自体输血治疗犬胸腹出血25例(2007-2012)

Veronica A Higgs, Elke Rudloff, Rebecca Kirby, Andrew K J Linklater
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引用次数: 28

摘要

目的:探讨犬自体输血(ABT)的应用及预后。设计:回顾性研究(2007年1月- 2012年7月)。环境:私人兽医转诊中心。动物:25只狗接受了继发于胸部或腹部出血的ABT。干预措施:没有。测量结果及主要结果:2007年1月至2012年7月,以“自体输血”为关键词检索医院交易数据库。收集的数据包括信号、体重、出血的病因、收集来源和方法、血容量和给药方法、抗凝剂的使用、报告的并发症和转归。25只犬共27次ABTs。出血的原因包括血管损伤(14/25,56%)、肿瘤破裂(8/25,32%)和溴法菌中毒引起的凝血功能障碍(3/25,12%)。从腹腔(19/ 25,76%)、胸腔(5/ 25,20%)或腹腔和胸腔(1/ 25,4%)采集自体血液。25例ABT患者中有13例(52%)添加抗凝剂。通过210 μm血药过滤器(21/ 27,78%)或18 μm血药过滤器(6/ 27,22%)输注ABT的中位体积为29.3 mL/kg(范围2.9-406.9 mL/kg)。报道的可能与ABT相关的并发症包括低钙血症(4/17,24%)、血清溶血(5/19,26%)和凝血时间延长(4/5,80%)。这些并发症被认为没有什么临床意义。25只狗中有17只(68%)接受了额外的血液制品。17只(68%)存活出院。其余病例的死亡原因为安乐死或继发于无法控制的出血的心脏骤停。结论:对于因血管损伤、肿瘤破裂或抗凝剂灭鼠剂中毒而继发胸腔或腹腔出血的犬,ABT是容量置换的辅助治疗。ABT可作为最终出血控制的桥梁,特别是在没有其他血液制品或负担不起的情况下。并发症可能包括低钙血症、凝血时间延长和溶血。
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Autologous blood transfusion in dogs with thoracic or abdominal hemorrhage: 25 cases (2007-2012).

Objective: To describe the use and outcome following autologous blood transfusion (ABT) in dogs.

Design: Retrospective study (January 2007-July 2012).

Setting: Private veterinary referral center.

Animals: Twenty-five dogs that underwent ABT secondary to thoracic or abdominal hemorrhage.

Interventions: None.

Measurements and main results: The hospital transaction database was searched using the keyword "autotransfusion" from January 2007 to July 2012. Data collected included signalment, body weight, etiology of hemorrhage, source and method of collection, volumes and method of ABT administration, use of anticoagulant, reported complications, and outcome. Twenty-five dogs were included for a total of 27 ABTs. Causes of hemorrhage included vascular trauma (14/25 dogs, 56%), ruptured tumor (8/25, 32%), and coagulopathy attributed to brodifacoum toxicosis (3/25, 12%). Autologous blood was collected from the abdominal (19/25, 76%), thoracic (5/25, 20%), or abdominal and thoracic cavities (1/25, 4%). Anticoagulant was added to the ABT blood in 13 of 25 (52%) cases. A median ABT volume of 29.3 mL/kg (range 2.9-406.9 mL/kg) was infused through either a 210 μm blood administration filter (21/27, 78%) or an 18 μm hemonate filter (6/27, 22%). Reported complications that may have been associated with ABT included hypocalcemia (4/17, 24%), hemolyzed serum (5/19, 26%), and prolonged coagulation times (4/5, 80%). These complications were considered of minimal clinical significance. Additional blood products were administered in 17 of 25 (68%) dogs. Seventeen (68%) dogs survived to discharge. Cause of death in the remaining cases was euthanasia or cardiac arrest secondary to uncontrollable hemorrhage.

Conclusions: ABT is an adjunct to volume replacement in dogs with thoracic or abdominal hemorrhage secondary to vascular trauma, ruptured tumor, or anticoagulant rodenticide toxicosis. ABT may be used as bridge to definitive hemorrhage control, particularly when other blood products are not available or affordable. Complications may include hypocalcemia, prolonged coagulation times, and hemolysis.

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