Comparison of whole blood and plasma colloid osmotic pressure in healthy dogs

Influence of intravenous 10% amino acids infusion on serum albumin concentration in hypoalbuminemic dogs

Objective

To evaluate the effect of parenteral amino acid application in hospitalized hypoalbuminemic dogs.

Materials and methods

Medical records of client-owned hypoalbuminemic dogs (albumin ≤ 25 g/L) were analyzed. Dogs receiving amino acids for only 1-2 days, receiving transfusions or surgery, or <6 months of age were excluded. Dogs were grouped as those receiving intravenous amino acids (AA, 80 dogs) over 3 days and longer, and those without additional amino acid treatment (CON, 78 dogs). Duration of hospitalization, albumin, and total protein concentrations were compared between groups by Mann-Whitney U test. Course of albumin and total protein concentration was evaluated by Friedman test and Dunn's multiple comparison test. Significance was set to p ≤ 0.05.

Results

Dogs in group AA received 10% amino acid solution intravenously over median 4 days (3-11 days). No significant differences regarding survival and adverse effects were observed between groups. Dogs of group AA had significantly longer duration of hospitalization (median 8 days; 3-33 days) compared to group CON dogs (median 6 days, 3-24 days; p < 0.001). Initial albumin concentration was lower in group AA compared to CON (p < 0.001). This difference was no longer present on day 2 (p = 0.134).

Conclusions and clinical relevance

Intravenous application of 10% amino acid solution in hypoalbuminemic dogs can improve albumin concentration after 2 days, but does not influence outcome.

Defining colloid osmotic pressure and the relationship between blood proteins and colloid osmotic pressure in dairy cows and calves

OBJECTIVE

To establish the reference interval for colloid osmotic pressure (COP) in neonatal and adult cattle and to investigate associations between COP and total protein, albumin, or globulin in the two populations sampled.

DESIGN

Cross-sectional observational study.

SETTING

Animals were sampled on commercial dairy farms in Southern Wisconsin, and samples were processed and analyzed in a clinical pathology laboratory at a university teaching hospital.

ANIMALS

Forty adult lactating Holstein cows between 2 and 4 years of age and 40 healthy Holstein calves of both sexes between 2 and 7 days of age.

INTERVENTIONS

Adult cows were sampled by coccygeal venipuncture into standard heparinized vacutainer tubes, calves were sampled by jugular venipuncture also into heparinized vacutainer tubes.

MEASUREMENTS AND MAIN RESULTS

For adult cows, the mean COP was 22.52 mm Hg, with a standard deviation of 1.0. For calves, the mean COP was 19.6 mm Hg, with a standard deviation of 1.9. Good correlation was demonstrated in adults between COP and albumin concentrations (r(2) = 0.72) and between COP and both total protein concentration (r(2) = 0.74) and globulin (r(2) = 0.65) in calves. For adults, regression plots established best fit relationships of COP = 0.472 (albumin) + 6.49, whereas for calves, two regression equations could be described; COP = 0.305 (globulin) + 8.62, and 0.268 (total plasma protein) + 2.73.

CONCLUSIONS

Suggested normal ranges (mean ± 2 standard deviations) for COP in adult lactating dairy cows and calves between 2 and 7 days of age were 21-25 mm Hg and 17-23 mm Hg, respectively.

Natural and Synthetic Colloids in Veterinary Medicine

This review article covers basic physiology underlying the clinical use of natural and artificial colloids as well as provide practice recommendations. It also touches on the recent scrutiny of these products in human medicine and how this may have an effect on their use in veterinary medicine.

Controversies in the use of hydroxyethyl starch solutions in small animal emergency and critical care

OBJECTIVES

To (1) review the development and medical applications of hydroxyethyl starch (HES) solutions with particular emphasis on its physiochemical properties; (2) critically appraise the available evidence in human and veterinary medicine, and (3) evaluate the potential risks and benefits associated with their use in critically ill small animals.

DATA SOURCES

Human and veterinary original research articles, scientific reviews, and textbook sources from 1950 to the present.

HUMAN DATA SYNTHESIS

HES solutions have been used extensively in people for over 30 years and ever since its introduction there has been a great deal of debate over its safety and efficacy. Recently, results of seminal trials and meta-analyses showing increased risks related to kidney dysfunction and mortality in septic and critically ill patients, have led to the restriction of HES use in these patient populations by European regulatory authorities. Although the initial ban on the use of HES in Europe has been eased, proof regarding the benefits and safety profile of HES in trauma and surgical patient populations has been requested by these same European regulatory authorities.

VETERINARY DATA SYNTHESIS

The veterinary literature is limited mostly to experimental studies and clinical investigations with small populations of patients with short-term end points and there is insufficient evidence to generate recommendations.

CONCLUSIONS

Currently, there are no consensus recommendations regarding the use of HES in veterinary medicine. Veterinarians and institutions affected by the HES restrictions have had to critically reassess the risks and benefits related to HES usage based on the available information and sometimes adapt their procedures and policies based on their reassessment. Meanwhile, large, prospective, randomized veterinary studies evaluating HES use are needed to achieve relevant levels of evidence to enable formulation of specific veterinary guidelines.

Fresh frozen plasma: red blood cells (1:2) coagulation effect is equivalent to 1:1 and whole blood

BACKGROUND

Preemptive treatment of trauma-associated coagulopathy involves transfusion of fresh frozen plasma (FFP) at 1:1 ratio with red blood cells (RBCs), but the optimal ratio remains controversial. In combat theaters, fresh whole blood (FWB) is also an option. The objective of this study was to determine the effect of FFP:RBC ratios 1:1, 1:2, 1:3 and FWB on coagulation during resuscitation.

MATERIALS AND METHODS

Thirty-six rats were randomized in the following six groups: Group 1: sham; Group 2: hemorrhage followed by sole lactated Ringer (LR) infusion; Group 3: FFP:RBC (1:1); Group 4: FFP:RBC (1:2); Group 5: FFP:RBC (1:3); Group 6: FWB transfusion. Another 25 animals were used for blood harvesting. Hemorrhage was induced by withdrawing 40% of total blood volume, mean arterial pressure (MAP) decreased to 45% of baseline, and laparotomy. Animals underwent LR infusion followed by blood product transfusion preset for each group. Blood samples were obtained at baseline and in the 105th minute for thromboelastometry and lactate.

RESULTS

Hemorrhage caused a significant decrease in MAP and increase in lactate (P < 0.05). MAP was persistently low in group 2 despite fluid infusion (P < 0.05), but not in the other groups after 20 min of resuscitation. Mean clot formation time, alpha angle, and maximum clot firmness decreased significantly (P < 0.05) in group 2 (LR) and group 5 (1:3) compared with other groups.

CONCLUSIONS

FFP:RBC in a 1:2 ratio optimally harnessed hemostatic resuscitation and prudent use of blood products compared with 1:1 and 1:3 ratios and to FWB transfusion.

Comparison of whole blood and plasma colloid osmotic pressure in healthy cats

OBJECTIVE

To establish reference intervals for whole blood and plasma colloid osmotic pressure (COP) in healthy cats between the ages of 1 and 10 years using a cage-side colloid osmometer.

DESIGN

Prospective, observational study.

SETTINGS

University veterinary teaching hospital.

ANIMALS

Sixty-three healthy cats.

INTERVENTIONS

Phlebotomy.

MEASUREMENTS AND MAIN RESULTS

Whole blood COP mean was 24.4 (±2.78) mmHg and plasma COP mean was 24.3 (±2.59) mmHg. Reference interval for our study population of feline whole blood COP was 18.9 to 30.4 mmHg, and for our study population of feline plasma COP was 18.3 to 30.8 mmHg. Difference of paired whole blood COP and plasma COP was +0.23 ± 1.68 mmHg (P = 0.32). There was no significant difference when comparing COP from neutered male and neutered female cats. Total protein and albumin were significantly correlated with whole blood COP (total protein to whole blood COP P < 0.0001, r = 0.53; albumin to whole blood COP P <0.0001, r = 0.68) and plasma COP (total protein to plasma COP P = 0.0025, r = 0.41; albumin to plasma COP P < 0.0001, r = 0.66).

CONCLUSIONS

No significant difference was found between mean whole blood and plasma COP in this study population of cats. Even though not statistically significant, evaluation of paired whole blood COP and plasma COP did reveal a slight difference; therefore, it seems prudent to maintain sample consistency for serial evaluations in cats.