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Abstract :
[en] Endotoxemia is the first mortality cause in equine intensive care. In humans with septic shock, some echocardiographic indicators are used to predict the efficiency of fluid resuscitation and outcome, allowing an early-goal-directed therapy. Echocardiography has never been investigated for this indication in horses. The aim of this study was to assess the prognosis value of echocardiographic and Doppler parameters of left ventricular (LV) function in horses with severe endotoxic shock. Twenty-one horses admitted to the clinic for colic with clinical signs of severe endotoxic shock underwent Doppler echocardiographic examination. LV echocardiographic and Doppler parameters were compared between the survivors (n=6) and the non-survivors (n=15) horses using a multivariable ANOVA analysis. The pre-ejection period to ejection time ratio (PEP/ET) of the Doppler aortic flow was significantly higher in the non-survivors than in the survivors group. All other measured parameters (including heart rate and end-diastolic-volume) were not significantly different between the groups. Doppler parameters of left ventricular function are subject to high variability and low repeatability in horses. This might explain that most variables were not significantly different between the two groups. Moreover, the number of investigated horses was limited, especially in the survivors group. However, with comparable HR and LV preload, a higher PEP/ET suggested a more compromised systolic dysfunction in the non-survivors. PEP/ET is often considered to be one of the best indicators of systolic function in horses and its measurement might therefore be useful in indicating the need for inotropic support in the management of horses with endotoxic shock.
