对低白蛋白血症犬以恒速输注羟乙基淀粉（130/0.4）后止血功能的血栓弹力图评估。
Thromboelastometric assessment of hemostasis following hydroxyethyl starch (130/0.4) administration as a constant rate infusion in hypoalbuminemic dogs.
作者信息
Botto Angelica, Bruno Barbara, Maurella Cristiana, Riondato Fulvio, Tarducci Alberto, Mengozzi Giulio, Borrelli Antonio
机构信息
Department of Veterinary Science, University of Turin, Largo Paolo Braccini n°2-5, 10095, Grugliasco, TO, Italy.
Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, via Bologna 148, 10154, Torino, Italy.
出版信息
BMC Vet Res. 2018 Jan 31;14(1):33. doi: 10.1186/s12917-018-1357-8.
BACKGROUND
The primary aim was to evaluate by means of thromboelastometry (ROTEM) the effects of hydroxyethyl starch (HES) 130/0.4 administered as a constant rate infusion (CRI) on hemostasis in hypoalbuminemic dogs. The second aim was to use ROTEM analysis to detect whether all hypoalbuminemic dogs of our population were hypercoagulable.
RESULTS
The study sample was 20 hypoalbuminemic dogs (albumin < 2 g/dl) with normal perfusion parameters and requiring intravenous fluid therapy. In order to support plasma colloid osmotic pressure, in addition to crystalloid, HES 130/0.4 was administered as a constant rate infusion at 1 ml/kg/h (group 1, n = 11) or 2 ml/kg/h for 24 h (group 2, n = 9). Blood samples were collected at baseline (T0) and 24 h postinfusion (T1); coagulation was assessed by standard coagulation profile (prothrombin time, activated partial thromboplastin time, and fibrinogen), and ROTEM analysis (in-TEM®, ex-TEM® and fib- TEM® profile). No statistically significant differences in ROTEM values in group 1 were observed (P > 0.05), whereas in group 2 statistically significant differences (P < 0.05) were found at T1 in the in-TEM® profile [decrease in clot formation time (P = 0.04) and increase in α angle (P = 0.02)] and in the ex-TEM® profile [increase in maximum clot firmness (P = 0.008) and α angle (P = 0.01)]; no changes were identified in the fib-TEM® profile. In both groups, a statistically significant decrease (P = 0.007) in hematocrit was noted, whereas no statistically significant differences in platelet count and standard coagulation profile were found. In group 2, a statistically significant increase in TS values (P = 0.03) was noted at T1. ROTEM tracings indicating a hypercoagulable state were observed in 7/20 dogs at T0 (5/11 in group 1 and 2/9 in the group 2).
CONCLUSION
Our findings suggest that HES 130/0.4 administered as CRI does not cause hypocoagulability in hypoalbuminemic dogs. A trend toward hypercoagulability, probably related to the underlying diseases, was observed in group 2 at T1. Although all dogs were hyoalbuminemic, only 7/20 were hypercoagulable at T0, confirming the lack of correlation between albumin level and prothrombotic state.
背景
主要目的是通过血栓弹力图（ROTEM）评估以恒速输注（CRI）方式给予羟乙基淀粉（HES）130/0.4对低白蛋白血症犬止血功能的影响。第二个目的是使用ROTEM分析检测我们研究群体中所有低白蛋白血症犬是否存在高凝状态。
结果
研究样本为20只灌注参数正常且需要静脉输液治疗的低白蛋白血症犬（白蛋白<2g/dl）。为了维持血浆胶体渗透压，除晶体液外，HES 130/0.4以1ml/kg/h的恒速输注给药（第1组，n = 11）或2ml/kg/h持续输注24小时（第2组，n = 9）。在基线（T0）和输注后24小时（T1）采集血样；通过标准凝血指标（凝血酶原时间、活化部分凝血活酶时间和纤维蛋白原）以及ROTEM分析（内源性凝血酶形成时间（in-TEM®）、外源性凝血酶形成时间（ex-TEM®）和纤维蛋白凝块形成时间（fib-TEM®）指标）评估凝血功能。第1组ROTEM值未观察到统计学显著差异（P>0.05），而第2组在T1时，in-TEM®指标出现统计学显著差异（P<0.05）[凝血形成时间缩短（P = 0.04）和α角增大（P = 0.02）]以及ex-TEM®指标[最大凝块硬度增加（P = 0.008）和α角增大（P = 0.01）]；fib-TEM®指标未发现变化。两组血细胞比容均出现统计学显著下降（P = 0.007），而血小板计数和标准凝血指标未发现统计学显著差异。在第2组中T1时TS值出现统计学显著升高（P = 0.03）。在T0时，20只犬中有7只ROTEM描记图显示为高凝状态（第1组5/11，第2组2/9）。
结论
我们的研究结果表明以CRI方式给予HES 130/0.4不会导致低白蛋白血症犬出现低凝状态。第2组在T1时观察到有高凝倾向，可能与潜在疾病有关。尽管所有犬均为低白蛋白血症，但在T0时只有7/20为高凝状态，证实白蛋白水平与血栓前状态之间缺乏相关性。
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