Effect of venipuncture quality on thromboelastography
Effect of venipuncture quality on thromboelastography
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DOI：
10.1111/j.1476-4431.2012.00724.x
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发表时间：
2012-04-01
影响因子：
1.3
通讯作者：
Brown, Andrew J.
中科院分区：
文献类型：
--
作者：
Garcia-Pereira, Brandi L.;Scott, Michael A.;Brown, Andrew J.
目的：确定静脉穿刺物的质量是否会影响血栓弹性成像(TEG)的结果，以及最初的废弃导管是否可以减轻创伤性静脉穿刺物的影响。设计：前瞻性观察性研究。设置-兽医教学医院。动物-15只私人拥有和研究群体的成年犬。测量-采用每个静脉2个静脉穿刺法中的1个从每个颈静脉采集样本。静脉穿刺术随机分为：(1)从1条颈静脉进行“清洁”静脉穿刺术(CV)；(2)从对侧颈静脉进行次优静脉穿刺术(SOV)。CV被定义为在第一次尝试时直接进入静脉。SOV被定义为在静脉附近插入至少一次重定向进入静脉的针。从每一次静脉穿刺术中连续采集两个样本而不拔出针头，产生4个样本：CV1、CV2、SOV1和SOV2。结果SOV1组R平均+/-SD(4.1+/-1.3 S)显著短于CV1组(5.7+/-1.4 S)和SOV2组(5.5+/-1.9)S(P<0.0 5)。CV1组和CV2组之间、SOV2组与CV1组和CV2组之间的R均无差异。组间α、K、MA无显著差异。结论轻、中度静脉穿刺伤对TEG总体影响不大，但对R有显著影响。质量较差的收集会导致血栓形成的速度更快。然而，这种影响是温和的，并通过在丢弃初始样本后在第二个采集管中测试样本来缓解。
Objective - To determine if the quality of venipuncture impacts thromboelastography (TEG) results and if an initial discard tube mitigates any effects of traumatic venipuncture.Design - Prospective, observational study.Setting - Veterinary teaching hospital.Animals - Fifteen privately owned and research colony adult dogs.Measurements - Samples were collected from each jugular vein using 1 of 2 venipuncture techniques per vein. The venipuncture technique was randomized to the vein as follows: (1) "clean" venipuncture (CV) from 1 jugular vein, and (2) suboptimal venipuncture (SOV) from the opposite jugular vein. CV was defined as a direct entry into the vein on the first attempt. SOV was defined as needle insertion adjacent to the vein with redirection at least once to enter the vein. Two consecutive samples were collected from each venipuncture without removal of the needle, yielding 4 samples: CV1, CV2, SOV1, and SOV2. TEG was performed on each blood sample and the TEG parameters R, K, alpha, and MA were recorded.Results-Mean +/- SD of R for the SOV1 group (4.1 +/- 1.3 s) was significantly shorter than that of the CV1 group (5.7 +/- 1.4 s) and the SOV2 group (5.5 +/- 1.9 s), P < 0.05. There was no difference in R between CV1 and CV2 groups, or between SOV2 and either CV1 or CV2. There was no significant difference in alpha, K, or MA among groups.Conclusions - Mild-to-moderate venipuncture trauma had little effect on TEG overall, but R was significantly affected. Poorer quality collection resulted in a more rapid initiation of clot formation. However, the effect was mild and mitigated by testing samples in a second collection tube after discard of an initial sample.