Baird Taylor N, Zersen Kristin M, Guillaumin Julien
Am J Vet Res. 2024 Nov 1;86(1). doi: 10.2460/ajvr.24.07.0196. Print 2025 Jan 1.
To use a point-of-care viscoelastic coagulation monitoring device (VCM-Vet; Entegrion) and traditional tests to assess hemostatic changes during hemorrhagic shock in dogs.
8 healthy, purpose-bred Beagles were enrolled in a hemorrhagic shock model conducted from September through December 2021. Dogs were anesthetized, had baseline hemostatic variables measured after blood pressure was stabilized at 70 to 80 mm Hg for 10 minutes (T1), had blood withdrawn from a jugular vein to achieve a mean blood pressure of 40 ± 5 mm Hg for 10 minutes (T2), were resuscitated with 100% shed blood, and then had hemostatic variables evaluated 10 minutes later (T3). At each time point, hemostatic variables were measured with traditional tests (Hct, WBC count, platelet count, mean platelet volume, prothrombin time, activated partial thromboplastin time [aPTT], and concentrations of fibrinogen, antithrombin, and D-dimer) and the VCM-Vet device (clot time, clot formation time, α-angle, maximum clot formation, amplitude at 10 minutes [A10], amplitude at 20 minutes [A20], clot lysis index at 30 minutes [LI30], and clot lysis index at 45 minutes [LI45]).
All dogs survived without complication. At T2 and T3 (vs T1), samples had significantly higher coagulability (increased median α-angle, A10, and A20) and fibrinolysis (decreased median LI30 and LI45) and significantly longer aPTT; however, all values remained within reference limits.
The use of VCM-Vet helped identify complex hemostatic disturbances in dogs with hemorrhagic shock.
The use of VCM-Vet shows promise in aiding veterinarians in optimizing resuscitation strategies based on real-time clotting data.
使用即时粘弹性凝血监测设备(VCM-Vet;Entegrion)和传统检测方法,评估犬失血性休克期间的止血变化。
8只健康的、专门培育的比格犬纳入了2021年9月至12月进行的失血性休克模型实验。犬只麻醉后,在血压稳定在70至80毫米汞柱10分钟后(T1)测量基线止血变量,从颈静脉抽血使平均血压达到40±5毫米汞柱并维持10分钟(T2),用100%的自体失血进行复苏,然后在10分钟后评估止血变量(T3)。在每个时间点,用传统检测方法(血细胞比容、白细胞计数、血小板计数、平均血小板体积、凝血酶原时间、活化部分凝血活酶时间[aPTT]以及纤维蛋白原、抗凝血酶和D-二聚体浓度)和VCM-Vet设备(凝血时间、凝块形成时间、α角、最大凝块形成、10分钟时的振幅[A10]、20分钟时的振幅[A20]、30分钟时的凝块溶解指数[LI30]和45分钟时的凝块溶解指数[LI45])测量止血变量。
所有犬只均存活且无并发症。在T2和T3(与T1相比)时,样本的凝血能力显著更高(中位数α角、A10和A20增加),纤维蛋白溶解显著降低(中位数LI30和LI45降低),aPTT显著延长;然而,所有值均保持在参考范围内。
使用VCM-Vet有助于识别失血性休克犬的复杂止血紊乱。
使用VCM-Vet在帮助兽医根据实时凝血数据优化复苏策略方面显示出前景。