Langston Cathy E, Eatroff Adam E
Animal Medical Center, New York, NY.
J Vet Emerg Crit Care (San Antonio). 2018 Jul;28(4):366-371. doi: 10.1111/vec.12721. Epub 2018 May 15.
To describe an intravascular fibrin sheath associated with a hemodialysis catheter in a dog.
A 4-year-old dog presented for hemodialysis to treat acute kidney injury. Hemodialysis catheter dysfunction during the course of treatment was temporarily alleviated using a tissue plasminogen activator. A thrombus composed of fibrin and granulation tissue creating a sheath around the catheter and focally adherent to the vessel wall was identified on postmortem evaluation.
Fibrin sheath formation is a commonly recognized problem of central venous catheters used for hemodialysis in people and is likely a common problem in veterinary patients undergoing dialysis as well. This report provides a description of the clinical features of the catheter dysfunction, response to treatment, postmortem radiographic and direct imaging, and histology of the fibrin sheath, and also provides a brief review of potential management techniques that have been described in people.
描述一只犬体内与血液透析导管相关的血管内纤维蛋白鞘。
一只4岁犬因急性肾损伤接受血液透析治疗。治疗过程中,血液透析导管功能障碍通过使用组织纤溶酶原激活剂暂时得到缓解。尸检评估发现,由纤维蛋白和肉芽组织构成的血栓在导管周围形成鞘,并局部附着于血管壁。
纤维蛋白鞘形成是人类血液透析使用中心静脉导管时普遍公认的问题,在接受透析的兽医患者中可能也是常见问题。本报告描述了导管功能障碍的临床特征、对治疗的反应、尸检影像学和直接成像以及纤维蛋白鞘的组织学,并简要回顾了人类中已描述的潜在管理技术。