Use of conjunctival oxygen index for evaluation of cardiac output in dogs.

The relationship between the palpebral conjunctival oxygen (PcjO2) index, mixed venous oxygen tension (PvO2), and cardiac index were compared, using a canine hemorrhagic shock model. The cardiac output was reduced by reducing the blood volume in 5% increments until the initial cardiac output was reduced by one half. In each of 7 dogs, the PcjO2 index and PvO2 were found to have good correlation with cardiac index; however, the correlation coefficients were markedly reduced when the data from all of the dogs were combined. It was concluded that PcjO2 index provides an excellent means of assessing changes in cardiac index over time in the same dog; however, it cannot be used to estimate cardiac index in an individual dog with a degree of accuracy that would be clinically significant.

Transconjunctival oxygen index in healthy awake dogs.

Transconjunctival oxygen tension (PcjO2) has been used clinically in human beings and experimentally in dogs to evaluate tissue perfusion and to estimate arterial O2 tension (PaO2); however, normal values in awake healthy dogs have not been reported. In this study, transconjunctival oxygen tension and arterial oxygen tension were measured once a week in 6 healthy conditioned dogs (15 to 28 kg) for 8 weeks. The conjunctival oxygen index (PcjO2 index = PcjO2/PaO2) was calculated. Mean PcjO2 index for all dogs was 0.47 +/- 0.08 (X +/- SD). The variability of repeated measurements on the same dog and between dogs was evaluated. A difference (P less than 0.05) in PcjO2 index among dogs was evident, and although there was not a difference in the same dog over time, there was a high coefficient of variability.

Total parenteral nutrition in clinically normal cats.

Seven clinically normal cats were maintained on total parenteral nutrition (TPN) with nothing given PO for 2 weeks. The TPN solution consisted of a mixture of dextrose, amino acids, soybean oil emulsion, electrolytes, and vitamins. Three cats were fed calories in excess of published maintenance requirements, and they gained some weight, vomited occasionally, had oral ulcerations, and had signs of depression after 10 to 13 days on TPN. Four cats that were not overfed did well clinically and maintained stable body weights. All cats developed anemia and thrombocytopenia to varying degrees during TPN administration and had polyuria and serum triglyceride concentrations higher than normal fasting values. Some cats had changes in liver-specific biochemical variables. Hepatocellular swelling and vacuolation and small intestinal villous atrophy and fusion were the most common histopathologic changes seen after TPN. These changes were reversible when TPN was discontinued and the cats were returned to enteral nutrition.

Further experience in the management of severe head injury.

A prospective and consecutive series of 225 patients with severe head injuries who were managed in a uniform way was analyzed to relate outcome to several clinical variables. Good recovery or moderate disability were achieved by 56% of the patients, 10% remained severely disabled or vegetative, and 34% died. Factors important in predicting a poor outcome included the presence of intracranial hematoma, increasing age, abnormal motor responses, impaired or absent eye movements or pupil light reflexes, early hypotension, hypoxemia or hypercarbia, and elevation of intracranial pressure over 20 mm Hg despite artificial ventilation. Most of these predictive factors were assessed on admission, but a subset of 158 patients was identified in whom coma was present on admission and was known to have persisted at least until the following day. Although the mortality in this subset (40%) was higher than in the total series, it was lower than in several comparable reported series of patients with severe head injury. Predictive correlations were equally strong in the entire series and in the subset of 158 patients with coma. A plea is made for inclusion in the definition of "severe head injury" of all patients who do not obey commands or utter recognizable words on admission to the hospital after early resuscitation.