The effect of flow rate and catheter diameter on hemolysis during blood transfusions using canine packed red blood cells.

OBJECTIVE: To evaluate the degree of hemolysis in canine packed RBCs at varying catheter sizes and flow rates as determined by RBC count, Hct, hemoglobin, creatine phosphokinase, and phosphorus. This study hypothesized that changes in flow rate and catheter diameter would change the degree of hemolysis. SAMPLE: A fresh unit of canine RBCs. PROCEDURES: A fresh unit of purchased canine packed RBCs was run through an IV infusion pump through 5 different catheter sizes (16, 18, 20, 22, and 24 gauge) at 5 different rates (50, 250, 500, 750, and 999 mL/h). Each sample was submitted for a CBC and chemistry, and RBC count, hemoglobin, hematocrit, creatine phosphokinase, and phosphorus were specifically evaluated to assess for the degree of hemolysis. RESULTS: Compared to the control, flow rate did not significantly affect the degree of hemolysis. Smaller catheter sizes had a significantly increased hemolysis (P < .05) based on variables to evaluate hemolysis (RBC count, Hct, hemoglobin, creatine phosphokinase, and phosphorus). This study's hypothesis was upheld in association with the catheter diameter but was rejected with flow rate. CLINICAL RELEVANCE: Blood transfusions are a common practice in veterinary medicine as treatment of anemia and hemorrhage. Hemolysis was greater when small catheter sizes were used. Larger catheters are recommended when feasible when performing transfusions.

Effect of duration of packed red blood cell storage on morbidity and mortality in dogs after transfusion: 3,095 cases (2001-2010).

BACKGROUND: Accumulating evidence suggests that transfusion of packed red blood cells (PRBCs) stored for >14 days is associated with increased rates of sepsis, multiple organ dysfunction, and mortality in human patients. OBJECTIVE: To determine if duration of PRBC storage has an effect on morbidity and mortality in dogs after transfusion. ANIMALS: Dogs admitted to the Matthew J Ryan Veterinary Hospital of the University of Pennsylvania. METHODS: A retrospective case review of dogs identified through blood bank logbooks that received PRBC transfusions (minimum, 5 mL/kg) between 2001 and 2010. Dogs were categorized according to major cause of anemia (eg, hemorrhage, hemolysis, ineffective erythropoiesis) for analysis. RESULTS: A total of 3,095 dogs received 5,412 PRBC units. Longer duration of PRBC storage was associated with development of new or progressive coagulation failure (P = .001) and thromboembolic disease (P = .005). There was no association between duration of PRBC storage and survival for all dogs overall. However, a logistic regression model indicated that for dogs with hemolysis, 90% of which had immune-mediated hemolytic anemia, longer duration of PRBC storage was a negative risk factor for survival. For every 7 day increase in storage, there was a 0.79 lesser odds of 30 day survival (95% CI, 0.64-0.97; P = .024). CONCLUSIONS AND CLINICAL IMPORTANCE: Duration of PRBC storage does not appear to be a major contributing factor to mortality in the overall canine population. However, longer duration of PRBC storage may negatively impact outcome in dogs with immune-mediated hemolytic anemia, thus warranting further investigation with prospective studies.

Ocorrência de anticorpos naturais contra antígenos eritrocitários, em cães do município de Fernandópolis, estado de São Paulo / Ocurrence of natural antibodies to canine erythrocyte antigens in dogs from Fernandópolis County, state of São Paulo

A transfusão de sangue é uma medida terapêutica muito difundida na prática veterinária devido ao alto número de pacientes que apresentam anemia e perdas sangüíneas agudas no momento da consulta. Felizmente, devido às características dos sistemas de grupos sangüíneos nessa espécie, as reações transfusionais fatais, causadas por incompatibilidade sanguínea, não são freqüentes. Os anticorpos de ocorrência natural podem ser encontrados em cães submetidos à uma primeira transfusão, podendo provocar reações transfusionais tardias caracterizadas pelo seqüestro e destruição das hemácias no período de 72 horas. Embora não provoquem reações fatais, sua presença neutraliza o benefício terapêutico da transfusão e prejudica a recuperação clínica do paciente. O presente estudo teve como objetivo verificar a ocorrência de anticorpos naturais em cães nunca submetidos a transfusões sanguíneas, no município de Fernandópolis, Estado de São Paulo. O teste de reação cruzada foi realizado à temperatura ambiente e á 37ºC, utilizando-se amostras de sangue provenientes de 100 cães triados junto ao ambulatório de clínica do Hospital Veterinário Domingos Alves. Encontrou-se reações positivas em 10 (10%) dentre os 100 (100%) testes realizados. Este resultado indica que, na população de cães estudada, 10% dos cães possuem anticorpos naturais capazes de provocar incompatibilidade sanguínea entre o doador de sangue e o receptor, em uma primeira transfusão de sangue e, consequentemente, uma reação transfusional. Sendo assim, o teste de reação cruzada, por sua simplicidade e baixo custo, deve ser instituído como rotina para a seleção de doadores e receptores adequados, previamente a todas as transfusões de sangue

Blood transfusion is a disseminated therapy in veterinary medicine, as far as there are a great number of patients presenting anemia and acute blood loss at the moment of the first appointment and, therefore, needing a blood transfusion. Fortunately, due the blood group system properties in this species, fatal transfusion reactions are not usual. Naturally occurrence antibodies may be found in the first transfused dogs, causing delayed transfusion reactions characterized for splenic capture and destruction of erythrocytes, over a 72 hour period. Even though they don’t elicit fatal reactions, their presence might neutralize the benefits of blood transfusion and retard recovery of the patient. The goal of this study was to verify the occurrence of natural antibodies in dogs reared in Fernandopolis, state of Sao Paulo. Crossmatching test was performed under 22 and 37%ºC, using blood samples from 100 dogs, referred to the Veterinary Hospital of Unicastelo, Fernandopolis/SP, Brazil. Positive reactions were found in 10 (10%) out of 100 (100%) reactions. This result might indicate there is a 10% probability of naturally occurrence antibodies in the studied canine population, and they could be responsible for blood incompatibility between blood donor and recipient, in the very first transfusion. Therefore, crossmatching test should be routinely performed before every blood transfusion, for adequate selection of donors and recipients

Ocorrência de anticorpos naturais contra antígenos eritrocitários, em cães do município de Fernandópolis, estado de São Paulo / Ocurrence of natural antibodies to canine erythrocyte antigens in dogs from Fernandópolis County, state of São Paulo

A transfusão de sangue é uma medida terapêutica muito difundida na prática veterinária devido ao alto número de pacientes que apresentam anemia e perdas sangüíneas agudas no momento da consulta. Felizmente, devido às características dos sistemas de grupos sangüíneos nessa espécie, as reações transfusionais fatais, causadas por incompatibilidade sanguínea, não são freqüentes. Os anticorpos de ocorrência natural podem ser encontrados em cães submetidos à uma primeira transfusão, podendo provocar reações transfusionais tardias caracterizadas pelo seqüestro e destruição das hemácias no período de 72 horas. Embora não provoquem reações fatais, sua presença neutraliza o benefício terapêutico da transfusão e prejudica a recuperação clínica do paciente. O presente estudo teve como objetivo verificar a ocorrência de anticorpos naturais em cães nunca submetidos a transfusões sanguíneas, no município de Fernandópolis, Estado de São Paulo. O teste de reação cruzada foi realizado à temperatura ambiente e á 37ºC, utilizando-se amostras de sangue provenientes de 100 cães triados junto ao ambulatório de clínica do Hospital Veterinário Domingos Alves. Encontrou-se reações positivas em 10 (10%) dentre os 100 (100%) testes realizados. Este resultado indica que, na população de cães estudada, 10% dos cães possuem anticorpos naturais capazes de provocar incompatibilidade sanguínea entre o doador de sangue e o receptor, em uma primeira transfusão de sangue e, consequentemente, uma reação transfusional. Sendo assim, o teste de reação cruzada, por sua simplicidade e baixo custo, deve ser instituído como rotina para a seleção de doadores e receptores adequados, previamente a todas as transfusões de sangue(AU)

Blood transfusion is a disseminated therapy in veterinary medicine, as far as there are a great number of patients presenting anemia and acute blood loss at the moment of the first appointment and, therefore, needing a blood transfusion. Fortunately, due the blood group system properties in this species, fatal transfusion reactions are not usual. Naturally occurrence antibodies may be found in the first transfused dogs, causing delayed transfusion reactions characterized for splenic capture and destruction of erythrocytes, over a 72 hour period. Even though they dont elicit fatal reactions, their presence might neutralize the benefits of blood transfusion and retard recovery of the patient. The goal of this study was to verify the occurrence of natural antibodies in dogs reared in Fernandopolis, state of Sao Paulo. Crossmatching test was performed under 22 and 37%ºC, using blood samples from 100 dogs, referred to the Veterinary Hospital of Unicastelo, Fernandopolis/SP, Brazil. Positive reactions were found in 10 (10%) out of 100 (100%) reactions. This result might indicate there is a 10% probability of naturally occurrence antibodies in the studied canine population, and they could be responsible for blood incompatibility between blood donor and recipient, in the very first transfusion. Therefore, crossmatching test should be routinely performed before every blood transfusion, for adequate selection of donors and recipients(AU)