一项初步研究评估储存前白细胞减少对接受输血的危重犬炎症标志物的影响。

Luis Bosch Lozano, Shauna L Blois, R Darren Wood, Anthony C G Abrams-Ogg, Alexa M Bersenas, Shane W Bateman, Danielle M Richardson
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引用次数: 8

摘要

目的:比较需要输血的危重犬在输注白细胞减少(LR)红细胞(prbc)和非LR红细胞(prbc)后的炎症标志物,并报告这些犬的出院存活率和输注反应率。设计:前瞻性随机盲法临床研究2014 / 6 - 2015 / 9。单位:大学兽医教学医院。动物:连续入选23只客户拥有的危重犬。干预措施:需要单次pRBC输血的狗被随机分为LR组和非LR组。排除标准包括:需要多种血液制品,既往输血史,入组前使用抗炎或免疫抑制药物。测量方法:输血前立即采集血样,输血后2小时和24小时采集血样。在每个时间点测量的参数包括:PCV、WBC计数、节段性和带状中性粒细胞计数、纤维蛋白原、血浆乳酸和c反应蛋白浓度。入院时计算急性患者生理及实验室评价快速评分。结果:LR组11只,非LR组12只;两组间疾病严重程度评分无显著差异。在pRBC输注24小时后,非LR组的WBC总数明显高于LR组,但在输注2小时后,这种差异不明显。在任何时间点,LR和非LR pRBC输注的狗之间没有其他炎症参数显着差异。LR组和非LR组的出院生存率分别为8/11和9/12。在LR组和非LR组中,分别有1/11和2/12只狗出现急性输血反应。所有输血血均保存≤12天。结论:与储存≤12天的非LR红细胞相比,在输注LR红细胞后,大多数炎症标志物没有显著增加。需要在临床患病犬中进行进一步的前瞻性随机试验,以确定储存前白细胞减少的益处。
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A pilot study evaluating the effects of prestorage leukoreduction on markers of inflammation in critically ill dogs receiving a blood transfusion.

Objectives: To compare markers of inflammation after transfusion of leukoreduced (LR) packed RBCs (pRBCs) versus non-LR pRBCs in dogs with critical illness requiring blood transfusion, and to report survival to discharge and rates of transfusion reactions in these dogs.

Design: Prospective randomized blinded clinical study June 2014-September 2015.

Setting: University veterinary teaching hospital.

Animals: Twenty-three client-owned critically ill dogs, consecutively enrolled.

Interventions: Dogs requiring a single pRBC transfusion were randomized into the LR or non-LR pRBC group. Exclusion criteria included: requirement for multiple blood products, history of previous blood transfusion, and administration of anti-inflammatory or immunosuppressive medication prior to enrollment.

Measurements: Blood samples were obtained immediately prior to transfusion, then 2 and 24 hours following transfusion. Parameters measured at each time point included: PCV, WBC count, segmented and band neutrophil counts, fibrinogen, and plasma lactate and C-reactive protein concentrations. Acute patient physiologic and laboratory evaluation fast score was calculated on admission.

Results: Eleven dogs were included in the LR group and 12 in the non-LR group; scores of illness severity were not significantly different between groups. Total WBC count was significantly higher in the non-LR versus LR group 24 hours following pRBC transfusion, but this difference was not evident 2 hours following transfusion. No other inflammatory parameters at any time point were significantly different between LR versus non-LR pRBC transfused dogs. Survival rates to discharge for LR and non-LR groups were 8/11 and 9/12, respectively. Acute transfusion reactions were identified in 1/11 and 2/12 dogs in the LR and non-LR group, respectively. All transfused blood was stored ≤12 days.

Conclusions: Most markers of inflammation did not significantly increase following transfusion of LR versus non-LR pRBCs stored ≤12 days in ill dogs. Further prospective, randomized trials are needed in clinically ill dogs to determine the benefit of prestorage leukoreduction.

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