Com o avanço de novas biotécnicas da reprodução (TE, FIV e Clonagem), exige-se o controle mais acurado da gestação e do parto, em razão dos problemas obstétricos decorrentes do nascimento de produtos com crescimento exacerbado ou com menor vitalidade por disfunções placentárias. Desta forma, a redução da mortalidade neonatal justifica-se por acompanhar o aprimoramento na área, visando ao bem-estar materno e neonatal, como também aos interesses do mercado pecuário. As distocias podem comprometer o fluxo sangüíneo materno-fetal e a ocitocina utilizada como agente ecbólico nas atonias uterinas pode aumentar o estresse do parto. Os objetivos deste estudo foram: identificar alterações do escore Apgar de vitalidade neonatal, temperatura corpórea, hemogasometria arterial, glicemia e cortisol ao nascimento e 1 hora pós-parto de neonatos nascidos em distintas condições obstétricas e verificar modificações da pressão arterial (PA), freqüência cardíaca, eletrocardiograma, glicemia e cortisol de vacas no pré-parto, intra-parto, pós-parto imediato e após 1 hora. Foram utilizadas 30 fêmeas bovinas e 30 bezerros da raça Holandesa subdivididos em: Grupo Eutocia (G EUT; n=10); Grupo Distocia com extração fetal forçada moderada a intensa (G DIST; n=10) e Grupo Atonia ou hipotonia uterina com infusão de Ocitocina (50UI) (G OCT; n=10). As vacas apresentaram hiperglicemia de estresse apenas 1 hora pós-parto no G EUT e G OCT, no entanto, já no intra-parto no G DIST. A distocia também elevou os níveis de cortisol no pós-parto imediato. Houve acréscimo significativo da PA no intra-parto do G DIST, decorrente de contrações uterinas e abdominais mais intensas. Os traçados eletrocardiográficos denotaram ritmo sinusal normal em todos os períodos. Os resultados demonstram adaptação hemodinâmica materna frente às alterações do parto, mesmo com infusão exógena de ocitocina. Os neonatos do G DIST ao nascimento apresentaram menor vitalidade (escore Apgar) e maior estresse (nível de cortisol) em relação aos demais grupos. Os bezerros apresentaram normotermia, a despeito da redução da temperatura corpórea 1 hora pós-parto, e mantiveram-se normoglicêmicos. Ainda, os valores de base-excess, HCO3- e pO2 eram baixos, enquanto os níveis de Anion-gap e pCO2, elevados. No entanto, apenas no G DIST observou-se acidose mista (metabólica e respiratória) evidente (pH<7,20), indicando maior grau de sofrimento fetal e redução do suprimento sangüíneo durante o parto. Os bezerros do G OCT apresentaram pCO2 superior e pO2 inferior aos demais grupos ao nascimento. A infusão de ocitocina pode promover padrões de contração uterina diferenciados, comprometendo ainda mais a oxigenação fetal. A ocitocina alterou momentaneamente as variáveis hemodinâmicas maternas com possível efeito bradicárdico e hipotensor intra-parto, promovendo menor adaptabilidade respiratória neonatal e, portanto, impondo assistência mais criteriosa ao nascimento. Todos os bezerros apresentaram reduzidos valores de hematócrito e hemoglobina, em decorrência da eritropoiese imatura e intensa metabolização de eritrócitos fetais. Após 60 minutos de vida, os bezerros apresentaram recuperação satisfatória do desequilíbrio ácido-base e capacidade evidente de termorregulação e manutenção glicêmica. A condição obstétrica ao nascimento é crítica para o desempenho clínico do neonato, comprometendo sua vitalidade inicial e influenciando a circulação materno-fetal nos casos de distocias. As alterações circulatórias maternas ocasionadas pela ocitocina são consideradas momentâneas, reversíveis e não comprometeram o êxito neonatal. / The novel reproductive biotechnologies (ET, IVF and Cloning) require more accurate control of pregnancy and parturition, due to obstetrical problems as a result of the large offspring syndrome or reduced calf vitality associated with placental anomalies. Hence, the reduction in neonatal mortality is justifiable as research in this area progresses, aiming maternal and neonatal well-being and livestock economic concernment. Dystocia may compromise dam-fetal blood flow and induces severe hypoxia at birth. Oxytocin employed as ecbolic treatment for uterine inertia can enhance calving stress. Therefore, the aims of this study were to identify abnormalities in neonatal Apgar score, body temperature, arterial blood gas analysis, glucose and cortisol assay at birth and after 1 hour of calving under distinct obstetrical conditions and to verify the changes on blood pressure (BP), heart rate, electrocardiogram record, glucose and cortisol assay of cows during the first stage of labor, intra-partum, immediately after calving and 1 hour later. Thirty Holstein cows and 30 Holstein calves were grouped according to the obstetrical condition into: Eutocia Group (EUT G; n=10); Dystocia Group with mild to severe obstetric assistance (DIST G; n=10) and Uterine Inertia Group treated with oxytocin (50UI) (OCT G; n=10). EUT G and OCT G cows showed stress-induced hyperglycemia 1 hour after calving. On the other hand, DIST G presented hyperglycemia yet during intra-partum. Dystocia also increased cortisol levels shortly after calving. During labor, DIST G presented significantly higher BP, due to uterine and abdominal strengthened contractions. Electrocardiogram recordings denoted normal sinus rhythm at all time points. DIST G neonates presented lower vitality (Apgar score) and higher stress (cortisol level) at birth compared to other groups. Calves were normothermic, despite the significative decrease in body temperature after 1 hour of birth, and remained normoglycemic. Moreover, base-excess, HCO3- and pO2 results were low, while Anion-gap and pCO2 were high, comparing to standard values. However, mixed acidosis (metabolic and respiratory; pH<7,2) was only noticeable in DIST G, suggesting higher fetal distress during calving and reduced blood supply (oxygenation). In addition, OCT G calves presented increased pCO2 and decreased pO2 at birth. Oxytocin infusion may cause a distinct pattern of uterine contraction, compromising neonatal hypoxia even more. The oxytocin infusion altered transitorily the maternal hemodynamic variables with a possible bradicardiac effect and intrapartum hypotension, causing lower neonatal respiratory adaptability, demanding more intensive care at birth. All newborns showed low hematocrit and hemoglobin concentration due to immature erythropoiesis and intense fetal erythrocyte metabolism. The present results indicate full maternal adaptation to labors requirement. Calves showed stark acid-base recovery during the critical period of adaptation to ex utero life, with also evident thermoregulation and glucose maintenance 1 hour after birth. The obstetrical condition presented at birth was determinant to neonatal clinical demeanor. Dystocia mainly compromised blood flow and oxygen supply and ultimately interfered with newborn vitality. Ponctual maternal circulatory alterations caused by oxytocin infusion were reversible and did not compromise neonatal outcome.

Com o avanço de novas biotécnicas da reprodução (TE, FIV e Clonagem), exige-se o controle mais acurado da gestação e do parto, em razão dos problemas obstétricos decorrentes do nascimento de produtos com crescimento exacerbado ou com menor vitalidade por disfunções placentárias. Desta forma, a redução da mortalidade neonatal justifica-se por acompanhar o aprimoramento na área, visando ao bem-estar materno e neonatal, como também aos interesses do mercado pecuário. As distocias podem comprometer o fluxo sangüíneo materno-fetal e a ocitocina utilizada como agente ecbólico nas atonias uterinas pode aumentar o estresse do parto. Os objetivos deste estudo foram: identificar alterações do escore Apgar de vitalidade neonatal, temperatura corpórea, hemogasometria arterial, glicemia e cortisol ao nascimento e 1 hora pós-parto de neonatos nascidos em distintas condições obstétricas e verificar modificações da pressão arterial (PA), freqüência cardíaca, eletrocardiograma, glicemia e cortisol de vacas no pré-parto, intra-parto, pós-parto imediato e após 1 hora. Foram utilizadas 30 fêmeas bovinas e 30 bezerros da raça Holandesa subdivididos em: Grupo Eutocia (G EUT; n=10); Grupo Distocia com extração fetal forçada moderada a intensa (G DIST; n=10) e Grupo Atonia ou hipotonia uterina com infusão de Ocitocina (50UI) (G OCT; n=10). As vacas apresentaram hiperglicemia de estresse apenas 1 hora pós-parto no G EUT e G OCT, no entanto, já no intra-parto no G DIST. A distocia também elevou os níveis de cortisol no pós-parto imediato. Houve acréscimo significativo da PA no intra-parto do G DIST, decorrente de contrações uterinas e abdominais mais intensas. Os traçados eletrocardiográficos denotaram ritmo sinusal normal em todos os períodos. Os resultados demonstram adaptação hemodinâmica materna frente às alterações do parto, mesmo com infusão exógena de ocitocina. Os neonatos do G DIST ao nascimento apresentaram menor vitalidade (escore Apgar) e maior estresse (nível de cortisol) em relação aos demais grupos. Os bezerros apresentaram normotermia, a despeito da redução da temperatura corpórea 1 hora pós-parto, e mantiveram-se normoglicêmicos. Ainda, os valores de base-excess, HCO3- e pO2 eram baixos, enquanto os níveis de Anion-gap e pCO2, elevados. No entanto, apenas no G DIST observou-se acidose mista (metabólica e respiratória) evidente (pH<7,20), indicando maior grau de sofrimento fetal e redução do suprimento sangüíneo durante o parto. Os bezerros do G OCT apresentaram pCO2 superior e pO2 inferior aos demais grupos ao nascimento. A infusão de ocitocina pode promover padrões de contração uterina diferenciados, comprometendo ainda mais a oxigenação fetal. A ocitocina alterou momentaneamente as variáveis hemodinâmicas maternas com possível efeito bradicárdico e hipotensor intra-parto, promovendo menor adaptabilidade respiratória neonatal e, portanto, impondo assistência mais criteriosa ao nascimento. Todos os bezerros apresentaram reduzidos valores de hematócrito e hemoglobina, em decorrência da eritropoiese imatura e intensa metabolização de eritrócitos fetais. Após 60 minutos de vida, os bezerros apresentaram recuperação satisfatória do desequilíbrio ácido-base e capacidade evidente de termorregulação e manutenção glicêmica. A condição obstétrica ao nascimento é crítica para o desempenho clínico do neonato, comprometendo sua vitalidade inicial e influenciando a circulação materno-fetal nos casos de distocias. As alterações circulatórias maternas ocasionadas pela ocitocina são consideradas momentâneas, reversíveis e não comprometeram o êxito neonatal. / The novel reproductive biotechnologies (ET, IVF and Cloning) require more accurate control of pregnancy and parturition, due to obstetrical problems as a result of the large offspring syndrome or reduced calf vitality associated with placental anomalies. Hence, the reduction in neonatal mortality is justifiable as research in this area progresses, aiming maternal and neonatal well-being and livestock economic concernment. Dystocia may compromise dam-fetal blood flow and induces severe hypoxia at birth. Oxytocin employed as ecbolic treatment for uterine inertia can enhance calving stress. Therefore, the aims of this study were to identify abnormalities in neonatal Apgar score, body temperature, arterial blood gas analysis, glucose and cortisol assay at birth and after 1 hour of calving under distinct obstetrical conditions and to verify the changes on blood pressure (BP), heart rate, electrocardiogram record, glucose and cortisol assay of cows during the first stage of labor, intra-partum, immediately after calving and 1 hour later. Thirty Holstein cows and 30 Holstein calves were grouped according to the obstetrical condition into: Eutocia Group (EUT G; n=10); Dystocia Group with mild to severe obstetric assistance (DIST G; n=10) and Uterine Inertia Group treated with oxytocin (50UI) (OCT G; n=10). EUT G and OCT G cows showed stress-induced hyperglycemia 1 hour after calving. On the other hand, DIST G presented hyperglycemia yet during intra-partum. Dystocia also increased cortisol levels shortly after calving. During labor, DIST G presented significantly higher BP, due to uterine and abdominal strengthened contractions. Electrocardiogram recordings denoted normal sinus rhythm at all time points. DIST G neonates presented lower vitality (Apgar score) and higher stress (cortisol level) at birth compared to other groups. Calves were normothermic, despite the significative decrease in body temperature after 1 hour of birth, and remained normoglycemic. Moreover, base-excess, HCO3- and pO2 results were low, while Anion-gap and pCO2 were high, comparing to standard values. However, mixed acidosis (metabolic and respiratory; pH<7,2) was only noticeable in DIST G, suggesting higher fetal distress during calving and reduced blood supply (oxygenation). In addition, OCT G calves presented increased pCO2 and decreased pO2 at birth. Oxytocin infusion may cause a distinct pattern of uterine contraction, compromising neonatal hypoxia even more. The oxytocin infusion altered transitorily the maternal hemodynamic variables with a possible bradicardiac effect and intrapartum hypotension, causing lower neonatal respiratory adaptability, demanding more intensive care at birth. All newborns showed low hematocrit and hemoglobin concentration due to immature erythropoiesis and intense fetal erythrocyte metabolism. The present results indicate full maternal adaptation to labors requirement. Calves showed stark acid-base recovery during the critical period of adaptation to ex utero life, with also evident thermoregulation and glucose maintenance 1 hour after birth. The obstetrical condition presented at birth was determinant to neonatal clinical demeanor. Dystocia mainly compromised blood flow and oxygen supply and ultimately interfered with newborn vitality. Ponctual maternal circulatory alterations caused by oxytocin infusion were reversible and did not compromise neonatal outcome.

As principais causas de morte perinatal em bezerros estão de alguma forma relacionadas a problemas cardiorrespiratórios. A maior parte de morte de bezerros ocorre justamente no período de até 48h após o nascimento, quando ainda estão sendo feitos os ajustes fisiológicos necessários à vida extrauterina. Com o aumento de animais advindos das técnicas de produção in vitro, também aumentaram os problemas de sobrevivência e sobrevida dos recém nascidos. Este estudo teve como objetivo geral padronizar valores de referência de hemogasometria e espirometria de bezerros a termo, nascidos por parto espontâneo, e prematuros, nascidos por cesariana, da raça Nelore concebidos por inseminação artificial (IA), assim como estabelecer protocolos de cuidados intensivos neonatais aos animais prematuros. Objetivamente, o estudo compreendeu: 1. A avaliação dos valores de pressão invasiva de átrio direito, ventrículo direito, artéria pulmonar e artéria pulmonar ocluída, hemogasometria, espirometria e capnografia de bezerros da raça Nelore, a termo, nascidos por parto espontâneo; 2. A avaliação e padronização da hemogasometria arterial de bezerros raça Nelore, a termo, nascidos de partos espontâneos; 3. A avaliação da pressão invasiva da artéria pulmonar e dos efeitos do sildenafil sobre os valores de pressão de artéria pulmonar em bezerros da raça Nelore, prematuros, nascidos por cesariana; 4. Diferenças hemodinâmicas (utilizando o cateter de Swan-Ganz), na função pulmonar e nas trocas gasosas entre bezerros a termo nascidos por parto espontâneo e prematuros nascidos por cesariana; 5. O estabelecimento de protocolos de cuidados neonatais para bezerros advindos de gestações complicadas com risco de morte neonatal prematura, onde foram realizadas 3 cesarianas em bezerros concebidos por IA e 16 concebidos por transferência nuclear por de células somática (clonagem), sendo estabelecidos protocolos de terapia neonatal com sildenafil, surfactante e oxigenoterapia. Bezerros da raça Nelore a termo nascidos por parto espontâneo estabilizam seus parâmetros de hemogasometria a valores de animais adultos em até 48 horas após o nascimento e têm valores de hemogasometria mais próximos dos valores normais para a espécie, enquanto os bezerros prematuros, nascidos por cesariana, têm valores mais deslocados em relação a normalidade. A padronização da hemogasometria de bezerros da raça Nelore nascidos por eutocia, pode fomentar as pesquisas com animais advindos de técnicas de PIV, assim como aumentar a sobrevida e sobrevivência além de diminuir a mortalidades desses animais. Já o sildenafil não apresenta efeitos adversos significativos quanto a oxigenação dos bezerros em que foi usado, mesmo quando houve alterações não desejadas da PAP. Dessa forma, quando não existe a possibilidade de se aferir a PAP e suspeita-se de hipertensão, o sildenafil é pode ser usado sem maiores consequências para a saúde do paciente. / The main causes of perinatal death in cattle are frequently related to cardiorespiratory distress. A great number of losses are placed during the first 48h after birth, when important physiological adjustments to the extra-uterine life are still in progress. Recent increase of offspring derived from assisted reproductive in vitro biotechnologies resulted in diminished survival rates of the newborn. The present study aimed to obtain standard values of hemodynamic evaluation, blood gas and spirometry of Nelore calves conceived by artificial insemination (AI) born at term, spontaneously, or from premature calves born by cesarean delivery, as well as to establish protocols of neonatal intensive care focusing on premature animals. Objectively, the study comprised: 1. The evaluation of invasive pressure values from right atrium, right ventricle, pulmonary artery and pulmonary wedge pressure, blood gas, spirometry and capnography of Nelore calves born spontaneously; 2. Evaluation and standardization of arterial blood gas of Nelore calves born at term spontaneously; 3. Evaluation of invasive pressure of pulmonary artery (PAP) and effects of sildenafil administration on its values from Nelore premature calves born by cesarean; 4. The comparison of hemodynamic, blood gas and spirometry of calves born at term spontaneously or premature calves born by cesarean delivery, during the first 30 days of life; 5. The establishment of neonatal care protocols focusing on complicated pregnancies at risk of premature neonatal death, when 3 cesarean sections of calves conceived by AI and 16 conceived by nuclear transfer of somatic cells (cloning) were monitored, and therefore protocols involving neonatal therapy with sildenafil, surfactant and oxygen therapy were established. Nelore calves born at term spontaneously have their blood gas stabilized in values similar to adult cattle until 48 hours after birth, and present a blood gas profile more similar to the expected for the species, whereas premature calves born from cesarean delivery present values different from normality. The standardization of blood gas of Nelore calves born at term from eutocic deliveries may promote better perinatal survival rates in offspring derived from in vitro production. The treatment with sildenafil does not present adverse effects related to the oxygen levels of calves even when adverse alterations were observed in PAP. Therefore, whenever hypertension is suspected and measurement of PAP is impaired, the sildenafil treatment may be used without major consequences to the patient health

Resumo:A competição de três tambores exige dos cavalos alto desempenho atlético. A raça mais utilizada nessa modalidade é o Quarto de Milha. Para ter sucesso, o animal deve ter agilidade e alta aceleração. Avaliações endoscópicas revelam uma elevada prevalência de doenças do sistema respiratório em cavalos atletas como a Hemorragia pulmonar induzida por exercício. Por permitir a avaliação das vias áreas posteriores dos equinos, a endoscopia propicia avaliar a quantidade de sangue depositado nas vias aéreas após exercícios. Associado ao exame endoscópico a hemogasometria arterial tem sido utilizada visando identificar o comportamento das trocas gasosas, além da compreensão do estado de equilíbrio hidroeletrolítico e ácido-base em que o animal se encontra, possuindo grande valor para o entendimento de distúrbios metabólicos. O objetivo do presente estudo foi avaliar as vias aéreas, o perfil de gases sanguíneos, eletrólitos e o equilíbrio ácido-base de equinos submetidos ao treinamento de três tambores. Dezesseis cavalos divididos em 2 grupos de 8 animais, Treino regular (TR - 5 vezes) e Treino esporádico (TE - 2 vezes por semana) foram utilizados no experimento. A endoscopia foi realizada antes e 90 min após o exercício. Foram realizadas 2 coletas de sangue por punção da Artéria facial transversa antes do aquecimento (M0) e imediatamente após o exercício (M1), e as leituras foram realizadas com o I-Stat®. Foram determinadas a PCO2, PO2, SO2, pH, BE, HCO3 e TCO2, Na+, K+, iCa, Glicose, Hg e Ht. Foi utilizado ANOVA com medidas repetidas no tempo para comparações dos grupos e momentos (p<0,05). A HFL acometeu em grau leve (1-2) os animais de ambos os grupos com 8/8 (100%) no TR e 5/8 (62,5%) para o TE. Presença de secreção serosa na traqueia em 4/8 (50%) para ambos os grupos. A HPIE acometeu em grau leve (1-2) os animais de ambos os grupos com 4/8 (50%)...(resumo completo, clicar acesso eletrônico abaixo) / Abstract:The Three barrel competition requires of high performance athletic horses. The race more used in this modality and the Quarter Horse usually begins training very young. To have success, the animals must have high speed and acceleration, requiring high performance athletic horses. Reviews endoscopic reveal a high prevalence of diseases of the System Respiratory as Exercise induced pulmonary hemorrhage in Athletes horses. For allow evaluation of post airways of horses, an endoscopy provides evaluate a blood amount deposited in the airways after exercises. Associated with endoscopic examination a blood gas analysis has been widely used in order to identify the behavior of gas exchange in high-performance horses, beyond for understanding of the balance electrolyte and acid-base in the animals find, possessing great value for understanding metabolic disorders. The present study goal was to assess how Airway, the profile of blood gases, electrolytes, acid-base balance of horses submitted the Three barrel training. Sixteen horses divided into two groups of 8 animals, regular training (RT - 5 times) and sporadic training (ET - 2 times a week) were used in the experiment. Endoscopy was performed before and 90 min after training. They were held two blood samples by puncturing the transverse facial artery before heating (M0) and immediately after training (M1), and the readings were performed with the I-Stat®. They were determined PCO2, PO2, SO2, pH, BE, HCO3 and TCO2, Na +, K +, iCa, Glucose, Hg e Ht. It was used ANOVA with repeated measures over time for comparisons of groups and time (p <0.05). The HFL befell was mild (1-2) the animals from both groups with 8/8 (100%) in the TR and 5/8 (62.5%) for the TE. Presence of serous trachea 4/8 (50%) for both groups. The EIPH befell was mild (1-2) the animals from both groups with 4/8 (50%) in the RT group and 3/8 (37.5%) for the TE group. Animals with grade 2 EIPH had mild hypoxemia and hypercapnia after exercise / Orientador:Luiz Cláudio Nogueira Mendes / Banca:Pedro Vicente Michelotto Júnior / Banca:Rafael Resende Faleiros / Mestre

Transcutaneous oxygen pressure measurement (TCp02) using a miniaturised Clarke electrode and a heating thermistor was developed independently by Huch et al and Eberhardt et al in 1972. After its initial use to non invasively monitor arterial partial pressure (Pa02) in neonates it was proposed as a useful test of skin blood flow and possibly amputation wound healing level selection in patients with peripheral vascular disease. Unfortunately a wide range of predictive values emerged with some authors reporting amputations healing when the TCp02 value was 0 mmHg. The investigation, while still considered useful, has not gained widespread support. This study investigates the use of TCp02, establishes a value for the use of the TCp02 Index to predict amputation wound healing potential and examines the hypothesis that the use of the TcpO Index to select amputation level can reduce patient morbidity and mortality. The literature is reviewed and a series of studies evaluating TCp02 use, undertaken in the Durban Metropolitan Vascular Service Non-Invasive Laboratories, are presented. TCp02 measurements were performed in a standardised manner with the subject supine breathing room air. Measurements were taken at fixed sites, on the mid dorsum of the foot (Foot), 10 cm distal to the tibial tuberosity and 2 cm lateral to the anterior tibial margin (BKA), 10 cm proximal to the patella in the midline (AKA) and on the chest in the mid-clavicular line. A TCp02 Index, the limb to chest ratio was defined. TCp02 data derived from control subjects asymptomatic of peripheral vascular disease were shown to be similar to age matched pooled data derived from the literature. In patients with peripheral vascular disease, absolute TCp02 and the TCp02 Index were shown to fall from proximal to distal sites and again were no different to pooled data derived from the literature. Based on presenting symptoms, the fall in TCp02 and the TCp02 Index was significant from proximal to distal sites. The reduction in absolute TCp02 and the TCp02 was also related to the most distal pulse present. TCp02 values were found to be no different in patients with peripheral vascular disease with or without diabetes. When comparing TCp02 and the TCp02 Index with Doppler pressure measurements at the Popliteal artery and at the foot, and the Doppler ankle brachial index (ABI), Doppler derived data were significantly higher in diabetic patients than in non-diabetic patients. No differences were noted in TCp02 data. TCp02 was compared with the 133Xe radio-isotope skin washout test. The best correlation was (r = 0.46) was obtained with a logarithmic curve y = 10.862Ln(x) + 38.751. TCp02 was compared with antibiotic concentrations (Cefoxitin) in muscle obtained from the site of amputation and the Cefoxitin Index, the ratio of muscle antibiotic concentration to plasma concentration, as an indication of the relationship of skin TCp02 to muscle blood flow. A significant correlation was shown between the Cefoxitin Index and TCp02 (r = 0.67, p = 0.035) and the TCp02 Index (r = 0.64, P = 0.045), suggesting that skin oxygen delivery may reflect muscle antibiotic delivery and hence blood flow. TCp02 and the TCp02 Index were compared with heated and unheated laser Doppler fluxmetry (LDF) in 35 patients undergoing amputation wound healing assessment. Significant correlations were shown between heated LDF, heated LDF Index and the TCp02 Index (r = 0.63 and r = 0.69, P < 0.0001). TCp02 Index values of 0.5 and 0.55 showed an accuracy of 96.2 % in predicting amputation outcome while LDF values of 3, 4 and 5 arbitrary units gave an accuracy of 88.5 %. Using receiver operator curves, a TCp02 Index of 0.55 was shown to be the best test. Over the years 1987 and 1988, TCp02 data were gathered on 193 patients undergoing lower limb amputation for peripheral vascular disease. Information on the outcome of the amputation was available for 152 amputations. Circumstances which might result in a reduced pre-operative TCp02 reading were identified and criteria were set for the use of TCp02 to predict amputation wound healing potential. 122 amputations which met the defined entry criteria were available for evaluation. A TCp02 Index of 0.50 gave a definitive predictive value below which no amputation healed. Similarly no amputation with an absolute TCp02 of less than 27 mmHg healed. Receiver operator characteristic curves showed the TCp02 Index to be a better test than absolute TCp02. A TCp02 Index of 0.55 was shown to have the best sensitivity of96.7 %, with a specificity of79.8 % and an accuracy of 90.2 %. When introduced to clinical practice, correct use of the TCp02 Index of 0.55 resulted in a reduction in amputation revision rate from 40.3 % in 1987, to 8.2 % in 1990. Initially some surgeons felt that the TCp02 Index predicted amputation wound failure at distal sites at which healing could be expected on clinical criteria, and chose amputate at sites with a TCp02 Index value less than 0.55. These amputations failed to heal. As surgeons gained confidence in the test, they chose to follow the TCp02 data more often and the percentage of amputations performed at sites predicted by the TCp02 Index to fail , fell from 35.5 % in 1987 to 6.6 % in 1990. Over a 15 year period at King Edward VIII Hospital, the amputation revision rate has fallen from an average of 32.7 % in the first five years when Tcp02 data were not available to the surgeon, to 21.4 % and 22.9 % in the two subsequent 5 year periods when Tcp02 data were available. The mortality rates were unchanged. The decline in revision rates was less than expected and relates to the fact that approximately only 42 % of patients requiring amputation undergo the test. This is because it is time consuming and available only during weekday office hours. These studies have confirmed the usefulness of Tcp02 measurement in the non-invasive vascular laboratory. The index is shown to be superior to absolute Tcp02 as a predictive test of amputation wound healing. The introduction of several criteria to define when Tcp02 use is appropriate has refined the investigation and made it clinically useful in our setting. A Tcp02 Index of 0.55 in the appropriate patient is a useful test to predict amputation wound healing and its use has resulted in reduced patient morbidity and mortality, confirming the hypothesis tested. / Thesis (M.D.)-University of Natal, 2001.

Thesis (M.S.)--University of Michigan, 1980.

Thesis (Ph. D.)--University of Washington, 1999. / Vita. Includes bibliographical references (p. 436-460).

Thesis (M.S.)--University of Michigan, 1980.

Made available in DSpace on 2016-05-17T16:51:18Z (GMT). No. of bitstreams: 0 Previous issue date: 2015-08-07. Added 1 bitstream(s) on 2016-05-17T16:54:53Z : No. of bitstreams: 1 000863870.pdf: 1531300 bytes, checksum: a86cccb40bec9374840bbe5fa8ddde18 (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / The Three barrel competition requires of high performance athletic horses. The race more used in this modality and the Quarter Horse usually begins training very young. To have success, the animals must have high speed and acceleration, requiring high performance athletic horses. Reviews endoscopic reveal a high prevalence of diseases of the System Respiratory as Exercise induced pulmonary hemorrhage in Athletes horses. For allow evaluation of post airways of horses, an endoscopy provides evaluate a blood amount deposited in the airways after exercises. Associated with endoscopic examination a blood gas analysis has been widely used in order to identify the behavior of gas exchange in high-performance horses, beyond for understanding of the balance electrolyte and acid-base in the animals find, possessing great value for understanding metabolic disorders. The present study goal was to assess how Airway, the profile of blood gases, electrolytes, acid-base balance of horses submitted the Three barrel training. Sixteen horses divided into two groups of 8 animals, regular training (RT - 5 times) and sporadic training (ET - 2 times a week) were used in the experiment. Endoscopy was performed before and 90 min after training. They were held two blood samples by puncturing the transverse facial artery before heating (M0) and immediately after training (M1), and the readings were performed with the I-Stat®. They were determined PCO2, PO2, SO2, pH, BE, HCO3 and TCO2, Na +, K +, iCa, Glucose, Hg e Ht. It was used ANOVA with repeated measures over time for comparisons of groups and time (p <0.05). The HFL befell was mild (1-2) the animals from both groups with 8/8 (100%) in the TR and 5/8 (62.5%) for the TE. Presence of serous trachea 4/8 (50%) for both groups. The EIPH befell was mild (1-2) the animals from both groups with 4/8 (50%) in the RT group and 3/8 (37.5%) for the TE group. Animals with grade 2 EIPH had mild hypoxemia and hypercapnia after exercise / FAPESP: 2014/23012-7

O presente trabalho foi realizado com o objetivo de verificar alterações do estado ácido-básico metabólico de equinos antes e após atividade física de intensidade máxima (corrida) através do exame hemogasométrico. Avaliou-se, ainda, a confiabilidade deste exame para o sangue armazenado a 4ºC durante doze horas. Duas amostras de sangue venoso foram coletadas de quinze animais clinicamente sadios, sendo a primeira coleta realizada com o animal em repouso e a segunda após o término da prova, e as mesmas foram divididas em dois grupos: Grupo I (GI) – pré-corrida e Grupo II (GII) – pós-corrida. As amostras de sete animais foram avaliadas imediatamente após a coleta, enquanto as amostras de oito animais foram mantidas sob-refrigeração a 4ºC (dentro do refrigerador) durante doze horas antes de serem analisadas. O sangue foi analisado para verificar os valores de pH, pCO2, TCO2, HCO3, BE, pO2, sO2 e Lactato. Os resultados grupos foram comparados através da análise de variância. O Teste T de Student foi utilizado para uma comparação das médias das avaliações das amostras analisadas imediatamente ou doze horas após a coleta. Foram observadas diferenças estatísticas para todas as variáveis analisadas pré e pós-exercício, verificando-se valores significativamente menores para pH, pCO2, BE, HCO3 e TCO2, e valores significativamente maiores para sO2, pO2 e lactato nas amostras coletadas após a corrida em relação aos valores obtidos para as mesmas variáveis com os animais em repouso. Verificou-se, também, diferença significativa entre os resultados obtidos imediatamente após a coleta em relação àqueles encontrados nas amostras refrigeradas para todas as variáveis analisadas, tanto com os animais em repouso como após o exercício, exceto para a pCO2 após o exercício. Esses resultados indicam que o exercício físico, bem como o armazenamento das amostras de sangue, promovem alterações nos parâmetros avaliados no presente trabalho. / This study was carried out to verify changes in the metabolic acid-base status of equines before and after physical activity of maximum intensity (race) using blood gas analysis. We also evaluated the reliability of this test for the blood stored at 4 ° C for twelve hours. Two venous blood samples were collected from fifteen clinically healthy animals, the first collection with the animal at rest and the second after the race, and then divided into two groups: Group I (GI) - pre-race and group II (GII) - post-race. Samples of seven animals were evaluated immediately after collection, while samples from eight animals were kept under refrigeration at 4ºC (in a refrigerator) for twelve hours before being analyzed. The blood was analyzed to check pH, pCO2, TCO2, HCO3, BE, pO2, sO2 and lactate values. The results of the groups were compared by analysis of variance. Student's t test was used for comparison of the means of the evaluations of the samples analyzed immediately or twelve hours after collection. Statistical differences were observed for all variables analyzed before and after exercise, showing significantly lower values for pH, pCO2, BE, HCO3 and TCO2, and significantly higher values for sO2, pO2 and lactate in the samples collected after the race compared to the values obtained for the same variables with the animals at rest. There was also a significant difference between the results obtained immediately after collection compared to those found in the refrigerated samples for all analyzed variables, both with the animals at rest and after exercise, except for pCO2 after exercise. These results indicate that exercise and storage of blood samples promote changes in the parameters evaluated in this study.