Department of Clinical Science and Services, Royal Veterinary College, London, UK.
J Vet Intern Med. 2021 Jan;35(1):43-50. doi: 10.1111/jvim.15969. Epub 2020 Dec 7.
Whether anemic cats and dogs with increased left heart dimensions are at higher risk of transfusion-associated circulatory overload, and the effect of blood transfusion on left heart dimensions in naturally occurring anemia is unknown.
HYPOTHESIS/OBJECTIVES: To evaluate the effect of blood transfusion on left heart dimensions in clinically relevant anemia.
Twenty dogs and 20 cats presenting to a university veterinary teaching hospital.
In this prospective observational study, anemic dogs and cats requiring blood transfusion were included. Packed cell volume (PCV), total solids, and echocardiography were performed before and within 24 hours of blood transfusion. Signalment, bodyweight, disease process, transfusion duration and volume, and prior treatments were recorded. Nonparametric statistics were reported as median [range]. Post hoc Bonferroni correction set significance at P < .006.
After transfusion, PCV increased in cats (12% [6-16] to 18% [10-33], P = .001) and dogs (14% [7-24] to 25% [9-37], P = .001), heart rate decreased in dogs (104 bpm [86-166] to 87 bpm [56-138], P < .001), and fractional shortening decreased in cats (57.1% [36.0-84.7] to 41.0% [28.1-69.6], P = .002) and dogs (33.79% [19.33-62.79] to 31.89% [19.06-51.47], P = .006). Left ventricular internal diameter in systole increased in cats (6.5 mm [2.7-9.8] to 7.9 mm [5.3-11.1], P = .001). Normalized left ventricular internal diameter in diastole (1.48 [1.25-1.79] to 1.57 [1.33-2.00], P = .001) and systole (0.87 [0.58-1.19] to 1.00 [0.74-1.36], P = .001) increased in dogs. Incidence of volume overload did not differ before (14/20 cats, 70%; 9/20 dogs, 45%) or after (12/20 cats, 60%; 11/20 dogs, 55%) transfusion (P = .64).
Blood transfusion is well tolerated when signs of volume overload are present before transfusion.
是否存在左心增大的贫血猫和狗有更高的发生输血相关循环超负荷的风险,以及输血对自然发生贫血的左心大小的影响尚不清楚。
假设/目的:评估输血对临床相关贫血的左心大小的影响。
20 只就诊于大学兽医教学医院的狗和 20 只猫。
在这项前瞻性观察研究中,纳入了需要输血的贫血犬和猫。在输血前和输血后 24 小时内进行红细胞压积(PCV)、总固体和超声心动图检查。记录了一般情况、体重、疾病过程、输血时间和输血量以及既往治疗情况。非参数统计数据以中位数[范围]表示。事后 Bonferroni 校正将 P <.006 设为显著差异。
输血后,猫的 PCV 增加(12%[6-16]至 18%[10-33],P =.001),狗的 PCV 增加(14%[7-24]至 25%[9-37],P =.001),狗的心率降低(104 bpm[86-166]至 87 bpm[56-138],P <.001),猫的射血分数降低(57.1%[36.0-84.7]至 41.0%[28.1-69.6],P =.002)和狗的射血分数降低(33.79%[19.33-62.79]至 31.89%[19.06-51.47],P =.006)。猫的左心室收缩内径增加(6.5 mm[2.7-9.8]至 7.9 mm[5.3-11.1],P =.001)。狗的左心室舒张内径归一化(1.48[1.25-1.79]至 1.57[1.33-2.00],P =.001)和收缩内径归一化(0.87[0.58-1.19]至 1.00[0.74-1.36],P =.001)增加。输血前(猫 14/20,70%;狗 9/20,45%)和输血后(猫 12/20,60%;狗 11/20,55%)的容量超负荷发生率无差异(P =.64)。
在输血前存在容量超负荷迹象时,输血可良好耐受。