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犬贫冷沉淀血浆、冷沉淀和新鲜冰冻血浆中白蛋白、胶体渗透压、血管性血友病因子及凝血因子的比较。

Comparison of albumin, colloid osmotic pressure, von Willebrand factor, and coagulation factors in canine cryopoor plasma, cryoprecipitate, and fresh frozen plasma.

作者信息

Culler Christine A, Iazbik Cristina, Guillaumin Julien

机构信息

Department of Veterinary Clinical Sciences, The Ohio State University Veterinary Medical Center, Columbus, OH 43210.

出版信息

J Vet Emerg Crit Care (San Antonio). 2017 Nov;27(6):638-644. doi: 10.1111/vec.12671. Epub 2017 Oct 24.

Abstract

OBJECTIVE

To compare albumin concentrations, coagulation factors activity, and colloid osmotic pressure (COP) of cryoprecipitate (CRYO) and cryopoor plasma (CPP) to that of source fresh frozen plasma (FFP).

DESIGN

Prospective in vitro study.

SETTING

University teaching hospital.

ANIMALS

Ten healthy, non-Greyhound dogs enrolled in an academic teaching hospital blood donor program.

INTERVENTIONS

Fresh blood was obtained from canine blood donors and separated into FFP and packed red blood cells. The source FFP was further separated into CRYO and CPP. Albumin and fibrinogen concentrations, COP, activities of coagulation factors II, V, VII, VIII, IX, X, and von Willebrand factor (vWf) were assessed for each FFP, CRYO, and CPP.

MEASUREMENTS AND MAIN RESULTS

The mean albumin concentration and COP in CPP were significantly higher compared with those found in FFP, with 31.7 g/L (±6) in CPP compared to 28.9 g/L (±0.5) in FFP (P < 0.001) and 14.5 mm Hg (±0.7) in CPP compared to 12.7 mm Hg (±0.3) in FFP (P = 0.03), respectively. CRYO had significantly higher concentrations of fibrinogen (median 3.46 g/L, 95% CI 2.65-4.27), and higher activities of factor VIII (mean activity 427.0%, ±95.4) and vWf (mean activity 504.7%, ±41.39) as compared to the other products. The activities of vitamin K dependent factors II, VII, and X were similar in CPP compared to FFP, although factor IX activity was lower in CPP. There was no significant difference in factor II or VII activities between the 3 products.

CONCLUSIONS

The mean albumin concentration and COP were highest in CPP, suggesting that CPP may be a potential alternative to FFP for oncotic support and albumin replacement. CRYO contained higher activities of vWf and factor VIII than other products and could be used to treat vWf deficiency and hemophilia A. As vitamin K dependent coagulation factors II, VII, and X in CPP were similar to FFP, CPP may be an option for replacement of most of vitamin K dependent factors.

摘要

目的

比较冷沉淀(CRYO)和少冷沉淀血浆(CPP)与来源新鲜冰冻血浆(FFP)的白蛋白浓度、凝血因子活性及胶体渗透压(COP)。

设计

前瞻性体外研究。

地点

大学教学医院。

动物

10只健康的非灵缇犬,参与一所大学教学医院的献血项目。

干预措施

从犬类献血者获取新鲜血液,分离为FFP和浓缩红细胞。将来源FFP进一步分离为CRYO和CPP。对每份FFP、CRYO和CPP评估白蛋白和纤维蛋白原浓度、COP以及凝血因子II、V、VII、VIII、IX、X和血管性血友病因子(vWf)的活性。

测量指标及主要结果

CPP中的平均白蛋白浓度和COP显著高于FFP,CPP中为31.7 g/L(±6),FFP中为28.9 g/L(±0.5)(P < 0.001);CPP中为14.5 mmHg(±0.7),FFP中为12.7 mmHg(±0.3)(P = 0.03)。与其他制品相比,CRYO的纤维蛋白原浓度显著更高(中位数3.46 g/L,95%CI 2.65 - 4.27),因子VIII活性更高(平均活性427.0%,±95.4),vWf活性更高(平均活性504.7%,±41.39)。与FFP相比,CPP中维生素K依赖因子II、VII和X活性相似,尽管CPP中因子IX活性较低。三种制品之间因子II或VII活性无显著差异。

结论

CPP中的平均白蛋白浓度和COP最高,提示CPP可能是用于胶体渗透压支持和白蛋白替代的FFP潜在替代品。CRYO所含vWf和因子VIII活性高于其他制品,可用于治疗vWf缺乏症和甲型血友病。由于CPP中维生素K依赖凝血因子II、VII和X与FFP相似,CPP可能是替代大多数维生素K依赖因子的一个选择。

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