目的:描述和比较凝血酶原时间(PT),活化部分凝血活酶时间(aPTT),血栓弹力图(TEG),HCT,和出血/过度复苏模型中的血小板计数测量。
方法:随机交叉研究。
方法:大学教学医院。
方法:六只猫。
方法:麻醉猫接受3次治疗,间隔2个月。治疗方法如下:NHR-无控制出血和假复苏;LRS控制出血和乳酸林格液(LRS)用于复苏;以及Voluven控制出血和6%四弓130/0.4用于复苏。LRS和Voluven以60和20mL/kg/h的剂量给药,分别,120分钟抽取血样作PT,aPTT,TEG,HCT,和健康检查时的血小板计数测量(T-7d),控制出血后(T0),在60和120分钟的复苏(T60和T120),复苏完成后24小时(T24h)。使用一般线性混合模型方法分析数据(显著性为P<0.05)。
结果:NHR在T120时的总中位失血量(从T0到T120的控制出血和采血)为11.4、31.0和30.8mL/kg,LRS,和Voluven,分别。与NHR相比,LRS和Voluven期间的PT和aPTT在T60和T120时延长(P<0.001)。在TEG上,反应时间,动力学时间,在所有治疗的所有时间点,α角都在猫的参考间隔内,与NHR相比,Voluven期间的T0,T60和T120以及LRS期间的T60和T120的最大振幅小于参考间隔(40mm)(均P<0.001)。与NHR相比,LRS和Voluven期间的T60和T120时的HCT和血小板计数显着降低(P<0.001)。
结论:在出血和自由液体复苏过程中观察到低凝血障碍。PT和aPPT的延长和凝块强度的降低可能是由血液稀释和血小板损失引起的。
OBJECTIVE: To describe and compare prothrombin time (PT), activated partial thromboplastin time (aPTT), thromboelastography (TEG), HCT, and platelet count measurements in a hemorrhage/over-resuscitation model.
METHODS: Randomized crossover study.
METHODS: University teaching hospital.
METHODS: Six cats.
METHODS: Anesthetized cats underwent 3 treatments at 2-month intervals. The treatments were as follows: NHR-no controlled hemorrhage and sham resuscitation; LRS-controlled hemorrhage and lactated Ringer\'s solution (LRS) for resuscitation; and Voluven-controlled hemorrhage and 6% tetrastarch 130/0.4 for resuscitation. The LRS and Voluven were administered at 60 and 20 mL/kg/h, respectively, for 120 minutes. Blood samples were drawn for PT, aPTT, TEG, HCT, and platelet count measurements at a healthy check (T - 7d), after controlled hemorrhage (T0), at 60 and 120 minutes of resuscitation (T60 and T120), and at 24 hours after completion of resuscitation (T24h). Data were analyzed using a general linear mixed model approach (significance was P < 0.05).
RESULTS: Total median blood loss (controlled hemorrhage and blood sampling from T0 to T120) at T120 was 11.4, 31.0, and 30.8 mL/kg for NHR, LRS, and Voluven, respectively. PT and aPTT during LRS and Voluven were prolonged at T60 and T120 compared to NHR (P < 0.001). On TEG, the reaction time, kinetic time, and alpha-angle were within reference intervals for cats at all time points in all treatments, while maximum amplitude was less than the reference interval (40 mm) at T0, T60, and T120 during Voluven and at T60 and T120 during LRS compared to NHR (both P < 0.001). The HCT and platelet count were significantly lower at T60 and T120 during LRS and Voluven compared to NHR (P < 0.001).
CONCLUSIONS: Hypocoagulopathy was observed during hemorrhage and liberal fluid resuscitation. Prolongation of PT and aPPT and decreased clot strength may have been caused by hemodilution and platelet loss.