Vertebral Heart Score: A Useful Parameter in Determination of Resuscitation Endpoint in Dogs with Hemorrhagic Shock

Abstract

BACKGROUND: GReliable prediction of patient response to fluid resuscitation is a crucial issue in the management of hemorrhagic shock. OBJECTIVES: This study was designed to investigate vertebral heart score (VHS) variation in fluid resuscitation of hemorrhagic shock patients and the feasibility of this method in determining resuscitation endpoint. METHODS: VHS values were assessed using previously published standard method in left to right lateral view. After induction of anesthesia (control assessments), hemorrhagic shock was induced by blood withdrawal to a mean arterial pressure of 40 to 50 mmHg within 30 minutes and then maintained in hypovolemic situation for an additional 30 minutes (second and third stages of assessments). Afterward, the dogs were randomly assigned to two groups which received 20 ml/kg lactated Ringer’s solution or 5 ml/kg Hydroxyethyl starch, in four consecutive 15 minute intervals (fourth stage of assessments). One hour after the last resuscitation step, final radiographic assessments were performed. RESUTLS: Hemorrhagic shock caused significant decrease in VHS values to a mean of 7.7 vertebrae (P<0.05). Following the fluid resuscitation VHS increased and returned to pre-shock values in both groups. CONCLUSIONS: This study confirms that the breed-specific VHS assessment can be a useful method in monitoring of patient’s response to fluid therapy and determination of resuscitation endpoint in dogs with hemorrhagic shock.