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Incidence of acute lung injury in dogs receiving transfusions

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  • 1 Department of Medical Science, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706.
  • | 2 Department of Medical Science, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706.

Abstract

Objective—To document the existence and incidence of acute lung injury (ie, veterinary acute lung injury [VetALI] per the 2007 consensus definition) in a population of client-owned dogs receiving transfusions for various clinical reasons.

Design—Prospective observational study.

Animals—54 client-owned dogs.

Procedures—Arterial blood gas analysis was performed for dogs receiving a transfusion (blood and plasma products) at 0 to 12 hours before and 24 to 48 hours after transfusion; dogs also underwent thoracic radiography 0 to 24 hours before and 24 to 48 hours after transfusion. The ratio of Pao2 to fraction of inspired oxygen (Fio2) was calculated. Dogs with posttransfusion radiographic signs of pulmonary infiltrates, a Pao2:Fio2 ratio < 300, or clinical signs of respiratory compromise were suspected of having VetALI and underwent echocardiography to exclude left-sided heart failure. The incidence of VetALI was calculated, and χ2 tests were used to compare the incidence in study dogs with the historical reported incidence of acute respiratory distress syndrome (ARDS) in ill dogs (not receiving transfusions) and transfusion-related acute lung injury (TRALI) in humans.

Results—The incidence of VetALI (2/54 [3.7%]; 95% confidence interval, 0% to 8.73%) in study dogs was significantly less than the reported incidence of TRALI in humans (25%) and not significantly different from the reported incidence of ARDS in ill dogs (10%).

Conclusions and Clinical Relevance—VetALI occurred in dogs that received transfusions at a frequency similar to that previously reported for ARDS in ill dogs that did not receive transfusions.

Abstract

Objective—To document the existence and incidence of acute lung injury (ie, veterinary acute lung injury [VetALI] per the 2007 consensus definition) in a population of client-owned dogs receiving transfusions for various clinical reasons.

Design—Prospective observational study.

Animals—54 client-owned dogs.

Procedures—Arterial blood gas analysis was performed for dogs receiving a transfusion (blood and plasma products) at 0 to 12 hours before and 24 to 48 hours after transfusion; dogs also underwent thoracic radiography 0 to 24 hours before and 24 to 48 hours after transfusion. The ratio of Pao2 to fraction of inspired oxygen (Fio2) was calculated. Dogs with posttransfusion radiographic signs of pulmonary infiltrates, a Pao2:Fio2 ratio < 300, or clinical signs of respiratory compromise were suspected of having VetALI and underwent echocardiography to exclude left-sided heart failure. The incidence of VetALI was calculated, and χ2 tests were used to compare the incidence in study dogs with the historical reported incidence of acute respiratory distress syndrome (ARDS) in ill dogs (not receiving transfusions) and transfusion-related acute lung injury (TRALI) in humans.

Results—The incidence of VetALI (2/54 [3.7%]; 95% confidence interval, 0% to 8.73%) in study dogs was significantly less than the reported incidence of TRALI in humans (25%) and not significantly different from the reported incidence of ARDS in ill dogs (10%).

Conclusions and Clinical Relevance—VetALI occurred in dogs that received transfusions at a frequency similar to that previously reported for ARDS in ill dogs that did not receive transfusions.

Contributor Notes

Dr. Thomovsky's present address is Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47906.

Supported in full by an intramural grant at the University of Wisconsin School of Veterinary Medicine.

The authors declare no financial conflicts of interest.

The authors thank Dr. Randi Drees for input on the study conclusions and blinded review of all radiographs after the study conclusion.

Address correspondence to Dr. Thomovsky (ethomovs@purdue.edu).