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Serial Evaluation of Haemostasis Following Acute Trauma Using Rotational Thromboelastometry in Dogs
Veterinary and Comparative Orthopaedics and Traumatology ( IF 1.0 ) Pub Date : 2020-11-17 , DOI: 10.1055/s-0040-1719167
Yaiza Herrero 1 , Rahel Jud Schefer 1 , Benjamin M Muri 2 , Nadja E Sigrist 1
Affiliation  

Objective The aim of this study was to describe the coagulation status of traumatized dogs over the first 24 hours after admission.

Study Design In 33 dogs presenting within 6 hours after trauma blood was sampled for rotational thromboelastometry (ROTEM), thrombocyte number and venous blood gas analysis at presentation and 6 and 24 hours thereafter. At each time point, dogs were defined as hypo-, normo- or hypercoagulable based on extrinsic, intrinsic and fibrinogen ROTEM profiles.

Results Significantly more dogs (11/33) presented hypocoagulable compared with 6 hours (p = 0.046) and 24 hours (p = 0.008) thereafter and none presented hypercoagulable. Significantly more dogs were hypercoagulable (6/23, p = 0.014) and no dog was hypocoagulable at 24 hours compared with presentation. All evaluated ROTEM parameters except maximum lysis were significantly more hypocoagulable at presentation compared with 24 hours thereafter.

Conclusion Hypocoagulability is more common in acutely traumatized dogs than previously described. Dogs were hypo- or normocoagulable at presentation and the coagulation status changed to normo- or hypercoagulability over the first 24 hours. Clotting times, clot formation and clot firmness but not clot lysis were significantly altered at presentation compared with 24 hours and fibrinogen concentration or function may play an important role in the dynamic change of coagulation state over time.



中文翻译:

在犬中使用旋转血栓弹力图连续评估急性创伤后的止血情况

目的 本研究的目的是描述受伤犬入院后最初 24 小时内的凝血状态。

研究设计 对 33 只在外伤后 6 小时内就诊的狗进行血液采样以进行旋转血栓弹力测定 (ROTEM)、就诊时以及之后的 6 小时和 24 小时的血小板数量和静脉血气分析。在每个时间点,根据外在、内在和纤维蛋白原 ROTEM 谱,狗被定义为低凝、正常或高凝状态。

结果 与 此后6 小时 ( p  = 0.046) 和 24 小时 ( p = 0.008)相比,明显更多的狗 (11/33)出现低凝状态,并且没有出现高凝状态。 与就诊相比,明显更多的狗出现高凝状态(6/23,p = 0.014),并且在 24 小时时没有狗出现低凝状态。与此后 24 小时相比,除最大裂解外,所有评估的 ROTEM 参数在就诊时都显着降低了低凝状态。

结论 与先前描述的相比,急性创伤狗的低凝状态更为常见。狗在出现时呈低凝或正常凝状态,并且在最初的 24 小时内,凝血状态变为正常或高凝状态。与 24 小时相比,凝血时间、凝块形成和凝块硬度(而非凝块溶解)在出现时显着改变,纤维蛋白原浓度或功能可能在凝血状态随时间的动态变化中起重要作用。

更新日期:2020-11-18
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