Kutter A, Kantyka M, Meira C, Bettschart-Wolfensberger R, Sigrist N
Section of Anaesthesiology, Department for Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich.
Division of Critical Care Medicine, Department of Small Animals, Vetsuisse Faculty, University of Zurich.
Schweiz Arch Tierheilkd. 2019 Jun;161(6):369-376. doi: 10.17236/sat00209.
In people, the antifibrinolytic drug tranexamic acid reduces bleeding and the need for blood products with both normal and exaggerated fibrinolysis without increasing the number of thromboembolic events. In dogs, in addition to prevention and treatment of bleeding, higher doses of tranexamic acid can be used to induce vomiting. The objective of this study was to evaluate the effect of a high dose of tranexamic acid on the coagulation of healthy Beagle dogs. A prospective trial was conducted in eight healthy Beagles receiving tranexamic acid for a concurrent trial evaluating different antiemetics. Rotational thromboelastometry (ROTEM) analysis (EXTEM, APTEM, FIBTEM, INTEM) was performed before and 30 minutes after intravenous administration of 50 mg/kg tranexamic acid. ROTEM parameters before and after tranexamic acid administration and between EXTEM and APTEM were compared with Wilcoxon matched-pairs signed rank test and data is presented as median (range). After tranexamic acid administration, FIBTEM clotting time became significantly shorter (p=0.03) from 37 s (28-124 s) to 33 s (27-40 s) and INTEM clot formation time significantly decreased (p=0.02) from 82 s (47-132 s) to 60 s (43-107 s). After tranexamic acid APTEM MCF was significantly weaker (p=0.01) with 45 mm (30-63 mm) than EXTEM MCF with 55 mm (43-69 mm) and than APTEM MCF before tranexamic acid with 55 mm (43-69 mm) (p=0.02). All other analysed parameters including maximum lysis did not change after administration of tranexamic acid. The administration of 50 mg/kg intravenous tranexamic acid resulted in small changes in ROTEM profiles without inducing a hypercoagulable clot. In conclusion, tranexamic acid can safely be administered to healthy dogs with normal coagulation profiles. As an additional finding, APTEM parameters measured in the current study do not support the use of this test in dogs.
在人类中，抗纤溶药物氨甲环酸可减少出血以及正常纤溶和过度纤溶情况下对血液制品的需求，且不会增加血栓栓塞事件的发生数量。在犬类中，除了预防和治疗出血外，高剂量的氨甲环酸还可用于诱导呕吐。本研究的目的是评估高剂量氨甲环酸对健康比格犬凝血功能的影响。对8只接受氨甲环酸治疗的健康比格犬进行了一项前瞻性试验，这些犬同时参与一项评估不同止吐药的试验。在静脉注射50mg/kg氨甲环酸前及注射后30分钟进行旋转血栓弹力图（ROTEM）分析（EXTEM、APTEM、FIBTEM、INTEM）。使用Wilcoxon配对符号秩检验比较氨甲环酸给药前后以及EXTEM和APTEM之间的ROTEM参数，数据以中位数（范围）表示。给予氨甲环酸后，FIBTEM凝血时间从37秒（28 - 124秒）显著缩短至33秒（27 - 40秒）（p = 0.03），INTEM凝块形成时间从82秒（47 - 132秒）显著缩短至60秒（43 - 107秒）（p = 0.02）。给予氨甲环酸后，APTEM的MCF显著弱于EXTEM的MCF（p = 0.01），分别为45mm（30 - 63mm）和55mm（43 - 69mm），且弱于给药前APTEM的MCF（55mm（43 - 69mm））（p = 0.02）。包括最大溶解率在内的所有其他分析参数在给予氨甲环酸后均未改变。静脉注射50mg/kg氨甲环酸导致ROTEM图谱有微小变化，但未诱导形成高凝凝块。总之，氨甲环酸可安全地给予凝血功能正常的健康犬。另外，本研究中测量的APTEM参数不支持在犬类中使用该检测方法。
