Evaluation of the rectal‐interdigital temperature gradient as a diagnostic marker of shock in dogs
Objective To evaluate the difference in the rectal‐interdigital temperature gradient (RITG) between dogs that were presented to an emergency room with clinical signs of shock compared to those without signs of shock, and if this gradient can be used as a diagnostic marker for shock. Design Prospecti...
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| Veröffentlicht in: | Journal of veterinary emergency and critical care (San Antonio, Tex. : 2000) Tex. : 2000), 2020-11, Vol.30 (6), p.670-676 |
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| container_title | Journal of veterinary emergency and critical care (San Antonio, Tex. : 2000) |
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| creator | Schaefer, Jonathan D. Reminga, Christin L. Reineke, Erica L. Drobatz, Kenneth J. |
| description | Objective
To evaluate the difference in the rectal‐interdigital temperature gradient (RITG) between dogs that were presented to an emergency room with clinical signs of shock compared to those without signs of shock, and if this gradient can be used as a diagnostic marker for shock.
Design
Prospective, single center, observational study conducted from 2014 to 2015.
Setting
University veterinary teaching hospital.
Animals
Twenty dogs with a clinical diagnosis of shock and 60 dogs without a clinical diagnosis of shock (controls).
Measurements and main results
Upon presentation to the emergency room and prior to intervention, measurements of rectal temperature, interdigital temperature, ambient temperature, systemic markers of perfusion (capillary refill time [CRT], heart rate [HR], respiratory rate [RR], Doppler blood pressure [DBP], and venous plasma lactate concentration), and venous blood gas analytes were recorded. Dogs were initially determined to be in shock by the attending clinician, and post hoc inclusion criteria were applied. Shock was defined as abnormalities in ≥3 of the 6 following criteria: HR > 120/min, RR > 40/min, CRT > 2 seconds, rectal temperature 2.5 mmol/L, or DBP |
| doi_str_mv | 10.1111/vec.12992 |
| format | Article |
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To evaluate the difference in the rectal‐interdigital temperature gradient (RITG) between dogs that were presented to an emergency room with clinical signs of shock compared to those without signs of shock, and if this gradient can be used as a diagnostic marker for shock.
Design
Prospective, single center, observational study conducted from 2014 to 2015.
Setting
University veterinary teaching hospital.
Animals
Twenty dogs with a clinical diagnosis of shock and 60 dogs without a clinical diagnosis of shock (controls).
Measurements and main results
Upon presentation to the emergency room and prior to intervention, measurements of rectal temperature, interdigital temperature, ambient temperature, systemic markers of perfusion (capillary refill time [CRT], heart rate [HR], respiratory rate [RR], Doppler blood pressure [DBP], and venous plasma lactate concentration), and venous blood gas analytes were recorded. Dogs were initially determined to be in shock by the attending clinician, and post hoc inclusion criteria were applied. Shock was defined as abnormalities in ≥3 of the 6 following criteria: HR > 120/min, RR > 40/min, CRT > 2 seconds, rectal temperature <37.8°C (100.0°F), venous plasma lactate concentration >2.5 mmol/L, or DBP < 90 mm Hg. Animals with circulatory shock had a significantly increased RITG. An increased RITG was also correlated with individual perfusion parameters including prolonged CRT (ρ = .353, P = 0.0013), tachycardia (ρ = .3485, P = 0.0015), decreased DBP (ρ = –0.6162, P = 0.0003), and shock index (ρ = 0.6168, P = 0.0003). Receiver operator curve analysis indicated a RITG cutoff point of 11.6°F had 90% specificity for the diagnosis of shock (area under the curve = 0.7604).
Conclusions
The RITG in this study was associated with a diagnosis of shock and therefore may serve as a diagnostic marker of circulatory shock. Future studies with larger sample sizes to validate the use of temperature gradients and other peripheral perfusion abnormalities as diagnostic and monitoring tools are warranted.</description><identifier>ISSN: 1479-3261</identifier><identifier>EISSN: 1476-4431</identifier><identifier>DOI: 10.1111/vec.12992</identifier><identifier>PMID: 32965089</identifier><language>eng</language><publisher>United States</publisher><subject>Animals ; Blood Pressure ; Blood Pressure Determination - veterinary ; Body Temperature - physiology ; Case-Control Studies ; Dog Diseases - diagnosis ; Dogs ; Female ; Heart Rate ; Hemodynamics ; Lactic Acid - blood ; Male ; Prospective Studies ; Shock - diagnosis ; Shock - veterinary ; shock index ; veterinary</subject><ispartof>Journal of veterinary emergency and critical care (San Antonio, Tex. : 2000), 2020-11, Vol.30 (6), p.670-676</ispartof><rights>Veterinary Emergency and Critical Care Society 2020</rights><rights>Veterinary Emergency and Critical Care Society 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3252-de40b8bb2f094a4c482fa6b2ad12f6bcea330e25510329c7fe3e21f02e3e96663</citedby><cites>FETCH-LOGICAL-c3252-de40b8bb2f094a4c482fa6b2ad12f6bcea330e25510329c7fe3e21f02e3e96663</cites><orcidid>0000-0002-1601-3848</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fvec.12992$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fvec.12992$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1413,27906,27907,45556,45557</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32965089$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schaefer, Jonathan D.</creatorcontrib><creatorcontrib>Reminga, Christin L.</creatorcontrib><creatorcontrib>Reineke, Erica L.</creatorcontrib><creatorcontrib>Drobatz, Kenneth J.</creatorcontrib><title>Evaluation of the rectal‐interdigital temperature gradient as a diagnostic marker of shock in dogs</title><title>Journal of veterinary emergency and critical care (San Antonio, Tex. : 2000)</title><addtitle>J Vet Emerg Crit Care (San Antonio)</addtitle><description>Objective
To evaluate the difference in the rectal‐interdigital temperature gradient (RITG) between dogs that were presented to an emergency room with clinical signs of shock compared to those without signs of shock, and if this gradient can be used as a diagnostic marker for shock.
Design
Prospective, single center, observational study conducted from 2014 to 2015.
Setting
University veterinary teaching hospital.
Animals
Twenty dogs with a clinical diagnosis of shock and 60 dogs without a clinical diagnosis of shock (controls).
Measurements and main results
Upon presentation to the emergency room and prior to intervention, measurements of rectal temperature, interdigital temperature, ambient temperature, systemic markers of perfusion (capillary refill time [CRT], heart rate [HR], respiratory rate [RR], Doppler blood pressure [DBP], and venous plasma lactate concentration), and venous blood gas analytes were recorded. Dogs were initially determined to be in shock by the attending clinician, and post hoc inclusion criteria were applied. Shock was defined as abnormalities in ≥3 of the 6 following criteria: HR > 120/min, RR > 40/min, CRT > 2 seconds, rectal temperature <37.8°C (100.0°F), venous plasma lactate concentration >2.5 mmol/L, or DBP < 90 mm Hg. Animals with circulatory shock had a significantly increased RITG. An increased RITG was also correlated with individual perfusion parameters including prolonged CRT (ρ = .353, P = 0.0013), tachycardia (ρ = .3485, P = 0.0015), decreased DBP (ρ = –0.6162, P = 0.0003), and shock index (ρ = 0.6168, P = 0.0003). Receiver operator curve analysis indicated a RITG cutoff point of 11.6°F had 90% specificity for the diagnosis of shock (area under the curve = 0.7604).
Conclusions
The RITG in this study was associated with a diagnosis of shock and therefore may serve as a diagnostic marker of circulatory shock. Future studies with larger sample sizes to validate the use of temperature gradients and other peripheral perfusion abnormalities as diagnostic and monitoring tools are warranted.</description><subject>Animals</subject><subject>Blood Pressure</subject><subject>Blood Pressure Determination - veterinary</subject><subject>Body Temperature - physiology</subject><subject>Case-Control Studies</subject><subject>Dog Diseases - diagnosis</subject><subject>Dogs</subject><subject>Female</subject><subject>Heart Rate</subject><subject>Hemodynamics</subject><subject>Lactic Acid - blood</subject><subject>Male</subject><subject>Prospective Studies</subject><subject>Shock - diagnosis</subject><subject>Shock - veterinary</subject><subject>shock index</subject><subject>veterinary</subject><issn>1479-3261</issn><issn>1476-4431</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kEtOwzAQhi0EoqWw4ALIS1iktSdOWi9RVR5SJTbANnKcSWuaJsV2irrjCJyRk-A-YMdsZkb69GnmJ-SSsz4PNVij7nOQEo5Il4thGgkR8-PdLKMYUt4hZ869McalTOCUdGKQacJGskuKyVpVrfKmqWlTUj9HalF7VX1_fpnaoy3MzISVelyu0CrfWqQzqwqDtafKUUULo2Z147zRdKnsAu1W5OaNXlBT06KZuXNyUqrK4cWh98jL3eR5_BBNn-4fx7fTSMeQQFSgYPkoz6FkUiihxQhKleagCg5lmmtUccwQkoSz8IAelhgj8JJB6DJN07hHrvfelW3eW3Q-WxqnsapUjU3rMhAiETCUAAG92aPaNs5ZLLOVNeH8TcZZtg01C6Fmu1ADe3XQtvkSiz_yN8UADPbAh6lw878pe52M98ofBXuC4Q</recordid><startdate>202011</startdate><enddate>202011</enddate><creator>Schaefer, Jonathan D.</creator><creator>Reminga, Christin L.</creator><creator>Reineke, Erica L.</creator><creator>Drobatz, Kenneth J.</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1601-3848</orcidid></search><sort><creationdate>202011</creationdate><title>Evaluation of the rectal‐interdigital temperature gradient as a diagnostic marker of shock in dogs</title><author>Schaefer, Jonathan D. ; Reminga, Christin L. ; Reineke, Erica L. ; Drobatz, Kenneth J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3252-de40b8bb2f094a4c482fa6b2ad12f6bcea330e25510329c7fe3e21f02e3e96663</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Animals</topic><topic>Blood Pressure</topic><topic>Blood Pressure Determination - veterinary</topic><topic>Body Temperature - physiology</topic><topic>Case-Control Studies</topic><topic>Dog Diseases - diagnosis</topic><topic>Dogs</topic><topic>Female</topic><topic>Heart Rate</topic><topic>Hemodynamics</topic><topic>Lactic Acid - blood</topic><topic>Male</topic><topic>Prospective Studies</topic><topic>Shock - diagnosis</topic><topic>Shock - veterinary</topic><topic>shock index</topic><topic>veterinary</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schaefer, Jonathan D.</creatorcontrib><creatorcontrib>Reminga, Christin L.</creatorcontrib><creatorcontrib>Reineke, Erica L.</creatorcontrib><creatorcontrib>Drobatz, Kenneth J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of veterinary emergency and critical care (San Antonio, Tex. : 2000)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schaefer, Jonathan D.</au><au>Reminga, Christin L.</au><au>Reineke, Erica L.</au><au>Drobatz, Kenneth J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluation of the rectal‐interdigital temperature gradient as a diagnostic marker of shock in dogs</atitle><jtitle>Journal of veterinary emergency and critical care (San Antonio, Tex. : 2000)</jtitle><addtitle>J Vet Emerg Crit Care (San Antonio)</addtitle><date>2020-11</date><risdate>2020</risdate><volume>30</volume><issue>6</issue><spage>670</spage><epage>676</epage><pages>670-676</pages><issn>1479-3261</issn><eissn>1476-4431</eissn><abstract>Objective
To evaluate the difference in the rectal‐interdigital temperature gradient (RITG) between dogs that were presented to an emergency room with clinical signs of shock compared to those without signs of shock, and if this gradient can be used as a diagnostic marker for shock.
Design
Prospective, single center, observational study conducted from 2014 to 2015.
Setting
University veterinary teaching hospital.
Animals
Twenty dogs with a clinical diagnosis of shock and 60 dogs without a clinical diagnosis of shock (controls).
Measurements and main results
Upon presentation to the emergency room and prior to intervention, measurements of rectal temperature, interdigital temperature, ambient temperature, systemic markers of perfusion (capillary refill time [CRT], heart rate [HR], respiratory rate [RR], Doppler blood pressure [DBP], and venous plasma lactate concentration), and venous blood gas analytes were recorded. Dogs were initially determined to be in shock by the attending clinician, and post hoc inclusion criteria were applied. Shock was defined as abnormalities in ≥3 of the 6 following criteria: HR > 120/min, RR > 40/min, CRT > 2 seconds, rectal temperature <37.8°C (100.0°F), venous plasma lactate concentration >2.5 mmol/L, or DBP < 90 mm Hg. Animals with circulatory shock had a significantly increased RITG. An increased RITG was also correlated with individual perfusion parameters including prolonged CRT (ρ = .353, P = 0.0013), tachycardia (ρ = .3485, P = 0.0015), decreased DBP (ρ = –0.6162, P = 0.0003), and shock index (ρ = 0.6168, P = 0.0003). Receiver operator curve analysis indicated a RITG cutoff point of 11.6°F had 90% specificity for the diagnosis of shock (area under the curve = 0.7604).
Conclusions
The RITG in this study was associated with a diagnosis of shock and therefore may serve as a diagnostic marker of circulatory shock. Future studies with larger sample sizes to validate the use of temperature gradients and other peripheral perfusion abnormalities as diagnostic and monitoring tools are warranted.</abstract><cop>United States</cop><pmid>32965089</pmid><doi>10.1111/vec.12992</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-1601-3848</orcidid></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Animals Blood Pressure Blood Pressure Determination - veterinary Body Temperature - physiology Case-Control Studies Dog Diseases - diagnosis Dogs Female Heart Rate Hemodynamics Lactic Acid - blood Male Prospective Studies Shock - diagnosis Shock - veterinary shock index veterinary |
| title | Evaluation of the rectal‐interdigital temperature gradient as a diagnostic marker of shock in dogs |
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