The influence of packed cell volume versus plasma proteins on thromboelastographic variables in canine blood
The influence of packed cell volume versus plasma proteins on thromboelastographic variables in canine blood
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DOI：
10.1111/vec.12979
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发表时间：
2020-06-25
影响因子：
1.3
通讯作者：
Hanel, Rita
中科院分区：
文献类型：
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作者：
Lynch, Alex M.;Ruterbories, Laura;Hanel, Rita
目的在离体模型中确定高岭土活化血栓弹力图（TEG）变量（R、K、角度和最大振幅[MA]）与PCV、纤维蛋白原浓度（FC）和总纤维蛋白原（TF）之间的相关性。动物两只健康的成年杂种犬。采集枸橼酸抗凝全血，分离成浓缩红细胞、富血小板血浆和贫血小板血浆（PPP）。将PPP的等分试样加热以使热不稳定蛋白质（纤维蛋白原、因子V、因子VIII）变性。重组血液成分用于分析6种生理情况：低纤维蛋白原贫血;中等纤维蛋白原贫血;正常纤维蛋白原贫血;生理盐水贫血;正常PCV和正常纤维蛋白原;正常PCV和低纤维蛋白原。使用Kruskal-Wallis检验以及TEG变量成对组合的线性回归沿着，确定TEG变量与PCV、FC和TF之间的相关性。结果最大波幅与FC（R（2）0.60，P < 0.001）和TF（R（2）0.57，P < 0.001）相关，与PCV无关（R（2）0.003，P = 0.7）。角度和K时间与FC（[角度：R（2）0.53，P < 0.001]; [K：R（2）0.55，P < 0.001]）和TF（[α角度：R（2）0.52，P < 0.001]; [K：R（2）0.51，P < 0.001]）中度相关，但与PCV无关。R时间与PCV呈弱相关（R（2）0.15，P < 0.009），与FC、TF无相关性。结论和临床相关性在离体模型中，血浆蛋白而不是PCV影响TEG变量。这表明贫血引起的TEG变化是由固定微环境中可用纤维蛋白原的变化引起的，而不是贫血的人为因素。
Objective Determine the correlation between kaolin-activated thromboelastography (TEG) variables (R, K, angle, and maximum amplitude [MA]) and PCV, fibrinogen concentration (FC), and total fibrinogen (TF) in an ex vivo model. Animals Two healthy adult mixed-breed dogs. Procedures Citrated whole blood was obtained and separated into packed red cells, platelet rich plasma, and platelet poor plasma (PPP). An aliquot of PPP was heated to denature heat labile proteins (fibrinogen, factor V, factor VIII). Blood components were recombined for analyses of 6 physiological scenarios: anemia with low fibrinogen; anemia with moderate fibrinogen; anemia with normal fibrinogen; anemia with normal saline; normal PCV and normal fibrinogen; and normal PCV and low fibrinogen. A Kruskal-Wallis test, along with linear regressions on pairwise combinations of TEG variables, was used to determine the correlation between TEG variables and PCV, FC, and TF. Results Maximum amplitude correlated with FC (R(2)0.60,P < 0.001) and TF (R(2)0.57,P < 0.001) but not PCV (R(2)0.003,P = 0.7). Angle and K time were moderately correlated with FC ([angle:R(2)0.53,P < 0.001]; [K:R(2)0.55,P < 0.001]) and TF ([alpha angle:R(2)0.52,P < 0.001]; [K:R(2)0.51,P < 0.001]) but not PCV. The R time was weakly correlated with PCV (R(2)0.15,P < 0.009) but not FC or TF. Conclusions and clinical relevance In an ex vivo model, plasma proteins but not PCV impacted TEG variables. This suggests that TEG changes noted with anemia are imparted by changes in available fibrinogen in a fixed microenvironment rather than artifact of anemia.