Compendium : continuing education for veterinarians
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Compend Contin Educ Vet · Jan 2012
ReviewCentral venous pressure: principles, measurement, and interpretation.
Central venous pressure (CVP), an estimate of right atrial pressure, has been used to assess cardiac preload and volume status in critically ill patients, assist in the diagnosis of right-sided heart failure, and guide fluid resuscitation. It is determined by the interaction between cardiac function and venous return. CVP measurements are relatively easy to obtain; however, because of the complex relationship between CVP, cardiac output, and the vascular system, they may be difficult to interpret. This article reviews the physiologic principles of CVP, indications for its use, technical aspects and pitfalls of CVP measurements, and interpretation of the information obtained.
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Compend Contin Educ Vet · Jan 2012
ReviewInterpreting lactate measurement in critically ill horses: diagnosis, treatment, and prognosis.
In hospitalized horses, hypovolemia and the resulting decrease in tissue perfusion is the most common cause of hyperlactatemia. Therefore, measurement of blood lactate concentration can be a useful tool for guiding fluid therapy. Similarly, measuring blood lactate concentration can be used to assess the need for and adequacy of transfusions in horses receiving whole blood. ⋯ Veterinary studies have suggested that serial blood lactate measurements might be a more useful prognostic indicator than a single lactate measurement. In hospitalized adult horses and foals, blood lactate concentration is higher at all time points in nonsurvivors compared with survivors, although the differences tend to be subtle. Measuring the rate at which lactate concentrations return to normal might also prove useful in equine medicine, but this requires further investigation.