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Coagulation/Transfusion > Journals > Flashcards

Journals Flashcards

1
Q

What were the primary findings of a study by Lynch et al examining transfusion practices in dogs following trauma?

Lynch et al. Transfusion practices for treatment of dogs hospitalized following trauma: 125 cases. JAVMA 2015 247.

A
  • 36% of dogs required transfusion with pRBC being the most commonly administered product
  • Transfusion reasons periop hemodynamic support, tx shock, worsening anemia
  • Dogs receiving transfusion had a higher mean heart rate, blood lactate and ATT scores, with lower mean PCV/TS and rectal temp on admission than dogs who did not require transfusion
  • PCV/TS were specific but insensitive predictors of subsequent transfusion
  • 87% survived to discharge, although significantly fewer dogs receiving transfusions survived
  • 70% of dogs receiving massive transfusion survived to discharge
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2
Q

What were the primary findings of a study by Lynch et al regarding transfusion practices in dogs undergoing splenectomy for splenic masses?

Lynch et al. Transfusion practices for treatment of dogs undergoing splenectomy for splenic masses 542 cases. JAVMA 2015.

A
  • 44% of dogs required transfusion
  • Dogs that needed transfusion had significantly higher ISS, heart rate, resp rate and blood lactate concentration, and PT
    • Had lower PCV/TS, albumin, and base deficit
  • Dogs that required transfusion were more likely to have a hemoperitoneum and malignant disease
  • Higher odds of death/euthanasia while hospitalized; lower odds of surviving to 30 or 180 days following discharge
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3
Q

What were the primary findings of a study examining transfusion practices following a variety of surgeries by Haley et al?

Haley et al. Perioperative red blood cell transfusion requirement for various surgical procedures in dogs: 207 cases. JAVAM 2015.

A
  • Dogs undergoing liver lobectomy and/or splenectomy were significantly likely to receive a transfusion when compared to all other procedures (gastrectomy, rhinotomy, thyroidectomy, herniorrhpahy)
    • 42% of splenectomy dogs, 40% liver lobectomy dogs
  • A significant association was found between body weight and perioperative RBC transfusion–greater body weight, greater risk of transfusion
  • 61% overall survival rate
  • Dogs requiring transfusion were significantly less likley to survive to 2 weeks after surgery
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4
Q

What were the primary findings of a study by Holowaychuk et al examining risk factors for transfusion complications in dogs?

Holowaychuk et al. Risk factors for transfusion associated complications and nonsurvival in dogs receiving pRBC transfusion 211 cases. JAVMA 2014 244.

A
  • 37% of dogs had transfusion complications (febrile reaction etc/AKI/ALI, pneumonia, volume overload, new infection)
    • Risk for transfusion reaction was higher in dogs receiving products other than pRBCs
  • A higher pre-transfusion PCV and a larger dose of pRBCs administered were risk fcators for nonsurvival
  • The age of the packed pRBC was not identified as a risk factor for transfusion associated complications
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5
Q

What were the primary findings of a study by Thomovsky et al regarding the incidence of ALI in dogs receiving transfusions?

Thomovsky et al. Incidence of ALI in dogs receiving transfusions. JAVMA 2014 244.

A
  • 2/54 dogs (3.7%) developed VetALI
  • This was significantly less than then reported incidence of TRALI in humans (25%) and not significantly diferent from the reported incidence of ARDS in ill dogs not receiving transfusions (10%)
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6
Q

What were the primary findings of a study by Aslanian et al examining the outcome in dogs after diagnosis of hemophilia A?

Aslanian et al. Clinical outcome after diagnosis of hemophilia A in dogs. JAVAM 2014.

A
  • Hemophilia A is a factor VIII deficiency
  • Affected dogs had similar signs of spontaneous hemorrhage regardless of the level of FVIII:C deficiency.
  • 30/39 dogs required more than one blood transfusion, however FVIII:C did not appear to influence transfusion requirement
  • Dogs with hemophilia A have variations in clinical course of disease and may have a good long term prognosis.
  • FVIII:C may not be useful for predicting severity of clinical signs, transfusion requirements or long-term prognosis
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7
Q

What were the primary findings of a study by McMichael et al evaluating coagulation status in dogs with blasto?

McMichael et al. Hypercoagulability in dogs with blastomycosis. JVIM 2015 29.

A
  • Cases had leukocytosis compared to controls; hyperfibrinogenemia and increased thrombin-antithrombin complexes
  • Hypercoagulable as evaluated by thromboelastometry
  • Hypercoagulability in blastomycosis dogs may lead to microemboli in the pulmonary circulation, contributing to inadequate O2 supply
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8
Q

What were the primary findings of a study by Kelley et al evaluating TEG in dogs with acute liver disease?

Kelley et al. TEG evaluation of dogs with acute liver disease. JVIM 2015 29.

A
  • TEG results defined dogs as hypocoagulable, normocoagulable, and hyperoagulable.
  • Hyperfibrinolysis was also identified in a portion of dogs.
  • Dogs with acute liver failure had greater increases in K and LY20, along with decreases in MA, G and PC activity than dogs with less severe hepatic impairment.
  • Results for mA and LY30 were positively correlated with serum biliubin and WBC count and negatively correlated with serum cholesterol
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9
Q

What were the findings of a study by Goggs et al on outcome prediction in dogs with IMHA?

Goggs et al. Predicting outcome in dogs with primary IMHA; results of a multicenter case registry. JVIM 2015 29/

A
  • CHAOS: canine hemolytic anemia objective score.
  • A higher risk of death during hospitalization was associated with a CHAOS score of >/= 3; CHAOS also associated with death within 30 days.
  • The Tokyo score was not determined to be statistically significant.
  • Three variables predictive of death in hospital:
    • ASA classification
    • Bilirubin
    • Urea
  • Three variables predictive of death by day 30:
    • ASA classification
    • Bilirubin
    • Creatinine
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10
Q

What were the findings of a study by Gauthier et al evaluating the effect of synthetic colloid administrion on coagulation in healthy dogs and dogs with systemic inflammation?

JVIM 2015 29.

A
  • Administration of either saline or tetrastarch to healthy dogs AND dogs with LPS induced inflammation resulted in increases in PT and ACT.
  • In healthy dogs:
    • Tetrastarch–>significant decrease in R
  • In BOTH healthy and dogs with LPS tetrastarch:
    • increased APTT, CL30 and K
    • Decreased platelet count, alpha angle, MA and vWF antigen
  • “Tetrastarch bolus administration to dogs with systemic inflammation resulted in a transient hypocoagulability characterized by a prolonged APTT, decreased clot formation speed and clot strength, and acquired type 1 vWD
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11
Q

What were the findings of a study by Walton et al evaluating coagulation factor and hemostatic protein concentration in canine plasma after storage of whole blood at ambient temperature?

JVIM 2014 28.

A
  • Regardless of time of processing (8,12,24 hours after collection), the units all contained therapeutic coagulation factors and hemostatic proteins
  • FP prepared after 24 hours had a significantly higher factor VIII and X when compared to 8 hour plasma.
  • Greyhound blood lead to lower levels of factor X, fibrinogen and vWF than blood evaluated from other breeds, although this does not preclude them as donors.
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12
Q

What were the findings of a study by Schwartz et al examining platelet volume and plateletcrit in dogs with presumed primary ITP?

JVIM 2014 28.

A
  • Mean platelet volume was higher in IMT dogs
  • The platelet distribution width was not significantly different amon the groups
  • The median time for PCT to reach threshold (selected at 75,000 platelets/uL) in confirmed responders to therapy was faster (3 days) compared to platelet count (4 days)
  • PCT may be a useful platelet parameter for monitoring dogs with ITP
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13
Q

What were the findings of a study by Klainbart et al evaluating peripheral and central venous blood glucose concentrations in dogs and cats with acute ATE?

JVIM 2014 28.

A
  • Compared systemic glucose and local (affected limb) glucose
  • Delta glucose and % delta glucose between the two are accurate markers of acute ATE in dogs and cats, being significantly higher in pets presenting with ATE as compared to those with acute limb paralysis secondary to orthopedic/neuro conditions, and ambulatory controls
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14
Q

What was the primary finding of a study by Hann et al examining the effect of duration of pRBC storage on morbidity and mortality in dogs after transfusion?

JVIM 2014 28.

A
  • Longer duration of pRBC storage was asociated with development of new/progressive coagulation failure and thromboembolic disease
  • No association between duration of pRBC storage and survival for all dogs overall, HOWEVER….
  • In dogs with hemolytic anemia, for every 7 day increase in length of storage, there was a 0.79 lesser odds of 30 day survival
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15
Q

What were the findings of a study by Purcell et al on the effect of luekoreduction on the concentration of IL8, IL1B and TNFalpha in canine pRBCs during storage?

AJVR 2015 76.

A
  • Leukoreduction was effective for removal of luekocytes (decreased by 99.9%) in all uinits
  • Significant increases in IL8 did not occur during storage
  • TNFalpha and IL1B concentrations were not significantly different
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16
Q

What were the findings of a study by Smith et al on procoagulant phospholipid concentration in canine erythrocyte concentrates stored with or without prestorage leukoreduction?

AJVR 2015.

A
  • The procoagulant phospholipid concentration gradually increased during the storage period, however, leukoreduction reduced the development of increased procoagulant activity over time
  • Presence of PPL in canine ECs may be associated with procoagulant and proinflammatory effects in vivo, which could have adverse consequences for dogs treated with EC
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17
Q

What were the findings of a study by Majoy et al regarding platelet activation in a population of critically ill dogs as measured with whole blood flow cytometry and TEG?

AJVR 2015.

A
  • In non-ADP treated samples, crtically ill and control dogs had no difference in platelet activation.
  • Critically ill dogs had significantly increased platelet activation in response to 2,6, and 10um ADP
  • Critically ill dogs had significantly increased MA, alpha angle, and global clot strength along with significantly decreased clot formation time.
  • Critically ill dogs had significantly increased fibrinogen concentration, PT, and PTT and signficantly decreased AT concentration.
  • No difference betweeen survivors and non survivors
  • Concluded that critically ill dogs had hyperreactive platelets which may have contributed to the high incidence of hypercoagulability in this patient population
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18
Q

What were the findings of a study by Meyer et al regarding the pharmacokinetics and pharmacodynamisc of the factor Xa inhibitor apixaban after oral and IV administration in cats?

AJVR 2015

A
  • Factor Xa was inihibited as a function of time after a single dose of apixban administered orally or IV and had moderate clearance, short half life and high bioavailability
  • Futher study needed after multidose administration
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19
Q

What were the findings of a study by Bailey et al evaluating the effects of protamine sulfate on clot formation time and clot strength TEG variables for canine blood samples?

AJVR 2014

A
  • Protamine prolonged clot formation time and decreased overall clot strength in a dose dependent manner
  • May contribute to a hypocoagulable state in dogs
  • Administration of protamine to reverse the effects of heparin should be performed with caution
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20
Q

What were the results of a study by Magee et al examining the in-vitro effects of the glycoprotein IIb/IIa receptor antagonists abciximab and eptifibitide on platelet aggregation in healthy cats?

AJVR 2014

A
  • Eptifibitide caused a significant reduction in platelet aggregation in vivo for healthy cats, but there was no identifiable antiplatelet effect for abciximab
  • Have different binding and inhibitory actions; theorized that abciximab would be ineffective in cats because of lack of receptor binding, reduced binding kinetics or lack of downstream signaling
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21
Q

What were the findings of a study by Fletcher et al evaluating tranexamic acid and EACA concentrations required to inhibit fibrinolysis in plasma of dogs and humans?

AJVR 2014.

A
  • Minimum concentrations for complete inhibition of fibrinolysis in dogs were 511 ug/ml for EACA and 145ug/ml for TEA
  • For people, 122ug/ml and 15ug/ml
  • Results supported the concept that dogs are hyperfibrinolytic compared to humans and that higher doses of EACA and TEA may be required to fully inhibit fibrinolysis in dogs.
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22
Q

What were the findings of a study by Tonkin et al examining the in vitro effects of lipid emulsion on platelet function and TEG in canine blood samples?

AJVR 2013

A
  • MA determined by TEG was significantly elevated by addition of concentrations of lipid that are several orders of magnitude higher than clinically relevant levels in dogs
  • Lipid treatment appears to have no significant effect on hemostatic variables in dogs, although clinical studies should be performed to confirm these in vitro findings
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23
Q

What were the findings of a study by Higgs et al regarding autologous blood transfusion in dogs with thoracic or abdominal hemorrhage?

JVECC 2015.

A
  • Reported complications that may arise with ABT included hypocalcemia, hemolysis, and prolonged coagulation times, although they were considered of minor clinical significance
  • ABT may be used as a bridge to definitive hemorrhage control, particularly when other blood products are not available or affordable.
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24
Q

What were the findings of a study by Bruce et al on the effect of premedication and other factors on the occurrence of acute transfusion reactions in dog?

JVECC 2015 25 5.

A
  • 15% dogs had a TR; most common fever alone (53%) and vomiting alone (18%)
  • Six dogs died secondary to TR however
  • Development of TR was not related to age, sex, weight, or premedication administraiton
    • When premedication was evaluated alone, antihistamines decreased the incidence of acute allergic reactions
  • pRBCs were significantly associated with development of a TR, whiel plasma was least likely
  • The presence of immune-mediated disease was significantly associated with development of TR
  • Transfusion during the perioperative period was less likely to be associated with TR development
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25
Q

What were the findings of a study by Conner et al evaluating coagulation abnormalities in 5 cats with naturally occurring cytauxzoonosis?

JVECC 2015 25 4

A
  • All 5 cats had lab evidence of overt DIC
  • Thrombocytopenia, low protein C activity, prolonged PT
    • No cats had low AT, which is in contrast to human/dog sepsis models of DIC
  • None of the cats had clinical signs of hemorrhage despite thrombocytopenia, coag factor deficiency and TEG evidence of hypocoagulability
26
Q

What were the findings of a study by Bruno et al on TEM evaluation of hemostatis in dogs infested with Leishmania?

JVEC 2015 25 4

A
  • Normal standard coagulation profiles were present in clinical dogs, asymptomatic dogs and a control group
  • ROTEM results did not fall outside of normal for all gropus
27
Q

What were the findings of a study by Kelmer et al on the effects of IV administration of TEA on hematological, hemostatic and TEG analytes in healthy adult dogs?

JVEcC 2015 25 4

A
  • Administration of TEA as a slow bolus at 10m/gkg followed by 10mg/kg/hr CRI was safe (higher doses led to vomiting)
  • TEA may enhance coagulation (decreased PT, R values on TEG), however, effect on fibrinolysis was inconsistent with what was expected
  • The TEG assay used in this study could not identify the presence of any fibrinolysis prior to TEA administration, therefore, it was likely difficult to assess any of the true effects of TEA
28
Q

What were the findings of a study by Wurlod et al on comparison of the in vitro effects of saline, hypertonic HES, HTS, and two forms of HES on whole blood coagulation and platelet function in dogs?

JVECC 2015 25 4.

A
  • Hypertonic solutaions affect platelet function and whole blood coagulation to a greater extent than saline and HES
    • HTS + HES 130, HES 600, HES 200
  • At dilutions that are clinically relevant, only platelet closure time was markedly more affected by the hypertonic solutions than by saline
  • At high dilutions, HES significantly affects coagulation but to no greater extent than saline at clinically relevant dilutions
29
Q

What were the findings of a study by Bruno et al on the assessment of coagulation utilizing TEM in dogs undergoing orthopedic surgery?

JVECC 2015 25 3.

A
  • Unlike hypercoagulability observed in human orthopedic patients, a hypercoagulable state measured by ROTEM did not develop in dogs following orthopedic surgery.
30
Q

What were the findings of a study by Panek et al on the use of enoxaparin in dogs with primary IMHA?

JVECC 2015 25 2.

A
  • 21 dogs with IMHA were treated with enoxaparin (0.8mg/kg SQ q6h) as the sole anticoagulation therapy starting at hospital admission
  • Only 2 dogs had minor hemorrhagic complications associated with enoxaparin
  • Frequency of thrombosis was not assessed
  • Long term survival was comparable to other anti-coagulation protocols reported for dogs with primary IMHA
  • Don’t know if it reduces mortality and thrombotic complications
31
Q

What were the findings of a study by Lynch et al regarding clinical experience of anti-Xa monitoring in critically ill dogs receiving dalteparin?

JVECC 2014 24 4.

A
  • Pretreatment hypercoagulability was evident in 34/35 dogs prior to starting dalteparin therapy
  • Bleeding complications were rare (3/38) and 29/38 dogs survived to discharge
  • Dose adjustment was possible with interpretation of the anti-Xa assay, however, reliable achievement of anti-Xa activity was not demonostrated
  • Dogs with higher G values on pretreatement TEG were significantly less likely to achieve the target anti-Xa activity (amy require closer monitoring and greater dose adjustment to achieve the target range)
32
Q

What were the findings of a study by Weltman et al on the influence of cross match on post-transfusion PCV in feline pRBC transfusion?

JVECC 2014 24 4.

A
  • pRBC dose, cross-match status and pretransfusion PCV were independent predictors of change in PCV with transfusion
  • The PCV increase post-transfusion (scaled by dose) was significantly greater for cross-match compatible transfusions
  • Administration of type-specific, cross-match compatible pRBC transfusions resulted in significantly greater increases in the posttransfusion PV when compared to administration of typed, noncross-matched pRBCs
33
Q

What were the findings of a study by Jackson et al on the comparisoin of whole blood and plasma COP in healthy cats?

JVECC 2014 24 4

A
  • There was not a statistically significant difference in whole blood/plasma COP in healthy cats, however, there were slight differences identifed
  • Prudent to maintain sample consistency for comparison’s sake
34
Q

What were the findings of a study by Helmbold et al on the effect of HES 670/0.75 administered in vivo as a CRI on platelet closure time in the dog?

JVECC 2014 24 4

A
  • HES used as a 24 hour CRI at 1ml/kg/hr and 2ml/kg/hr prolongs platelet CT in healthy dogs at 6,12, and 24 hours–HOWEVER–the median CT only exceeded the reference interval at 24 hours at 2ml/kg/h
  • No clinical evidence of spontaneous bleeding in any dog during the 24 hour infusion at either rate
35
Q

What were the findings of a study by Grochowsky et al on the ex-vivo evaluation of efficacy of refrigerated canine plasma?

JVECC 204 24 4

A
  • Refrigerated storage resulted in significant decreases in the activity of all clotting factors and a subsequent prolongation in clotting times, however, none of the values were outside of the reference intervals
  • Bacterial cultures of the units lead to no growth
  • Kept refrigerated for 14 days
36
Q

What were the findings of a study by Corsi et al on the cytokine concentrations in stored canine erythrocyte concentrates?

JVECC 2014 24 3

A
  • There were no significant effects of leukoreduction/non-leukoreduction or storage time for IL-1B, IL-10, TNF-alpha.
  • IL-8 concentration was significantly increased over the storage period (35 days) in the NLR units and was significantly higher compared to the LR units on days 28 and 35.
37
Q

What were the findings of a study by Armentano et al on the TEG evaluation of hemostatic function in dogs treated for cortalid snake envenomation?

JVECC 2014 24 2

A
  • 40% of dogs were hypocoagulable on presentation based on a G-value <reference>
    </reference><li>13% mortality rate. Of the dogs that died, 80% had flatline TEG tracings (alpha-angle, MA equal to zero on presentation)</li><li>A decreased G and MA were significantly associated with mortality</li><li>Over treatment time, G and MA significantly increased</li>

</reference>

38
Q

What were the findings of a study by Holowaychuk et al in a prospective multicenter evaluation of coagulation abnormalities in dogs following severe acute trauma?

JVECC 204 24 1.

A
  • Decreased platelet count was a risk factor for body cavity hemorrhage
  • Decreased platelet count, protein C activity, alpha angle, MA and G were risk factors for blood product administration
  • Nonsurviving dogs were hypocoagulable with prolonged apTT, decreased plasmin inhibition, decreased alpha angle and MA compared to surviving dogs
  • Prolonged aPTT was the strongest predictor of non-survival
    • Was positively correlated with APPLEfast score, lactate, and negative base excess
  • ATC was diagnosed in 15% of dogs ad admission, more common in dogs with increased disease severity, decreased systolic blood pressure and increased lactate
39
Q

What were the findings of a study by Brown et al evaluating the effect of aminocaproic acid on clot strength and clot lysis of canine blood determined by the use of an in vitro model of hyperfibrinolysis?

AJVR 2016 77.

A
  • A significantly higher TEG MA compared with baseline detected at 60 and 240 minutes.
  • At 240 minutes significantly less fibrinolysis for dogs receiving 100mg/kg as opposed to those receiving 20mg/kg
  • ACA may be useful for in vivo prevention of fibrinolysis in dogs
40
Q

What were the primary findings of a study by Mischke at el on enoxaparin: pharmacokinetcis and treatment schedule for cats?

The Vet Journal 2014; 200; 375-381

A
  • Aims to establish pharmacokinetic data of SQ administered enoxaparin and to establish a treatment schedule.
  • A dosage schedule of 0.75mg/kg 4 times daily seemed to be suitable for therapeutic use of enoxaparin in cats as it leads to reproducible peak and anti-FXa activities within the target range for the treatment of thrombosis in humans.
41
Q

What were the primary findings of a study by Schonig et al on the assessment of the effects of dalteparin on coagulation variables and determination of a treatment schedule for use in cats?

AJVR 2016; 77: 700-707

A
  • Cats received 14 injections of dalteparin (75 anti-Xa U/kg SQ) at 6 hour intervals
  • 2 hours after the second injection, the target peak anti-Xa activity range of ).5-1.0 U/ml was achieved in all ccats whereas median trough values remained below this range
  • Peak anti-Xa activity had only minimal effects on coagulation variables
42
Q

What were the conclusions of a study by Haines et al regarding the in vitro and in vivo assessment of platelet function in healthy dogs during the administration of a low dose aspirin regimen?

AJVR 2016; 77:174-185

A
  • Dogs received aspirin 1mg/kg PO q24 x 7d and platelet function was evaluated by aggregometry, PFA and determination urine 11-dehydro-thromboxane B2 concentration
  • 14 days after cessation of aspirin, PRP was incubated with acetylsalicylic acid and platelet function assessed
  • 13 dogs had aggregometry results athat were decreased by >25% from baseline on days 3 and 7; 4 and 7 dogs had PFA closure times >300 seconds on days 3 and 7
  • Responsen to a low-dose aspirin regimen varied among healthy dogs
43
Q

What were the conclusions of a study by Thomason et al evaluating the effects of cyclosporine and aspirin on platelet function in normal dogs?

JVIM 2016; 30: 1022-1030.

A
  • Low dose aspirin inhibits cyclosporine induced thromboxane synthesis and concurrent use of these medications does not alter the antiplatelet effects of aspirin
44
Q

What were the primary findings of a case series by Yang et al regarding the use of rivaroxabn for the treatment of thrombotic complications in four dogs?

JVECC 2016; 26 (5)

A
  • Two patients were treated with rivaroxaban for PE; decreases in thrombus size were obseved, but one patient suffered acute respiratory distress and was euthanized while the other continued to do well
  • Two patients were treated for systemic thromboses and had decreases in thrombus size
45
Q

What were the major findings of a study by Li et al evaluating platelet function with multiple electrode platelet aggregometry in dogs with septic peritonitis?

JVECC 2016; 26 (5)

A
  • MEPA using arachidonic acide, adenosine diphosphate and collagen as agaonists was measured within 24 hours of a sepsis diagnosis
  • Compared to healthy dogs, platelete aggregation was reduced in dogs with septic peritonitis for all agonists
  • Overall mortality rate was 40%
  • MEPA in response to collagen was significantly reduced in nonsurvivors compared to survivors
46
Q

What were the findings of a study by Dixon-Jimenez et al regarding pharmacokinetic and pharmacodynamic evaluation of oral rivaroxaban in healthy adult cats?

JVECC 2016; 26 (5)

A
  • Treated cats had no signs of hemorrhage or clinicopathologic off-target adverse effects
  • Dose dependent prolongations of coagulation times and increase in aXa with peak effect at 3 hours post administration
  • Oral RVX was well tolerated by helathy cats with predictable pharmacokinetics and anticoagulant effects
47
Q

What were the primary findings of a study by Morassi et al evaluating the safety and tolerability of rivaroxaban in dogs with presumed primary IMHA?

JVECC 2016 26 4

A
  • Compared RIV to clopidogrel+low dose aspirin
  • No adverse drug reaction, evidence of hemorrhage, significant prolongation of PT or aPTT, or increase in transfusion requirements comparing RIV to CL+LDA
  • No significant difference between groups with respect to thrombotic events, survival rates to discharge at 1 and 3 months from diagnosis
48
Q

What were the main findings of a study by McBride et al regarding platelet closure time in anesthestized Greyhounds with hemorrhagic shock treated with HES 130/0.4 or 0.9% NaCl infusions?

JVECC 2016 26 4

A
  • Cntorlled hemorrhagic shock in Greyhounds under anesthesia did not cause a significant change in PCT
  • Both HES 130/0.4 and 0.9% NaCl after administration after induction of shock increased PCT
  • Results do not support that HES 130/0.4 causes relevant platelet dysfunction beyond hemodilution
49
Q

What were the findings of a study by Thawley et al regarding retrospective comparison of TEG results to postmortemk evidence of thrombosis in critically ill dogs: 39 cases (2005-2010)?

JVECC 2016 26 3

A
  • Study group was 39 dogs for which TEG was performed within 7 days of complete necropsy
  • Spayed females were significantly more likely to have thrombosis
  • No association between any TEG parameter and the presence of thrombosis on postmortem
  • D-dimers significantly higher in dogs with thrombosis, weak positive correlation between D-dimer value and number of sites of thrombosis
  • Dogs with WBC >16 x 10^3 more likely to have thrombosis
50
Q

What were the findings of a retrospective study by Song et al evaluating shortened PT or PTT for the diagnosis of hypercoagulability in dogs: 25 cases?

JVECC 2016 26 3

A
  • Dogs with shortened PT or PTT had significantly more thrombus formation, supsicion of PTE, and increased D-dimer concentration compared to dogs with normal values
  • No significant findings compared to TEG values
    *
51
Q

What were the findings of a study by Morris et al evaluating the effects of in vitro hemodilution with crystalloids, colloids, and plasma on canine whole blood coagulation as determined by kaolin-activated TEG?

JVECC 2016; 26(1)

A
  • LRS, HES, FFP
  • In vitro hemodilution of whole blood with LRS and HES but not FFP resulted in significant effects on coagulation with HES having a more profound effect.
  • No significant difference in any TEG parameter was found for FFP
52
Q

What were the main findings of a study by White et al regarding evaluation of the relationship between clinical variables and TEG findings in dogs with PLN?

JVECC 2016; 26 (1)

A
  • Purpose was to look for hypercoagulability in proteinuric dogs, defined by TEG, and see if it is related to the degree of proteinuria, presence of systemic arterial hypertension, presence of hypoalbuminemia, or reduced anti-thrombin activity
  • 89% hypercoagulability identified
  • No statistically significant associations between any of the variables
  • Low prevalence of thromboembolism (6%)
53
Q

What were the findings of a limited study by Manion et al evaluating the anticoagulant effects of inhaled unfractionated heparin in the dog as determined by PTT and factor Xa activity?

JVECC 2016; 26 (1)

A
  • Inhaled unfractionated sodium heparin was administered in doses ranging from 50k to 200k IU (even at doses higher than those known to be effective in people)
  • Even at high doses, inhaled heparin appears to have no detectable local or systemic anticoagulant effects in dogs
54
Q

What were the findings of a study by Fletcher e al regarding assessment of the relationships among coagulopathy, hyperfibrinolysis, plasma lactate and protein C in dogs with spontaneous hemoperitoneum?

JVECC 2016; 26(1)

A
  • Dogs with SHP have evidence of hypocoagulability, protein C deficiency, and hyperfibrinolysis
  • The parameters of hyperfibrinolysis were related to plasma lactate concentration and the volume of plasma transfused during hospitalization
  • Derangements resemble those found in people with acute coagulopathy of trauma/shock; activation of protein C may be common to both syndromes
55
Q

What were the findings of a study by Miglio et al regarding stored canine whole blood units: what is the real risk of bacterial contamination?

JVIM 2016; 30

A
  • On bacterial culture, 47/49 units were negative at all time points. 1 unit was positive for enterococcus, 1 positive for e coli
  • On PCR 26/49 units were positive.
  • Most of the organisms were common bacteria not usually indicated in septic transfusion reaction.
  • The very low number of bacteria consitutes an acceptable risk of bacterial contamination indicating the WB units have a good shelf life during commercial storage
56
Q

What were the findings of a study regarding a survey of two new canine blood groups in North American dogs?

JVIM 2016 30

A
  • New blood types are Kai 1 and Kai 2. Unrelated to DEA 1,3,4,7 and Dal.
  • Kai 1+/Kai2- dogs were most commonly found in North America.
  • Clinical relevance in transfusion medicine is unknown currently
57
Q

What were the primary findings of a retrospective study by Ng et al regarding cryopreserved platelet concentrate transfusions in 43 dogs?

JVECC 2016; 26 (5)

A
  • Dogs that received cPC were significantly more likely to have a platelet trigger for cPC transfusion, lower platelet count, and Hct and presentation, as well as a lower Hct after cPC
  • Statistically significant increase in platelet count from pre to post-cPC transfusion, however, cPC was not found to be effective in improving clinical bleeding or increasing survival compared to the control group.
58
Q

What were the findings of a study by Cummings et al regarding the effect of storage on ammonia, cytokine, and chemokine concentrations in feline whole blood?

JVECC 2016; 26 (5)

A
  • Ammonia concentration increases with storage time in feline SWB
    • Clinical significance yet to be determined
  • CXCL-8 was also present, however, do not know if it can incite an inflammatory response in the recipient
59
Q

What were the primary findings of a study by Lynch et al assessing hemostatic changes in a model of acute hemorrhage in dogs?

JVECC 2016 26(3) 333-343

A
  • Platelet dysfunction occurred during hemorrhage in this model despite a stable platelet count
  • Significnt changes associated with hemorrhage were documented in aPTT (significantly prolonged), fibrinogen (decreased) and MA (altered).
  • Platelet function testing in dogs with naturally occurring hemorrhage warrants further investigation.
60
Q

What were the primary findings of a study by Balakrishnan et al regarding the development of anemia, phlebotomy practices and blood transfusion requirements in 45 critically ill cats (2009-2011)?

JVECC 2016 26 (3)

A
  • Iatrogenic anemia from frequent phlebotomies is an important cause for increased transfusion requirement
  • Fewer phelbotomies and blood conserving strategies may help reduce the incidence of anemia and decrease transfusion requirements

Coagulation/Transfusion (2 decks)

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