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回顾性评估 2009 年至 2016 年间 121 例猫使用新鲜冷冻血浆的情况。

Retrospective evaluation of fresh frozen plasma use in 121 cats: 2009-2016.

机构信息

Department of Emergency and Critical Care, Angell Animal Medical Center, Boston, Massachusetts.

出版信息

J Vet Emerg Crit Care (San Antonio). 2020 Sep;30(5):558-566. doi: 10.1111/vec.12972. Epub 2020 Jul 9.

Abstract

OBJECTIVES

To document indications for fresh frozen plasma (FFP) use in cats, doses administered, and frequency of adverse transfusion reactions (ATR).

DESIGN

Retrospective observational study from January 2009 to November 2016.

SETTING

Large urban referral and emergency facility.

ANIMALS

One hundred twenty-one client-owned cats that received FFP.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Signalment, indication(s), dose, pre- and posttransfusion total plasma protein, prothrombin time, activated partial thromboplastin time, as well as possible ATR, primary disease process, and outcome were recorded. Doppler blood pressure was increased posttransfusion (mean pre 99.5 ± 30.8 mm Hg; post 108.5 ± 32.5 mm Hg, P = .027). Cats were significantly less likely to be coagulopathic posttransfusion (P < 0.001). Most common indications were suspected coagulopathy (n = 105, 83%), hemorrhage (n = 45, 35%), and hypotension (n = 32, 25%). Median dose was 6 mL/kg (interquartile range = 3 mL/kg) and was negatively correlated with body weight (r = -.598, P < 0.001). Possible ATR occurred in 17 of 108 (16%, 95% confidence interval [CI], 10-24%) of transfusions. Increased body temperature was most common in 11 of 108 (10%, 95% CI, 5-18%), followed by tachypnea/dyspnea in 8 of 108 (7%, 95% CI, 3-13%). Common primary disease processes included liver disease (n = 41, 34%), neoplasia (n = 19, 16%), and sepsis (n = 15, 12%). Overall mortality was 54%. Improvement of clotting times was associated with increased odds of survival (odds ratio = 2.4; 95% CI, 1.1-5.3; P = 0.023).

CONCLUSIONS

Clinician justifications for FFP transfusions are comparable to that reported in dogs; however, the mL/kg dose is lower. Coagulopathy and blood pressure significantly improve posttransfusion. Possible ATR were as frequent as that reported with feline packed RBCs transfusions and classified as mild.

摘要

目的

记录猫新鲜冷冻血浆(FFP)使用的适应证、给予的剂量以及不良反应输血反应(ATR)的频率。

设计

2009 年 1 月至 2016 年 11 月的回顾性观察性研究。

地点

大型城市转诊和急救机构。

动物

121 只接受 FFP 的患宠猫。

干预措施

无。

测量和主要结果

记录了一般信息、适应证、剂量、输血前后总血浆蛋白、凝血酶原时间、活化部分凝血活酶时间,以及可能的 ATR、主要疾病过程和结果。输血后,猫的多普勒血压升高(平均输注前 99.5 ± 30.8 mmHg;输注后 108.5 ± 32.5 mmHg,P =.027)。猫在输血后不太可能发生凝血功能障碍(P < 0.001)。最常见的适应证是疑似凝血功能障碍(n = 105,83%)、出血(n = 45,35%)和低血压(n = 32,25%)。中位剂量为 6 mL/kg(四分位距= 3 mL/kg),与体重呈负相关(r = -.598,P < 0.001)。108 次输注中有 17 次(16%,95%置信区间 [CI],10-24%)出现可能的 ATR。108 次输注中有 11 次(10%,95% CI,5-18%)最常见的是体温升高,其次是 8 次(7%,95% CI,3-13%)呼吸急促/呼吸困难。常见的主要疾病过程包括肝病(n = 41,34%)、肿瘤(n = 19,16%)和败血症(n = 15,12%)。总死亡率为 54%。凝血时间的改善与存活几率的增加相关(比值比= 2.4;95% CI,1.1-5.3;P = 0.023)。

结论

FFP 输血的临床指征与犬相似;然而,给予的剂量更低。输血后凝血功能障碍和血压显著改善。可能的 ATR 与猫浓缩红细胞输血报告的频率一样高,并且被归类为轻度。

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