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  4. Mestrado em Medicina Veterinária (Patologia e Ciências Clínicas)
Please use this identifier to cite or link to this item: https://rima.ufrrj.br/jspui/handle/20.500.14407/14081
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dc.contributor.authorPeixoto, Anna Julia Rodrigues
dc.date.accessioned2023-12-22T02:56:24Z-
dc.date.available2023-12-22T02:56:24Z-
dc.date.issued2020-02-18
dc.identifier.citationPEIXOTO, Anna Julia Rodrigues. Fatores de risco de mortalidade e disfunção de órgão em cães com sepse causada por piometra. 2020. 58 f. Dissertação (Mestrado em Medicina Veterinária, Patologia e Ciências Clínicas) - Instituto de Veterinária, Departamento de Medicina e Cirurgia Veterinária, Universidade Federal Rural do Rio de Janeiro, Seropédica, RJ, 2020.por
dc.identifier.urihttps://rima.ufrrj.br/jspui/handle/20.500.14407/14081-
dc.description.abstractA sepse é uma síndrome que induz alterações celulares, microcirculatórias e hemodinâmicas ante uma infecção, provocando disfunções em sistemas orgânicos e altas taxas de mortalidade. É reconhecida e amplamente estudada em humanos porem na medicina veterinária os dados da literatura são pouco contundentes e por vezes discrepantes. Sobre a sepse em cães, quase que a totalidade dos estudos ainda utilizam os critérios SRIS para identificação da síndrome, embora já seja discutido a limitação desta ferramenta diagnóstica também nesta espécie. Além disso, alguns poucos estudos apontam para a forte correlação entre a disfunção de órgãos e a mortalidade provocada pela sepse em cães, assim como já demonstrado em humanos. Desta forma, este estudo tem a proposição de determinar, a partir de cadelas portadoras de piometra: incidência da sepse; mortalidade; fatores de risco para o desenvolvimento da sepse; bem como, a prevalência, quantidade e fatores de risco das disfunções orgânicas para a mortalidade na sepse. O estudo foi desenvolvido no período de 2017 a 2019 a partir de cadelas admitidas no Hospital Veterinário da UFRRJ com diagnóstico ultrassonográfico sugestivo de piometra. As variáveis estudadas (epidemiológicas, clínicas e laboratoriais) foram coletadas na admissão do paciente. Todas as cadelas foram tratadas cirurgicamente e acompanhadas por 90 dias. O óbito foi considerado até o décimo quarto dia. Os critérios para identificação da disfunção de órgãos foram: PAS via doppler <90 mmHg; Escala de Coma de Glasgow Modificada para Cães ≤13 pontos; plaquetometria <200.000 cel/μl; bilirrubina total sérica >0,5 mg/dl e creatinina sérica >1,7 mg/dl. Cadelas sem disfunção foram alocadas no grupo piometra (P); com uma ou mais disfunções e sobreviventes no grupo sepse sobreviventes (SS) e; com uma ou mais disfunções e não sobreviventes no grupo sepse óbitos (SO). Foram incluídas 130 cadelas com média de 8±4 anos e 14±10 kg, sendo alocadas 29 cadelas no grupo P, 89 em SS e 12 em SO. A ocorrência de sepse foi de 78%. Nos pacientes com sepse (SS), a disfunção orgânica mais prevalente foi a hemostática, seguida da hepática, neurológica, cardiovascular e renal. A disfunção renal foi a mais prevalente no grupo SO, aumentando em 31 vezes o risco de mortalidade. A quantidade de disfunções no mesmo paciente foi significativamente maior no grupo SO, com mais de 50% dos pacientes apresentando 3 ou mais disfunções. A disfunção cardiovascular aumenta em 8 vezes a chance de óbito e a presença de 4 disfunções aumenta em até 20 vezes a chance de óbito. Nossos resultados inferem uma dinâmica da morbidade e mortalidade da sepse similar a descrita em humanos, onde o tipo e quantidade de disfunções orgânicas presentes são mais importantes que o tipo de infecção e a presença de uma resposta inflamatória sistêmica para predizer morbidade e mortalidade. As disfunções orgânicas estudas são preditores de mortalidade na sepse em cães e acreditamos que os critérios clínicos definidos no último consenso (Sepsis-3) pela medicina, possam ser extrapolados para a espécie canina.por
dc.description.sponsorshipCAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superiorpor
dc.formatapplication/pdf*
dc.languageporpor
dc.publisherUniversidade Federal Rural do Rio de Janeiropor
dc.rightsAcesso Abertopor
dc.subjectescore SOFApor
dc.subjectcritérios SRISpor
dc.subjectlactatopor
dc.subjectSDMOpor
dc.subjectSOFA scoreeng
dc.subjectSRIS criteriaeng
dc.subjectlactateeng
dc.subjectMODSeng
dc.titleFatores de risco de mortalidade e disfunção de órgão em cães com sepse causada por piometrapor
dc.typeDissertaçãopor
dc.description.abstractOtherSepsis is a syndrome that induces cellular, microcirculatory and hemodynamic changes before an infection, causing dysfunctions in organic systems and high mortality rates. It is recognized and widely studied in humans, but in veterinary medicine the data in the literature are not very striking and sometimes discrepant. Regarding sepsis in dogs, almost all studies still use the SRIS criteria to identify the syndrome, although the limitation of this diagnostic tool in this species has already been discussed. In addition, a few studies point to a strong correlation between organ dysfunction and mortality from sepsis in dogs, as has already been demonstrated in humans. Thus, this study proposes to determine, from bitches with pyometra: incidence of sepsis; mortality; risk factors for the development of sepsis; as well as, the prevalence, quantity and risk factors of organ dysfunctions for mortality in sepsis. The study was developed in the period from 2017 to 2019 from bitches admitted to the Veterinary Hospital of UFRRJ with ultrasound diagnosis suggestive of pyometra. The studied variables (epidemiological, clinical and laboratory) were collected on the patient's admission. All dogs were surgically treated and followed for 90 days. Death was considered until the fourteenth day. The criteria for identifying organ dysfunction were: SBP via doppler <90 mmHg; Glasgow Coma Scale ≤13 points; platelet counts <200,000 cell / µl; total serum bilirubin> 0.5 mg / dl and serum creatinine> 1.7 mg / dl. Bitches without dysfunction were allocated to the pyometra group (P); with one or more dysfunctions and survivors in the sepsis survivors (SS) group; with one or more dysfunctions and non-survivors in the sepsis deaths (SO) group. 130 bitches with an average of 8 ± 4 years and 14 ± 10 kg were included, with 29 bitches allocated in group P, 89 in SS and 12 in SO. Sepsis was 78%. In patients with sepsis (SS), the most prevalent organ dysfunction was hemostatic, followed by liver, neurological, cardiovascular and renal. Renal dysfunction was the most prevalent in the SO group, increasing the risk of mortality by 31 times. The number of dysfunctions in the same patient was significantly higher in the SO group, with more than 50% of patients presenting 3 or more dysfunctions. Cardiovascular dysfunction increases the chance of death by 8 times and the presence of 4 disorders increases the chance of death by up to 20 times. Our results infer a sepsis morbidity and mortality dynamics similar to that described in humans, where the type and amount of organic dysfunctions present are more important than the type of infection and the presence of a systemic inflammatory response to predict morbidity and mortality. The organic dysfunctions studied are predictors of mortality in sepsis in dogs and we believe that the clinical criteria defined in the last consensus (Sepsis-3) by medicine, can be extrapolated to the canine species. Risk factors for mortality and organ dysfunction in dogs with sepsis caused by pyometra, 2020.eng
dc.contributor.advisor1Coelho, Cássia Maria Molinaro
dc.contributor.advisor1ID085.429.797-96por
dc.contributor.advisor1Latteshttp://lattes.cnpq.br/1209397269710785por
dc.contributor.referee1Coelho, Cássia Maria Molinaro
dc.contributor.referee2Baldani, Cristiane Divan
dc.contributor.referee3Miranda, Marcos Lopes de
dc.creator.ID376.774.308-64por
dc.creator.Latteshttp://lattes.cnpq.br/2340544956968414por
dc.publisher.countryBrasilpor
dc.publisher.departmentInstituto de Veterináriapor
dc.publisher.initialsUFRRJpor
dc.publisher.programPrograma de Pós-Graduação em Medicina Veterinária (Patologia e Ciências Clínicas)por
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dc.subject.cnpqMedicina Veterináriapor
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dc.originais.urihttps://tede.ufrrj.br/jspui/handle/jspui/5939
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Appears in Collections:Mestrado em Medicina Veterinária (Patologia e Ciências Clínicas)

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