一项比较骨髓抽吸和静脉血在健康狗的紧急护理点血液参数的初步研究。

Lindsey Ackert, Søren R Boysen, Teresa Schiller
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引用次数: 2

摘要

目的:比较兽医院使用即时诊断设备进行静脉和骨内吸血的情况。设计:前瞻性研究。环境:私人转诊医院。动物:接受胫骨平台平截骨或囊外前交叉韧带稳定手术的狗被纳入研究。方法:全身麻醉下,颈静脉和胫骨近端同时采血0.5 mL。在采集后10分钟内对样品进行一式两份的评估,并对以下各项参数取平均值:血尿素氮(BUN)、葡萄糖、堆积细胞体积、血浆总蛋白(TPP)、血浆乳酸、钠、钾、氯化物、尿素、葡萄糖、pH、阴离子间隙、pO2和pCO2。用柯尔莫戈洛夫-斯米尔诺夫试验检测正常。采用学生t检验和Bland-Altman图比较静脉注射和骨内样本。结果:12只狗被招募到研究中。钠(P = 0.0216)、氯(P = 0.0225)、尿素氮(P = 0.014)、钾(P < 0.0001)在静脉和骨内标本中的含量差异有统计学意义。其他参数的评估没有发现显著差异。讨论:骨内空间为评估血液参数提供了一个容易接近的、不可折叠的选择。如果不考虑钾元素,不同部位之间的统计学差异并不具有临床意义。虽然统计上不显著,但红细胞压积值的巨大差异表明样品不应互换使用。结论:骨内吸液,不包括钾和红细胞压积,似乎是评估健康犬大多数护理点分析物的可靠选择,尽管需要调查更大的样本量。这些数据在休克患者中的应用尚不清楚。
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A pilot study comparing bone marrow aspirates and venous blood for emergency point-of-care blood parameters in healthy dogs.

Objective: To compare intravenous and intraosseous blood aspirates using point-of-care diagnostic equipment available in veterinary hospitals.

Design: Prospective study.

Setting: Private referral hospital.

Animals: Dogs undergoing a tibial plateau leveling osteotomy or extracapsular anterior cruciate ligament stabilization procedure were enrolled.

Methods: Under general anesthesia, simultaneous 0.5 mL intravenous and intraosseous blood samples were collected from the jugular vein and proximal tibia, respectively. Samples were evaluated in duplicate within 10 minutes of collection and averaged for each of the following parameters: blood urea nitrogen (BUN), glucose, packed cell volume, total plasma protein (TPP), plasma lactate, sodium, potassium, chloride, urea, glucose, pH, anion gap, pO2, and pCO2 . Normalcy was tested with Kolmogorov-Smirnov test. A Student's t-test and Bland-Altman plot were used to compare intravenous and intraosseous samples.

Results: Twelve dogs were recruited into the study. There were statistically significant differences between intravenous and intraosseous samples for sodium (P = 0.0216), chloride (P = 0.0225), BUN (P = 0.014), and potassium (P < 0.0001), respectively. No significant differences were detected for the other parameters evaluated.

Discussion: The intraosseous space provides an easily accessible, noncollapsible alternative for assessing blood parameters. Omitting potassium, the statistically significant differences noted between sites was not felt to be clinically significant. Although statistically insignificant, the large difference in hematocrit values indicates that the samples should not be used interchangeably.

Conclusion: Intraosseous aspirates, excluding potassium and hematocrit, appear to be a reliable alternative for assessing most point-of-care analytes in healthy dogs, although a larger sample size should be investigated. The application of these data in shock patients is unknown.

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