Garcia-Pereira Brandi L, Scott Michael A, Koenigshof Amy M, Brown Andrew J
Departments of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA.
J Vet Emerg Crit Care (San Antonio). 2012 Apr;22(2):225-9. doi: 10.1111/j.1476-4431.2012.00724.x. Epub 2012 Apr 5.
To determine if the quality of venipuncture impacts thromboelastography (TEG) results and if an initial discard tube mitigates any effects of traumatic venipuncture.
Prospective, observational study.
Veterinary teaching hospital.
Fifteen privately owned and research colony adult dogs.
Samples were collected from each jugular vein using 1 of 2 venipuncture techniques per vein. The venipuncture technique was randomized to the vein as follows: (1) "clean" venipuncture (CV) from 1 jugular vein, and (2) suboptimal venipuncture (SOV) from the opposite jugular vein. CV was defined as a direct entry into the vein on the first attempt. SOV was defined as needle insertion adjacent to the vein with redirection at least once to enter the vein. Two consecutive samples were collected from each venipuncture without removal of the needle, yielding 4 samples: CV1, CV2, SOV1, and SOV2. TEG was performed on each blood sample and the TEG parameters R, K, α, and MA were recorded.
Mean ± SD of R for the SOV1 group (4.1 ± 1.3 s) was significantly shorter than that of the CV1 group (5.7 ± 1.4 s) and the SOV2 group (5.5 ± 1.9 s), P< 0.05. There was no difference in R between CV1 and CV2 groups, or between SOV2 and either CV1 or CV2. There was no significant difference in α, K, or MA among groups.
Mild-to-moderate venipuncture trauma had little effect on TEG overall, but R was significantly affected. Poorer quality collection resulted in a more rapid initiation of clot formation. However, the effect was mild and mitigated by testing samples in a second collection tube after discard of an initial sample.
确定静脉穿刺质量是否会影响血栓弹力图（TEG）结果，以及初始弃血试管是否能减轻创伤性静脉穿刺的任何影响。
前瞻性观察研究。
兽医教学医院。
15只私人拥有的和研究群体中的成年犬。
每只静脉使用两种静脉穿刺技术中的一种从每条颈静脉采集样本。静脉穿刺技术随机分配到静脉如下：（1）从一条颈静脉进行“清洁”静脉穿刺（CV），（2）从对侧颈静脉进行次优静脉穿刺（SOV）。CV定义为首次尝试时直接进入静脉。SOV定义为在静脉旁插入针头并至少重新定向一次以进入静脉。从每次静脉穿刺中不拔出针头连续采集两个样本，得到4个样本：CV1、CV2、SOV1和SOV2。对每个血样进行TEG检测并记录TEG参数R、K、α和MA。
SOV1组的R平均值±标准差（4.1±1.3秒）显著短于CV1组（5.7±1.4秒）和SOV2组（5.5±1.9秒），P<0.05。CV1组和CV2组之间，或SOV2组与CV1组或CV2组之间的R无差异。各组之间的α、K或MA无显著差异。
轻度至中度静脉穿刺创伤总体上对TEG影响不大，但R受到显著影响。采集质量较差导致凝血形成启动更快。然而，这种影响很轻微，并且通过在丢弃初始样本后在第二个采集试管中检测样本而减轻。
