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健康和危重病成年马匹颈静脉和横面部静脉窦血液分析物的比较。

Comparison of jugular and transverse facial venous sinus blood analytes in healthy and critically ill adult horses.

作者信息

Lascola Kara M, Vander Werf Karie, Freese Stephanie, Morgera Alison, Schaeffer David J, Wilkins Pamela

机构信息

Department of Veterinary Clinical Medicine, University of Illinois, Urbana, IL, 61802.

出版信息

J Vet Emerg Crit Care (San Antonio). 2017 Mar;27(2):198-205. doi: 10.1111/vec.12588. Epub 2017 Feb 16.

Abstract

OBJECTIVE

To compare blood gas, electrolyte, and metabolic analysis results between blood obtained by jugular and transverse facial venous sinus (TFVS) venipuncture in healthy adult horses and sick adult horses presented for emergency evaluation.

DESIGN

Prospective, experimental study, from June 2012 to October 2013.

SETTING

Large animal university teaching hospital.

ANIMALS

Ten healthy adult University-owned horses and 48 client-owned adult horses (≥2 years old) presenting to the large animal hospital emergency service for medical or surgical evaluation of systemic illness.

INTERVENTIONS

Venipunctures (jugular vein [JV] and TFVS) were performed using preheparinized syringes and obtained prior to institution of medical therapy. Samples were analyzed in random order within a 10-minute interval using a point-of-care blood gas analyzer (NOVA Critical Care Xpress) that also reports electrolyte and metabolite results. Comparisons between venipuncture sites were analyzed using the Student's paired t-test for normally distributed data and the Wilcoxon paired test for nonnormally distributed data. Bland-Altman analysis was used to assess agreement between venipuncture sites.

MEASUREMENTS AND MAIN RESULTS

There were no statistically significant differences found between variables for JV and TFVS in healthy horses. In sick horses, JV measurements were greater than TFVS for ionized calcium (P = 0.002) and glucose (P = 0.001), and less than TFVS for hematocrit (P = 0.015). Bland-Altman plots demonstrated small biases but overall agreement between sites.

CONCLUSIONS

The TFVS can be used interchangeably with JV for venous blood gas analysis in healthy horses. In sick horses, identified differences were small and likely not clinically important. The reliability of this point-of-care blood gas analyzer for measurement of hematocrit remains to be determined.

摘要

目的

比较健康成年马和因紧急评估而就诊的患病成年马经颈静脉和横面静脉窦(TFVS)静脉穿刺采集的血液的血气、电解质及代谢分析结果。

设计

2012年6月至2013年10月的前瞻性实验研究。

地点

大型动物大学教学医院。

动物

10匹健康的成年大学自有马以及48匹客户拥有的成年马(≥2岁),这些马因全身疾病的医疗或手术评估而前往大型动物医院急诊室就诊。

干预措施

使用预肝素化注射器进行静脉穿刺(颈静脉[JV]和TFVS),并在开始药物治疗前采集血液样本。样本在10分钟内随机顺序使用即时血气分析仪(NOVA Critical Care Xpress)进行分析,该分析仪还可报告电解质和代谢物结果。静脉穿刺部位之间的比较采用Student配对t检验分析正态分布数据,采用Wilcoxon配对检验分析非正态分布数据。采用Bland-Altman分析评估静脉穿刺部位之间的一致性。

测量指标及主要结果

健康马中,JV和TFVS的各项变量之间未发现统计学上的显著差异。在患病马中,JV测量的离子钙(P = 0.002)和葡萄糖(P = 0.001)高于TFVS,而血细胞比容低于TFVS(P = 0.015)。Bland-Altman图显示偏差较小,但各部位总体一致。

结论

在健康马中,TFVS可与JV互换用于静脉血气分析。在患病马中,所发现的差异较小,可能在临床上并不重要。这种即时血气分析仪测量血细胞比容的可靠性仍有待确定。

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