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对有出血临床症状的血小板减少症犬使用新鲜血小板浓缩液或冻干血小板:37只犬的初步试验

Use of fresh platelet concentrate or lyophilized platelets in thrombocytopenic dogs with clinical signs of hemorrhage: a preliminary trial in 37 dogs.

作者信息

Davidow Elizabeth B, Brainard Benjamin, Martin Linda G, Beal Matthew W, Bode Arthur, Ford Michael J, Ramsey Noel, Fagella Alicia, Jutkowitz Ari

机构信息

Animal Critical Care and Emergency Services, Seattle, WA 98125, USA.

出版信息

J Vet Emerg Crit Care (San Antonio). 2012 Feb;22(1):116-25. doi: 10.1111/j.1476-4431.2011.00710.x.

Abstract

OBJECTIVE

To examine the safety and feasibility of using lyophilized platelets (LYO) and fresh platelet concentrate (FRESH) in bleeding thrombocytopenic dogs.

DESIGN

Preliminary prospective randomized clinical trial.

SETTING

Two private referral centers and 3 university teaching hospitals.

ANIMALS

Thirty-seven dogs with a complaint of hemorrhage associated with thrombocytopenia (platelet count <70 × 10(9) /L [70,000/μL], a hematocrit >15%, and that had received neither vincristine nor platelet-containing transfusions within 72 h of enrollment were studied.

INTERVENTIONS

Animals were randomized to receive LYO or FRESH, dosed according to weight. Physical examination, complete blood counts, and coagulation testing (prothrombin time and activated partial thromboplastin time) were performed at enrollment. Physical examinations were also performed immediately post transfusion, and at 1 and 24 h after transfusion. Complete blood counts were repeated immediately post transfusion and at 24 h. Collected data included bleeding score (BLS), response to transfusion, adverse reactions, hospitalization time, need for additional transfusions, survival to discharge, and 28-d survival.

MEASUREMENTS AND MAIN RESULTS

Twenty-two dogs received LYO and 15 received FRESH. There was no difference between groups in age, weight, BLS, platelet count, white blood cell count, hematocrit, or presence of melena. There was no difference between groups in transfusion reaction rates, the need for additional transfusions, 24-h BLS, hospitalization time, survival to discharge, or 28-d survival.

CONCLUSIONS

Transfusion of LYO was feasible and associated with a low transfusion reaction rate in this limited study of thrombocytopenic canine patients presenting with mild-to-severe hemorrhage. LYO were easy to use and provided storage advantages over FRESH. Further study of this product, including examination of efficacy and platelet life span, is warranted.

摘要

目的

研究冻干血小板(LYO)和新鲜血小板浓缩液(FRESH)用于血小板减少性出血犬的安全性和可行性。

设计

初步前瞻性随机临床试验。

地点

两家私立转诊中心和三家大学教学医院。

动物

37只主诉有与血小板减少相关出血的犬(血小板计数<70×10⁹/L[70,000/μL],血细胞比容>15%,且在入组72小时内未接受过长春新碱或含血小板输血)被纳入研究。

干预措施

动物被随机分为接受LYO或FRESH组,根据体重给药。入组时进行体格检查、全血细胞计数和凝血检测(凝血酶原时间和活化部分凝血活酶时间)。输血后立即、输血后1小时和24小时也进行体格检查。输血后立即和24小时重复全血细胞计数。收集的数据包括出血评分(BLS)、输血反应、不良反应、住院时间、额外输血需求、出院生存率和28天生存率。

测量指标和主要结果

22只犬接受LYO,15只接受FRESH。两组在年龄、体重、BLS、血小板计数、白细胞计数、血细胞比容或是否有黑便方面无差异。两组在输血反应率、额外输血需求、24小时BLS、住院时间、出院生存率或28天生存率方面无差异。

结论

在这项对出现轻至重度出血的血小板减少犬患者的有限研究中,输注LYO是可行的,且输血反应率低。LYO易于使用,与FRESH相比具有储存优势。有必要对该产品进行进一步研究,包括疗效和血小板寿命的检查。

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