusion, prolonged anesthesia in sheep is associated with a wide range of complex physi- ologic changes. An in-depth understanding of all metabolic compensatory mechanisms and their underlying cause during prolonged anesthesia is necessary for interpreting data from the primary study, with special considerations to account for ruminant-specific physiology.

Clinical features and significance of leukopenia occurring immediately after endovascular surgery

PURPOSE

Inflammation after stent graft surgery is known as postimplantation syndrome (PIS) and it causes leukocytosis. However, we have experienced leukopenia in the very early postoperative phase of endovascular surgery at our institution. We investigated leukopenia, an under-recognized phenomenon that occurred after transcatheter aortic valve implantation (TAVI), endovascular aortic repair (EVAR), and thoracic endovascular aortic repair (TEVAR).

METHODS

Records of patients who underwent TAVI, EVAR, and TEVAR between March 2018 and February 2019 were retrospectively reviewed. Primary outcomes were the decline rate of white blood cell count (DR-WBC) in the immediate postoperative period and its differences among surgical procedures. The secondary endpoint was the relationship between DR-WBC and infectious complications. Furthermore, the incidence of PIS and its differences among the procedures and associations with DR-WBC were evaluated.

RESULTS

A total of 108 patients (TAVI 41, EVAR 37, TEVAR 30) were included. DR-WBC immediately after surgery was higher in the TAVI group when compared with other groups (TAVI, 43.1 ± 22.6%; EVAR, 27.6 ± 17.3%; TEVAR, 25.4 ± 27.4%; P < 0.01). DR-WBC was not significantly different regardless of postoperative infection (P = 0.45) or PIS (P = 0.62). The incidence rate of PIS was higher in the EVAR group compared with the TAVI group, and was not associated with DR-WBC.

CONCLUSIONS

Leukopenia was a common phenomenon immediately after endovascular surgery, especially TAVI. It resolved a day after surgery and was not associated with PIS or infectious complications. Therefore, it seems to be a transient abnormal hematological finding and a self-limiting condition.

Evaluation of hematological, biochemical and oxidative stress profile in calves under propofol anesthesia

Propofol is a widely used drug in veterinary medicine to induce anesthesia; as well as the chosen compound for protocols of intravenous anesthesia. The present study aimed to describe the hematological, biochemical and oxidative stress alterations in calves kept under anesthesia by propofol in different dosages. In order to achieve this, eight Holstein calves were induced using propofol in a 5 mg/kg dosage and maintained under continuous propofol infusion for 60 min, having being administered 0.6 mg/kg/h or 0.8 mg/kg/h in crossover design with seven days interval. Blood samples were collected immediately before the anesthesia induction (baseline), and 30 min, 1, 2, 3, 4 and 5 h after the procedure started. Statistically relevant propofol influence was observed both in blood and biochemical parameters, with differences between dosages according to the time of infusion. The drug action over oxidative stress was also observed, causing a raise of the total antioxidant capacity (TAC) with an uric acid increase. Additionally, the increase of triglycerides, induced by the anesthesia maintenance with propofol, caused lipemia in the samples, which was capable of interfering directly in the measurements made by refractometry and spectrophotometry. It was concluded that, in spite of propofol induced alterations in blood and biochemical parameters, such alterations are subtle. In addition to that, the drug presented an antioxidative effect, which reinstates the safety of anesthesia maintenance with propofol in calves.

Comparison of Hematological and Biochemical Results Derived from Arterial and Venous Blood Samples in Post-Anesthetic Dogs

Simple Summary

In contrast to humans, general anesthesia is required for both surgical procedures and diagnostic imaging like magnetic resonance imaging (MRI) and computed tomography (CT) in small animals. Because the post-anesthetic period is a particularly high risk time for death, serial monitoring of biochemical and hematological parameters could be required. Blood samples could be collected from an indwelling arterial catheter to avoid stress caused by venipuncture, but studies using arterial blood for hematological and biochemical testing have been limited. The aim of this study is to compare hematological and biochemical results derived from venous and arterial blood samples, and to evaluate their clinical interchangeability in post-anesthetic dogs. We found statistically significant but clinically irrelevant differences in hemoglobin, glucose, creatinine, and calcium levels, and results from venous and arterial blood samples are not clinically interchangeable for gamma-glutamyl transpeptidase and potassium levels.

Abstract

Collecting blood from an indwelling arterial catheter may reduce stress from repeated venipuncture in patients requiring serial monitoring, but the use of arterial blood for hematological and biochemical testing remains understudied. Here, we compared hematological and biochemical results of arterial and venous blood and evaluated their clinical interchangeability. Blood samples from dogs who had recovered from anesthesia, collected by both arterial catheterization and venipuncture, were analyzed. To assess clinical acceptance between paired samples, the limit of agreement between the values derived from the arterial and venous blood samples was compared with the allowable total error (TEa) recommended for each parameter. We found no significant differences between the arterial and venous sample results for red/white blood cell and platelet counts and hematocrit, blood urea nitrogen, phosphate, total protein, albumin, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transpeptidase, total bilirubin, sodium, potassium, and chloride levels, whereas hemoglobin, glucose, creatinine, and calcium levels differed significantly (p < 0.05). Moreover, only gamma-glutamyl transpeptidase and potassium exceeded the recommended TEa. Hematological and biochemical results derived from venous and arterial blood samples are clinically interchangeable in post-anesthetic dogs, with the exception of gamma-glutamyl transpeptidase and potassium; thus, these values should be used with caution.

Avaliação metabólica e hemodinâmica de dois protocolos de sedação prolongada em cães

RESUMO Objetivou-se determinar a viabilidade de dois protocolos de sedação para ventilação prolongada em cães e seus efeitos hemodinâmicos e metabólicos. Doze cães, alocados aleatoriamente em dois grupos (n=6), receberam infusão contínua de midazolam (0,5mg/kg/h), fentanil (10µg/kg/h) e propofol (18mg/kg/h) no GMF ou cetamina (0,6mg/kg/h), morfina (0,26mg/kg/h) e propofol (18mg/kg/h) no GCM, durante 24 horas. Os cães foram ventilados mecanicamente com FiO2 de 40%, mantendo-se a normocapnia. A FC diminuiu 32% no GMF e 34% no GCM ao longo do tempo, reduzindo o IC em 24% no GMF e em 29% no GCM. A CaO2, o CvmO2, a DO2 e o VO2 diminuíram no GCM (5%, 16%, 31% e 7%) e no GMF (4%, 19%, 26% e 15%), respectivamente. A TEO2 aumentou 32% no GMF e 36% no GCM, sem diferenças entre grupos, porém a calorimetria indireta demonstrou diminuição do VO2, minimizando a redução da DO2. Não houve diferença entre os tempos para extubação, deambulação e recuperação total, com médias globais (minutos) de 33,8±15,9, 134,8±60,7 e 208±77,5, respectivamente. Conclui-se que ambos os protocolos permitiram a ventilação mecânica, com redução do IC e da DO2, porém sem prejuízos hemodinâmicos e metabólicos, podendo ser utilizados com segurança em cães hígidos.

Efeito da fluidoterapia transcirúrgica sobre o hematócrito pós-cirúrgico em cadelas submetidas a ovariossalpingo-histerectomia eletiva

RESUMO Apesar dos inúmeros benefícios da fluidoterapia transcirúrgica, sobrecarga de volume pode trazer efeitos deletérios, como a alteração de parâmetros hematimétricos. Dessa maneira, o presente trabalho teve como objetivo avaliar duas diferentes taxas de infusão de solução cristaloide no período transanestésico e seus efeitos até 24 horas pós-operatório. Foram utilizados dois grupos de seis animais cada, um deles recebeu solução de cloreto de sódio 0,9% a 10mL/kg/h (G10) e o outro a 5mL/kg/h (G5). Os valores de hematócrito foram avaliados no período de 24 horas em 10 diferentes momentos. Os resultados não apontaram diferenças significativas entre os grupos, porém foi observada redução significativa do hematócrito após indução anestésica. Foi ainda observada redução de hematócrito após o término da cirurgia em ambos os grupos, e o retorno aos valores basais de hematócrito ocorreu de forma significativa 12 horas após o procedimento cirúrgico em G10, e após oito horas em G5, mostrando uma tendência à hemodiluição mais persistente em G10.