University of Florida Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Gainesville, Florida, USA.
Blue Pearl Veterinary Partners, Rockville, Maryland, USA.
J Vet Intern Med. 2022 Sep;36(5):1628-1640. doi: 10.1111/jvim.16518. Epub 2022 Aug 27.
Sampling from a peripheral intravenous catheter (PIVC) might be a more efficient and less traumatic collection of blood for serum biochemistry (SB) or CBC than direct venipuncture (DV). Agreement between results of samples obtained by these methods has not been evaluated in dogs.
The primary objectives were to determine whether sampling from PIVC could be used in place of DV for dogs. We hypothesized DV and PIVC samples would have clinically equivalent SB and CBC results.
Sixty-one client-owned dogs were included in each study arm.
This was a partially randomized method-comparison study. Paired DV and PIVC samples obtained within 1 to 2 minutes after, or approximately 24 hours after, placement of a PIVC in a cephalic vein were evaluated for agreement and bias using percentage difference plots (with a priori application of consensus total allowable error), Bland-Altman analysis, Passing-Bablok regression analysis, Wilcoxon signed rank test, and McNemar's test.
There was statistically and clinically acceptable agreement and no bias between sampling methods for the majority of results. Analytes with the most frequent disagreement were aspartate aminotransferase, total bilirubin, potassium, bicarbonate, and leukocyte differential counts, as well as red blood cell count, hemoglobin, hematocrit, and packed cell volume in the hospitalized PIVC sampling group. Few observed differences would change clinical decision making.
PIVC sampling can provide generally acceptable SB and CBC results for most dogs, but clinicians should be aware of a few values for which disparate results might occasionally be obtained.
与直接静脉穿刺(DV)相比,从外周静脉导管(PIVC)中采集血液进行血清生化(SB)或全血细胞计数(CBC)可能更有效且创伤更小。这两种方法采集的样本结果之间的一致性尚未在犬中进行评估。
主要目的是确定是否可以用 PIVC 代替 DV 对犬进行采样。我们假设 DV 和 PIVC 样本的 SB 和 CBC 结果具有临床等效性。
在每个研究臂中纳入 61 只患犬。
这是一项部分随机方法比较研究。在头静脉中放置 PIVC 后 1 至 2 分钟内或大约 24 小时后,同时采集 DV 和 PIVC 样本,使用百分比差异图(预先应用共识总允许误差)、Bland-Altman 分析、Passing-Bablok 回归分析、Wilcoxon 符号秩检验和 McNemar 检验评估一致性和偏差。
在大多数结果中,两种采样方法之间具有统计学上和临床上可接受的一致性,没有偏差。在住院 PIVC 采样组中,最常出现不一致的分析物包括天冬氨酸氨基转移酶、总胆红素、钾、碳酸氢盐和白细胞分类计数,以及红细胞计数、血红蛋白、血细胞比容和红细胞压积。很少有观察到的差异会改变临床决策。
PIVC 采样可以为大多数犬提供一般可接受的 SB 和 CBC 结果,但临床医生应该注意偶尔可能会获得不同结果的几个值。