preprints.org > medicine and pharmacology > veterinary medicine > doi: 10.20944/preprints202405.1599.v1

Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Version 1 : Received: 23 May 2024 / Approved: 24 May 2024 / Online: 24 May 2024 (08:38:37 CEST)

The aim of this prospective, randomized, clinical study was to evaluate the use of the pleth variability index (PVi) to guide the rate of intra-operative fluid therapy as compared with a traditional fixed fluid rate approach in ASA 1-2 dogs undergoing surgery. Twenty-seven dogs meet the inclusion criteria and were randomly assigned to conventional fluid management group (CFM, n = 12) or PVi-guided group (PVi, n = 15). The CFM group received a fixed rate of 5 ml kg-1 h-1 of crystalloid solution, while in the PVi group the rate was continuously adjusted based on PVi: PVi < 14% = 3 ml kg-1 h-1; 14% ≤ PVi ≥ 20% = ml kg-1 h-1; PVi > 20% = 15 ml kg-1 h-1. Hypotension (MAP < 65 mmHg) was managed in CFM with maximum two fluid boluses (5 ml kg-1 in 10 minutes) and in case of no response dobutamine (1-3 mcg kg-1 min-1) was administered. In the PVi group treatment of hypotension was similar except when PVi > 14% when dobutamine was directly initiated. The total fluid amount was significantly lower in PVI group (0.056 ± 0.027 ml kg-1 min-1) vs. CFM group (0.132 ± 0.115 ml kg-1 min-1), and hypotension incidence was lower (p = 0.023) in PVi group (0%) vs. CFM group (41%). Mean arterial pressure (MAP) was significantly higher during surgery in the PVi group. Dobutamine was never administered in both groups. Preliminary data suggest that PVi may be considered a potential target to guide fluid therapy in dogs; larger studies are needed, especially in cases of cardiovascular instability.

fluid therapy; conventional fluid management; pleth variability index; dog; intraoperative management; anesthesia

Medicine and Pharmacology, Veterinary Medicine

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