Evaluation of the levels of cardiac troponin I as an end point in resuscitation of dogs with hemorrhagic shock

Document Type : Research Articles


1 shahid chamran university

2 Shahid Chamran university


This study sought to assess the levels of cardiac troponin I, as a resuscitation end point, along with oxygen delivery (DO2) and oxygen consumption (VO2) during resuscitation of dogs with experimental hemorrhagic shock using lactated Ringer’s solution or 6% hydroxyethyl starch. After induction of anesthesia (control measurements), hemorrhagic shock was induced by rapid removal of blood to achieve a mean arterial pressure (MAP) of 40 to 50 mmHg within 30 minutes and then maintained in hypovolemic situation for additional 30 minutes (second and third stages of measurements). 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 minutes intervals (forth stage of measurements). One hour after the last resuscitation step, final measurements were performed. Hemorrhagic shock caused marked elevation in the levels of cTnI and reduction in DO2 and VO2 (p < 0.05). Following resuscitation, a significant reduction was observed in the levels of cTnI and VO2 but a significant elevation was seen in DO2 levels (p < 0.05), without significant differences between the groups (p > 0.05). The results of this study proved that cTnI can be evaluated for better monitoring during fluid therapy in hemorrhagic shock, as a novel resuscitation end point.


Main Subjects

1. Alpert JS, Thygesen K, Antman E, Bassand JP. Myocardial infarction
redefined: A consensus document of the Joint European
Society of Cardiology/ American College of Cardiology
Committee for the Redefinition of Myocardial Infarction. J
Am Coll Cardiol. 2000 Sep;36(3):959-69.
2. Archie JP, Mertz WR. Myocardial oxygen delivery after experimental
hemorrhagic shock. Ann Surg. 1978 Feb;187(2):205-
3. Arlati S, Brenna S, Prencipe L, Marocchi A, Casella GP, Lanzani
M, et al. Myocardial necrosis in ICU patients with acute
non-cardiac disease: a prospective study. Intensive Care Med.
2000 Jan;26(1):31-7.
4. Baue AE, Tragus ET, Wolfson SK Jr, Cary AL, Parkins WM. Hemodynamic
and metabolic effects of Ringer’s lactate solution
in hemorrhagic shock. Ann Surg. 1967 Jul;166(1):29-38.
5. Braz J, Nascimento P, Filho O, Braz L, Vane LA, Galva˜oVianna
PT, et al. The early systemic and gastrointestinal oxygenation
effects of hemorrhagic shock resuscitation with hypertonic
saline and hypertonic saline 6% dextran-70: A comparative
study in dogs. Anesth Analg. 2004 Aug;99(2):536-46.
6. Cheung AT, Driessen B, Jahr JS, Duong PL, Ramanujam S, Chen
PC, et al. Blood substitute resuscitation as a treatment modality
for moderate hypovolemia. Artif Cells Blood Substit
Immobil Biotechnol. 2004 May;32(2):189-207.
7. Cilli F, Alibhai H, Armitage-Chan E, Boswood A, Hammond
RA, Jasani S, et al. Incidence of elevation of cardiac troponin
I prior to and following routine general anaesthesia in dogs.
Vet Anaesth Analg. 2010 Sep;37(5):409-16.
8. Dyson D, Sinclair M. Impact of dopamine or dobutamine infusions
on cardiovascular variables after rapid blood loss and
volume replacement during isoflurane-induced anesthesia in
dogs. Am J Vet Res. 2006 Jul;67(7):1121-30.
9. Hagman R, Lagerstedt AS, Fransson BA, Bergström A, Häggström
J. Cardiac troponin I levels in canine pyometra. Acta
Vet Scand. 2007 Feb 28;49:6.
10. Hamacher L, Dӧrfelt R, Müller M, Wess G. Serum cardiac troponin
I concentrations in dogs with systemic inflammatory
response syndrome. J Vet Intern Med. 2015 Jan;29(1):164-70.
11. Haskins S, Pascoe PJ, Ilkiw JE, Fudge J, Hopper K, Aldrich J.
Reference cardiopulmonary values in normal dogs. Comp
Med. 2005 Apr;55(2):156-61.
12. Karpati PC, Rossignol M, Pirot M, Cholley B, Vicaut E, Henry
P, et al. High incidence of myocardial ischemia during postpartum
hemorrhage. Anesthesiology. 2004 Jan;100(1):30-6.
13. Keefe J. Shock and Initial Stabilization. In: Norkus C, editor.
Veterinary Technician’s Manual for Small Animal Emergency
and Critical Care. 1st ed. Iowa: Wiley-Blackwell; 2012.
14. Ko JJ, Alam R, Kim NS. Hemodynamic effects of fluid resuscitation
with 6% hydroxyethyl starch and whole blood in experimental
hypovolemic shock in Beagle dogs. Turk J Vet Anim
Sci. 2012 Jan;36(4):416-23.
15. Lopes PC, Sousa MG, Camacho AA, Carareto R, Nishimori
CT, Santos PS, et al. Comparison between two methods for
cardiac output measurement in propofol-anesthetized dogs:
thermodilution and Doppler. Vet Anaesth Analg. 2010
16. Marik P. Hemodynamic parameters to guide fluid therapy.
Transfus Altern Transfus Med. 2010 Sep;11(3):102-112.
17. Moore KE, Murtaugh RJ. Pathophysiologic characteristics of
hypovolemic shock. Vet Clin North Am Small Anim Pract.
2001 Nov;31(6):1115-28.
18. Murakawa K, Kobayashi A. Effects of vasopressors on renal
tissue gas tensions during hemorrhagic shock in dogs. Crit
Care Med. 1988 Aug;16(8):789-92.
19. Nascimento P.Jr, De Paiva Filho O, de
Carvalho LR, Braz JR. Early Hemodynamic
and Renal Effects of Hemorrhagic
Shock Resuscitation with Lactated
Ringer’s Solution, Hydroxyethyl
Starch, and Hypertonic Saline with or
without 6% Dextran-70. J Surg Res.
2006 Nov;136(1):98-105.
20. Oyama MA, Sisson DD. Cardiac troponin-
I concentration in dogs with
cardiac disease. J Vet Intern Med.
2004 Nov-Dec;18(6):831-9.
21. Oyama MA, Solter PF. Validation of an
immunoassay for measurement of canine
cardiac troponin-I. J Vet Cardiol.
2004 Nov;6(2):17-24.
22. Schober K, Cornand C, Kirbach B,
Aupperle H, Oechtering G. Serum
cardiac troponin I and cardiac troponin
T concentrations in dogs with
gastric dilatation-volvulus. J Am Vet
Med Assoc. 2002 Aug 1;221(3):381-8.
23. Strickland KN. Pathophysiology and
Therapy of Heart Failure. In: Smith
FWK, Tilley LP, Oyama MA, Sleeper
MM, editors. Manual of canine and
feline cardiology. 5th ed. Missouri:
Elsevier; 2016.
24. Udelsmann A, Bonfim MR, Silva WA,
Moraes AC. Hemodynamic effects
of volume replacement with saline
solution and hypertonic hydroxyethyl
starch in dogs. Acta Cir Bras. 2009
25. Vincent JL, Dufaye P, Berre J, Leeman
M, Degaute JP, Kahn RJ. Serial
lactate determinations during circulatory
shock. Crit Care Med. 1983