Abstract
To evaluate the quality of the veterinary literature investigating IV fluid therapy in dogs, cats, horses, and cattle. Systematic review. The preferred reporting of items for systematic review and meta-analysis protocols (PRISMA-P) was employed for systematic review of all relevant IV fluid therapy manuscripts published from January 1969 through December 2016 in the Commonwealth Agricultural Bureaux International (CABI) database. Independent grading systems used to evaluate manuscripts included the updated CONsolidated Standards of Reporting Trials 2012 checklist, risk of bias for animal intervention studies, criteria for levels of evidence, and methodological quality (Jadad scale). The quality of articles published before and after 2010 was compared. One hundred and thirty-nine articles (63 dogs, 7 cats, 39 horses, 30 cattle) from 7,258 met the inclusion criteria. More than 50% of the manuscripts did not comply with minimal requirements for reporting randomized controlled trials. The most non-compliant items included identification of specific predefined objectives or a hypothesis, identification of trial design, how sample size was determined, randomization, and blinding procedures. Most studies were underpowered and at risk for selection, performance, and detection bias. The overall quality of the articles improved for articles published after 2010. Most of the veterinary literature investigating the administration of IV fluid therapy in dogs, cats, horses, and cattle is descriptive, does not comply with standards for evidence, or provide adequate translation to clinical practice. Authors should employ and journal editors should enforce international consensus recommendations and guidelines for publication of data from animal experiments investigating IV fluid therapy.
Highlights
Intravenous fluid therapy is prescribed as therapeutic treatment for most critically ill animals
Review and data extraction were performed by the study participants using four independent grading systems that included the updated CONsolidated Standards of Reporting Trials (CONSORT) 2012 checklist (25 items including identification of a control group), risk of bias (RoB) for animal intervention studies (SYRCLE’s RoB tool), criteria for levels of evidence [Center for Evidence-Based Medicine (CEBM): http://cebm.com; 2011], and the Jadad scale [21, 22, 24]
Items that were the most non-compliant (
Summary
Intravenous fluid therapy is prescribed as therapeutic treatment for most critically ill animals. Large preclinical and clinical human trials buoyed by data generated from various experimental animal (rodent, canine, swine) models are generally considered to provide the best evidence for current recommendations [15, 17, 18]. Systematic reviews of animal trials investigating IV fluid therapy in controlled and uncontrolled hemorrhage published in PubMed, Medline, Embase, Scopus, and The Cochrane Library have concluded that, animal experiments are essential for human health, their results are underpowered and suffer from substantial heterogeneity, model dependency, and bias [17,18,19,20]. We conducted a systematic review of animal trials that investigated IV fluid therapy and were published in the Commonwealth Agricultural Bureaux International (CABI) database in order to determine their compliance with current standards of evidence [21]. We evaluated whether or not citations investigating IV fluid therapy complied with documented grading systems for methodological quality, minimal requirements for randomized controlled trials (RCTs), methodologies employed for the elimination of bias, and clinical relevance [21,22,23,24]
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