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Biomedical subjects

W E Wingfield

Publications and source records attributed to W E Wingfield.

At least 19 recordsLinked to original sources

Controversial issues in drug treatment during cardiopulmonary resuscitation.

The goal of advanced life support in CPR must be to restore and maintain respiratory and hemodynamic effectiveness, and to correct the underlying dysrhythmia. Optimal basic life-support techniques must be continued to meet these goals. Many drugs have been suggested in the treatment of cardiac arrest, but unfortunately, drug effects are inconsistent and resuscitation rates remain low. Epinephrine, atropine, lidocaine, bretylium, and naloxone remain important drugs for consideration in CPR in most animals with cardiac arrest. The best chance of survival remains in early recognition of animals susceptible to arrest and in treatment of the underlying cause.

Animals

Respiratory and cardiopulmonary arrest in dogs and cats: 265 cases (1986-1991).

Outcomes of cardiopulmonary arrest and resuscitation in clinically affected dogs and cats have not been adequately studied. We examined the records from 200 dogs and 65 cats that had received cardiopulmonary resuscitation for respiratory or cardiopulmonary arrest; none of the animals had been anesthetized or intubated at the time of arrest, and all had been hospitalized in a veterinary critical care facility. Cardiopulmonary arrest was found to be more common than respiratory arrest in dogs and cats. Hospital discharge rates for animals with cardiopulmonary arrest ranged from 4.1% for dogs to 9.6% for cats, and were consistent with those reported from studies of human beings with cardiopulmonary arrest. Hospital discharge rates for dogs and cats with respiratory arrest were 28% and 58.3%, respectively.

Animals

Bacterial culture of blood from critically ill dogs and cats: 100 cases (1985-1987).

Of 100 critically ill dogs and cats, 49 (39 dogs, 10 cats) had bacteremia. Gram-negative bacilli were the most common isolates from the bloodstream of dogs with bacteremia (46%), and gram-positive cocci and anaerobic bacteria were isolated from 36% and 31% of positive cultures, respectively; 15% of positive cultures were polymicrobial. In cats, gram-negative bacilli (especially Salmonella enteritidis) and anaerobic bacteria were the most common isolates, and 30% of positive cultures were polymicrobial. Gram-positive cocci were not isolated from the blood-stream of cats. Odds ratios, adjusted for the combined effects of disease status (severe vs nonsevere), results of bacterial culture of blood result (positive vs negative), and species (dog vs cat) were calculated for mortality in animals in the study. In animals with bacteremia, severe disease increased the risk of death 11.6-fold, compared with the risk in animals with nonsevere disease. Bacteremia increased mortality 10-fold in animals with severe disease, compared with mortality in animals with severe disease without bacteremia. Animals with severe disease and bacteremia were 15.6 times more likely to die than were those with nonsevere disease and negative culture results. In animals with nonsevere disease, culture results (positive vs negative) were not related significantly to mortality. Disease status (severe vs nonsevere) in animals without bacteremia also was not significantly related to mortality. There was no significant difference in overall mortality in dogs, compared with that in cats.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

Abnormal bleeding.

Animals with disorders of hemostasis are often presented as emergency patients and, as such, offer a challenge to the attending clinician. This article reviews the basic physiology of hemostasis and laboratory tests used for diagnosis. Guidelines for the evaluation and treatment of patients with bleeding disorders are provided.

Animals

Atrial fibrillation in a pregnant mare: treatment with quinidine sulfate.

Atrial fibrillation in a pregnant, lactating, 15-year-old mare nursing a 70-day-old foal was converted to normal sinus rhythm, using quinidine sulfate. The maximum concentration of quinidine was 4.3 mg/L in the mare's milk and was 2.6 mg/L in the mare's serum. Treatment with quinidine did not interrupt the pregnancy. Six months after treatment, the mare developed acute volvulus of the large colon and died. At necropsy, the mare did not have macroscopic or microscopic cardiac lesions. The fetus was macroscopically and histologically normal.

Animals

Echocardiography for the diagnosis of congenital heart defects in the dog.

Echocardiography utilizing M-mode and real-time techniques is a safe, noninvasive diagnostic technique for use in veterinary cardiology. It provides a means to assess structural sizes and relationships and can be used to provide quantitative data for diagnosis of congenital heart disease. Although its availability is largely limited to veterinary colleges and specialty hospitals, the practicing veterinarian should know of its advantages and disadvantages. He or she is also encouraged to consider the use of ultrasound in the diagnosis and management of heart disease in all species of veterinary patients.

Animals

Effects of body position and ventilation/compression ratios during cardiopulmonary resuscitation in cats.

Eighteen cats were anesthetized and were randomly assigned to 2 groups (9 cats/group). Cardiopulmonary resuscitation (CPR) was performed on each cat, with the cat in dorsal (group 1) or lateral (group 2) recumbency, by administering 5 external cardiac compressions/1 interposed (diastolic) ventilation (American Heart Association [AHA] technique; n = 3 cats/technique), simultaneous compression and ventilation (SCV; n = 3 cats/technique), or SCV with 1 interposed (diastolic) ventilation every tenth compression (SCV/DV; n = 3 cats/technique). Fourteen of the 18 cats were resuscitated. Central aortic and venous pressures were determined concurrently with lead II electrocardiography. Arterial blood samples were collected during the base-line period (after pressure fluctuations had stabilized, with the cats spontaneously breathing room air), 2.5 minutes after the onset of arrest (defined as the cessation of aortic pressure fluctuations), and after 10 minutes of CPR. Arterial blood gas values during the base-line period or during the period of arrest were not significantly different between group-1 and group-2 cats. After CPR, arterial pH and bicarbonate values were not significantly different between groups or between technique categories. The PaCO2 values were significantly lower in cats resuscitated by SCV or by SCV/DV than in cats resuscitated by AHA (P less than 0.05). The PaO2 values were significantly (P less than 0.001) higher in group-2 cats than in group-1 cats and were significantly (P less than 0.001) different between each technique category, with cats resuscitated by AHA having the lowest PaO2 and cats resuscitated by SCV/DV having the highest PaO2. Body position, CPR technique, sex, weight, or arterial blood gas values after CPR were not predictors of successful resuscitation.

Animals

M-mode echocardiographs of endurance horses in the recovery phase of long-distance competition.

M-mode echocardiographic structures, and cardiac function indices, PCV, and total plasma protein values were determined for 34 endurance equine athletes before (base line) and after (after race) a 161-km endurance competition and were compared. The PCV (base-line mean, 37%; after-race mean, 46%) and total plasma protein value (base-line mean, 6.9 g/dl; after-race mean, 7.5 g/dl) increased. Compared with base-line echocardiography, after-race echocardiography indicated an increase in heart rate, as determined from the simultaneous ECG recorded on the echocardiograph (base-line mean, 41 beats/min; after-race mean, 54 beats/min), and an increase in interventricular septal diastolic thickness (base-line mean, 28 mm; after-race mean, 33 mm). The septal thickening fraction (base-line mean, 59%; after-race mean, 38%), the left atrioventricular valve E to F slope (base-line mean, 224 mm/s; after-race mean, 175 mm/s), the left ventricular diastolic dimension (base-line mean, 99 mm; after-race mean, 86 mm), the fractional shortening of the left ventricle (base-line mean, 41%; after-race mean, 37%), the aortic root dimension (base-line mean, 63 mm; after-race mean, 58 mm), the caudal aortic wall excursion (base-line mean, 19 mm; after-race mean, 11 mm) and the left atrial diastolic dimension (base-line mean, 46 mm; after-race mean, 39 mm), decreased significantly (P less than 0.05). In base-line echocardiographs, late diastolic left atrioventricular valve motion was evident in 9 horses. The aberrant left atrioventricular valve motion was not evident in after-race echocardiographs. Seemingly, central vascular volume decreased in these horses during the recovery phase of severe strenuous endurance competition.

Animals

Gastric emptying of liquids in the dog: effect of volume.

Effect of liquid test meal volume on gastric emptying was investigated in healthy nonoperated dogs fed meal sizes of 6.6 to 110 ml/kg of body weight. For meals less than or equal to 66 ml/kg, the amount of test meal emptied from the stomach in 30 minutes vs meal size could be described as following a linear, exponential, or square root pattern. Deviation from these patterns was seen with test meals of 77, 88, and 110 ml/kg. A mean +/- SEM maximum of 0.99 +/- 0.06 ml/kg/min of liquid test meal was emptied from the stomach of dogs fed test meals of 77, 88, and 110 ml/kg. Massive gastric distension induced in dogs during this study did not alter gastric emptying of the liquid test meal.

Animals