Thomovsky Elizabeth J, Bach Jonathan
Department of Medical Science, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706.
J Am Vet Med Assoc. 2014 Jan 15;244(2):170-4. doi: 10.2460/javma.244.2.170.
To document the existence and incidence of acute lung injury (ie, veterinary acute lung injury [VetALI] per the 2007 consensus definition) in a population of client-owned dogs receiving transfusions for various clinical reasons.
Prospective observational study.
54 client-owned dogs.
Arterial blood gas analysis was performed for dogs receiving a transfusion (blood and plasma products) at 0 to 12 hours before and 24 to 48 hours after transfusion; dogs also underwent thoracic radiography 0 to 24 hours before and 24 to 48 hours after transfusion. The ratio of PaO2 to fraction of inspired oxygen (FIO2) was calculated. Dogs with posttransfusion radiographic signs of pulmonary infiltrates, a PaO2:FIO2 ratio < 300, or clinical signs of respiratory compromise were suspected of having VetALI and underwent echocardiography to exclude left-sided heart failure. The incidence of VetALI was calculated, and χ(2) tests were used to compare the incidence in study dogs with the historical reported incidence of acute respiratory distress syndrome (ARDS) in ill dogs (not receiving transfusions) and transfusion-related acute lung injury (TRALI) in humans.
The incidence of VetALI (2/54 [3.7%]; 95% confidence interval, 0% to 8.73%) in study dogs was significantly less than the reported incidence of TRALI in humans (25%) and not significantly different from the reported incidence of ARDS in ill dogs (10%).
VetALI occurred in dogs that received transfusions at a frequency similar to that previously reported for ARDS in ill dogs that did not receive transfusions.
记录因各种临床原因接受输血的宠物犬群体中急性肺损伤(即根据2007年共识定义的兽医急性肺损伤[VetALI])的存在情况和发生率。
前瞻性观察性研究。
54只宠物犬。
对接受输血(血液和血浆制品)的犬在输血前0至12小时和输血后24至48小时进行动脉血气分析;犬在输血前0至24小时和输血后24至48小时也进行胸部X线摄影。计算动脉血氧分压(PaO2)与吸入氧分数(FIO2)的比值。输血后出现肺部浸润的X线征象、PaO2:FIO2比值<300或有呼吸功能不全临床体征的犬被怀疑患有VetALI,并接受超声心动图检查以排除左心衰竭。计算VetALI的发生率,并使用χ²检验比较研究犬的发生率与患病犬(未接受输血)中急性呼吸窘迫综合征(ARDS)的历史报道发生率以及人类输血相关急性肺损伤(TRALI)的发生率。
研究犬中VetALI的发生率(2/54 [3.7%];95%置信区间,0%至8.73%)显著低于人类TRALI的报道发生率(25%),且与患病犬中ARDS的报道发生率(10%)无显著差异。
接受输血的犬中发生VetALI的频率与先前报道的未接受输血的患病犬中ARDS的频率相似。