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术前用药及其他因素对犬急性输血反应发生情况的影响。

Effect of premedication and other factors on the occurrence of acute transfusion reactions in dogs.

作者信息

Bruce Joshua A, Kriese-Anderson Lisa, Bruce Ashley M, Pittman Jennifer R

机构信息

Georgia Veterinary Specialists, Atlanta, GA, 30328.

Department of Animal Science, Auburn University, Auburn, AL, 36849.

出版信息

J Vet Emerg Crit Care (San Antonio). 2015 Sep-Oct;25(5):620-30. doi: 10.1111/vec.12327. Epub 2015 Jun 24.

Abstract

OBJECTIVE

To evaluate the effect of premedication on transfusion reactions (TRs) within 24 hours after blood product transfusions in dogs.

DESIGN

Retrospective study between 2008 and 2011.

SETTING

Private veterinary referral hospital.

ANIMALS

Nine hundred and thirty-five transfusion events in 558 dogs.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Medical records of dogs receiving blood product transfusions were reviewed. Information collected included signalment, weight, transfusion product type, reason for transfusion, first or subsequent transfusion, whether an acute reaction occurred, type of reaction, whether the reaction was treated, premedication prior to the transfusion and the premedication used, other medications the animal was given, whether the animal had an immune-mediated process, and whether the transfusion was administered in the perioperative period. A total of 144 (15%) acute TRs were documented in 136 dogs. The most common TRs were fever alone (77/144 [53%]) and vomiting alone (26/144 [18%]). Six dogs died due to the TR (4%). TR was not associated with age (P = 0.257), sex (P = 0.754), weight (P = 0.829), or premedication (P = 0.312). The type of blood product transfused (P < 0.001) was significantly associated with TRs, with packed RBCs most likely associated with a TR, and plasma least likely. Immune disease (P = 0.015) was significantly associated with occurrence of a TR. Significantly fewer reactions were documented following transfusions given in the perioperative period (P = 0.023).

CONCLUSIONS

While most TRs were mild, there were some serious reactions observed including hemolysis, dyspnea, and 6 deaths. Immune-mediated disease was associated with development of a TR, while transfusion during the perioperative period was associated with lower likelihood of reaction. Packed RBC transfusions were associated with development of acute TRs. Overall occurrence of TR was not significantly altered with premedication; however, when evaluated alone, antihistamines decreased the incidence of acute allergic reactions.

摘要

目的

评估术前用药对犬类血液制品输注后24小时内输血反应(TRs)的影响。

设计

2008年至2011年的回顾性研究。

地点

私立兽医转诊医院。

动物

558只犬的935次输血事件。

干预措施

无。

测量指标及主要结果

回顾接受血液制品输注犬的病历。收集的信息包括特征、体重、输血产品类型、输血原因、首次或后续输血、是否发生急性反应、反应类型、反应是否得到治疗、输血前的术前用药及所用药物、动物接受的其他药物、动物是否有免疫介导过程以及输血是否在围手术期进行。共记录到136只犬发生144次(15%)急性TRs。最常见的TRs是单纯发热(77/144 [53%])和单纯呕吐(26/144 [18%])。6只犬因TR死亡(4%)。TR与年龄(P = 0.257)、性别(P = 0.754)、体重(P = 0.829)或术前用药(P = 0.312)无关。输注的血液制品类型(P < 0.001)与TRs显著相关,浓缩红细胞最易引发TRs,血浆引发的可能性最小。免疫疾病(P = 0.015)与TRs的发生显著相关。围手术期输血后记录到的反应明显较少(P = 0.023)。

结论

虽然大多数TRs较轻微,但观察到一些严重反应,包括溶血、呼吸困难和6例死亡。免疫介导疾病与TRs的发生有关,而围手术期输血与较低的反应可能性有关。浓缩红细胞输血与急性TRs的发生有关。术前用药总体上未显著改变TRs的发生率;然而,单独评估时,抗组胺药可降低急性过敏反应的发生率。

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