7.2% 高渗盐水和 20% 甘露醇对疑似颅内高压犬全血凝血和血小板功能影响的比较 — — 一项初步研究Comparison of the effects of 7.2% hypertonic saline and 20% mannitol on whole blood coagulation and platelet function in dogs with suspected intracranial hypertension

Abstract：

BACKGROUND: Hyperosmolar therapy with either mannitol or hypertonic saline (HTS) is commonly used in the treatment of intracranial hypertension (ICH). In vitro data indicate that both mannitol and HTS affect coagulation and platelet function in dogs. The aim of this study was to compare the effects of 20% mannitol and 7.2% HTS on whole blood coagulation using rotational thromboelastometry (ROTEM®) and platelet function using a platelet function analyzer (PFA®) in dogs with suspected ICH. Thirty client-owned dogs with suspected ICH needing osmotherapy were randomized to receive either 20% mannitol (5 ml/kg IV over 15 min) or 7.2% HTS (4 ml/kg IV over 5 min). ROTEM® (EXTEM® and FIBTEM® assays) and PFA® analyses (collagen/ADP cartridges) were performed before (T0), as well as 5 (T5), 60 (T60) and 120 (T120) minutes after administration of HTS or mannitol. Data at T5, T60 and T120 were analyzed as a percentage of values at T0 for comparison between groups, and as absolute values for comparison between time points, respectively.
RESULTS: No significant difference was found between the groups for the percentage change of any parameter at any time point except for FIBTEM® clotting time. Within each group, no significant difference was found between time points for any parameter except for FIBTEM® clotting time in the HTS group, and EXTEM® and FIBTEM® maximum clot firmness in the mannitol group. Median ROTEM® values lay within institutional reference intervals in both groups at all time points, whereas median PFA® values were above the reference intervals at T5 (both groups) and T60 (HTS group).
CONCLUSIONS: Using currently recommended doses, mannitol and HTS do not differ in their effects on whole blood coagulation and platelet function in dogs with suspected ICH. Moreover, no relevant impairment of whole blood coagulation was found following treatment with either solution, whereas a short-lived impairment of platelet function was found after both solutions.

摘要：

背景：甘露醇或高渗盐水（HTS）的高渗性治疗通常用于治疗颅内高压（ICH）。体外数据表明甘露醇和HTS都影响狗的凝血和血小板功能。这项研究的目的是比较使用旋转血栓弹性测定法（ROTEM®）和使用血小板功能分析仪（PFA®）在疑似ICH的狗中使用20％甘露醇和7.2％HTS对全血凝血的影响。30只疑似ICH需要渗透治疗的客户拥有的狗被随机分配接受20％甘露醇（15分钟内5ml/kgIV）或7.2％HTS（5分钟内4ml/kgIV）。ROTEM®（EXTEM®和FIBTEM®测定）和PFA®分析（胶原蛋白/ADP盒）在（T0）之前进行，5（T5）给予HTS或甘露醇后60(T60)和120(T120)分钟。T5，T60和T120的数据作为T0值的百分比进行分析，以进行组间比较，作为时间点之间比较的绝对值，分别。
结果：除FIBTEM®凝血时间外，在任何时间点任何参数的百分比变化在组间均未发现显着差异。在每一组中,在HTS组中，除FIBTEM®凝血时间外，任何参数在时间点之间均无显著差异，以及甘露醇组中的EXTEM®和FIBTEM®最大凝块硬度。在所有时间点，两组的ROTEM®中值均在机构参考区间内，而在T5(两组)和T60(HTS组)时,PFA®中值均高于参考区间.
结论：使用目前推荐的剂量，甘露醇和HTS对疑似ICH犬的全血凝血和血小板功能的影响没有差异。此外，两种溶液治疗后均未发现全血凝血相关损害,而在两种解决方案后发现血小板功能短期受损。

Comparison of the effects of 7.2% hypertonic saline and 20% mannitol on whole blood coagulation and platelet function in dogs with suspected intracranial hypertension - a pilot study.