Saint-Pierre Laurence M, Farrell Kate S, Hopper Kate, Reagan Krystle L
William R. Pritchard Veterinary Medical Teaching Hospital, University of California, Davis, California, USA.
Department of Veterinary Surgical and Radiological Sciences, University of California, Davis, California, USA.
J Vet Emerg Crit Care (San Antonio). 2023 May-Jun;33(3):360-370. doi: 10.1111/vec.13281. Epub 2023 Feb 17.
To describe patient characteristics, underlying disease processes, clinical outcomes, transfusion dose and type (therapeutic or prophylactic), platelet count changes, and adverse events associated with platelet concentrate (PC) administration in dogs.
Retrospective study.
University teaching hospital.
A total of 149 dogs, representing 189 PC transfusion episodes.
None.
In this population, 39 of 149 dogs (26.2%) were diagnosed with primary immune-mediated thrombocytopenia, 22 of 149 (14.8%) had decreased bone marrow production, 12 of 149 (8.0%) received PC during a massive transfusion, 3 of 149 (2.0%) had congenital thrombocytopathia, 59 of 149 (39.6%) had severe thrombocytopenia of other causes, and 14 of 149 (9.4%) underwent transfusion for miscellaneous causes without a documented severe thrombocytopenia. In 117 of 149 dogs (78.5%), >1 site of hemorrhage was noted. The most common sites of hemorrhage were the gastrointestinal (GI) tract in 89 of 149 (59.7%) and the skin in 78 of 149 (52.3%). Overall survival to discharge was 59.1% (88/149). The median PC dose was 0.8 units per 10 kg of body weight per transfusion episode (range: 0.2-6.7). Of 189 episodes, 29 of 189 (15.7%) were prophylactic, and 158 of 189 (83.6%) were therapeutic. For 99 of 189 transfusion episodes, paired pre- and postplatelet counts were available within 24 hours. The median platelet count change was 5.0 × 10 /L (5000/μL; range: -115 × 10 /L to 158 × 10 /L [-115,000 to 158,000/μL]); the posttransfusion platelet count was significantly higher than pretransfusion (P < 0.0001). The increase in platelet count after transfusion was greater in the prophylactic group than the therapeutic group (P = 0.0167). Transfusion reactions were suspected during 2 of 168 episodes (1.2%).
Immune-mediated thrombocytopenia was the most common disease process that resulted in PC transfusion. PC was more frequently administered to animals with active hemorrhage rather than prophylactically, and most dogs had evidence of hemorrhage in multiple organ systems, particularly the GI tract and skin. PC transfusions typically appeared safe, and the median platelet count increased after transfusion.
描述犬类接受血小板浓缩液（PC）输注时的患者特征、潜在疾病过程、临床结局、输血剂量和类型（治疗性或预防性）、血小板计数变化以及不良事件。
回顾性研究。
大学教学医院。
共149只犬，代表189次PC输血事件。
无。
在该群体中，149只犬中有39只（26.2%）被诊断为原发性免疫性血小板减少症，149只中有22只（14.8%）骨髓生成减少，149只中有12只（8.0%）在大量输血期间接受PC，149只中有3只（2.0%）患有先天性血小板病，149只中有59只（39.6%）因其他原因出现严重血小板减少，149只中有14只（9.4%）因各种原因接受输血但未记录有严重血小板减少。在149只犬中有117只（78.5%）观察到>1个出血部位。最常见的出血部位是胃肠道（GI），149只中有89只（59.7%）；皮肤，149只中有78只（52.3%）。总体出院存活率为59.1%（88/149）。每次输血事件的PC中位剂量为每10千克体重0.8单位（范围：0.2 - 6.7）。在189次事件中，189次中有29次（15.7%）为预防性输血，189次中有158次（83.6%）为治疗性输血。在189次输血事件中有99次，可在24小时内获得配对的输血前和输血后血小板计数。血小板计数的中位变化为5.0×10⁹/L（5000/μL；范围：-115×10⁹/L至158×10⁹/L [-115,000至158,000/μL]）；输血后血小板计数显著高于输血前（P < 0.0001）。预防性输血组输血后血小板计数的增加大于治疗性输血组（P = 0.0167）。在168次事件中有2次（1.2%）怀疑发生输血反应。
免疫性血小板减少症是导致PC输血的最常见疾病过程。PC更常用于有活动性出血的动物而非预防性使用，且大多数犬有多个器官系统出血的证据，尤其是胃肠道和皮肤。PC输血通常看起来是安全的，输血后血小板计数中位数增加。
