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一项评估犬类急性输血反应发生率和危险因素的前瞻性多中心观察研究。

A prospective multicenter observational study assessing incidence and risk factors for acute blood transfusion reactions in dogs.

机构信息

Clinical Science and Services, The Royal Veterinary College, London, UK.

The Ralph, Marlow, UK.

出版信息

J Vet Intern Med. 2024 Sep-Oct;38(5):2495-2506. doi: 10.1111/jvim.17175. Epub 2024 Sep 6.

Abstract

BACKGROUND

Reported incidence of blood transfusion reactions (TR) varies greatly.

OBJECTIVE

To prospectively evaluate the incidence of acute TRs in dogs receiving allogenic blood products, using consensus definitions, and to assess factors associated with TRs.

ANIMALS

Dogs (n = 858) administered allogenic blood products (n = 1542) between March and November 2022.

METHODS

Prospective, multicenter surveillance study occurring in referral hospitals in the United States, United Kingdom, and Australia recording TRs in dogs administered blood products as defined by the consensus guidelines published by The Association of Veterinary Hematology and Transfusion Medicine in 2021.

RESULTS

The incidence of acute TR was 8.9% (95% CI 7.0-11.1) for packed red blood cells (pRBCs) and 4.5% (95% CI 2.9-6.6) for plasma products. The most frequently reported TRs were febrile nonhemolytic TRs (FNHTR; 4%, 95% CI 2.8-5.5) when administering pRBCs and allergic TRs (3.2%, 95% CI 1.80-5.10) when administering plasma products. A higher dose of pRBC (adjusted odds ratio [aOR] 1.04 [95% CI 1.00-1.08]) was associated with a higher odds of TR. Administration of pRBCs stored for longer than 28 days was associated with higher odds of FNHTR (aOR 4.10 [95% CI 1.58-10.65]) and acute hemolytic TR (AHTR; OR 15.2 [95% CI 3.35-68.70]) when compared with pRBCs stored for 14 days or fewer. Leukoreduction of pRBC was not associated with lower odds of developing a TR (OR 1.47 [95% CI 0.89-2.42]).

CONCLUSIONS AND CLINICAL IMPORTANCE

Clinicians should be mindful of the age and dose of pRBC prescribed to dogs.

摘要

背景

输血反应(TR)的报告发生率差异很大。

目的

使用共识定义前瞻性评估接受异体血液制品的犬发生急性 TR 的发生率,并评估与 TR 相关的因素。

动物

2022 年 3 月至 11 月在美国、英国和澳大利亚的转诊医院接受异体血液制品(n=1542)的犬(n=858)。

方法

前瞻性、多中心监测研究,在美国、英国和澳大利亚的转诊医院进行,根据 2021 年兽医血液学和输血医学协会发布的共识指南定义记录接受血液制品的犬的 TR。

结果

输注红细胞(pRBC)的急性 TR 发生率为 8.9%(95%CI 7.0-11.1),输注血浆制品的急性 TR 发生率为 4.5%(95%CI 2.9-6.6)。最常报告的 TR 是发热非溶血性 TR(FNHTR;4%,95%CI 2.8-5.5),当给予 pRBC 时,过敏 TR(3.2%,95%CI 1.80-5.10)当给予血浆制品时。pRBC 剂量较高(调整后的优势比[OR]1.04[95%CI 1.00-1.08])与 TR 发生的几率较高相关。与储存 14 天或更短时间的 pRBC 相比,储存超过 28 天的 pRBC 与 FNHTR(OR 4.10[95%CI 1.58-10.65])和急性溶血性 TR(AHTR;OR 15.2[95%CI 3.35-68.70])的发生几率更高。pRBC 的白细胞减少与 TR 发生几率降低无关(OR 1.47[95%CI 0.89-2.42])。

结论和临床意义

临床医生应注意给犬开的 pRBC 的年龄和剂量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/add3/11423481/b3fd070e9dea/JVIM-38-2495-g001.jpg

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