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Risk factors for transfusion-associated complications and nonsurvival in dogs receiving packed red blood cell transfusions: 211 cases (2008–2011)

Marie K. HolowaychukDepartment of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada.

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Jessica L. LeaderDepartment of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada.

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Gabrielle MonteithDepartment of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada.

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Abstract

Objective—To determine whether the number, volume, or age of transfused packed RBC units; volume of other blood products; or pretransfusion PCV was a risk factor for transfusion-associated complications or nonsurvival in dogs.

Design—Retrospective case series.

Animals—211 client-owned dogs receiving stored packed RBC transfusions.

Procedures—Information collected or calculated from the medical record of each dog included the total number, volume, and dose of packed RBC units; mean age of packed RBC units; number of packed RBC units > 14 days old; age of oldest packed RBC unit; volume and dose of other blood products used; pretransfusion PCV; acute patient physiologic and laboratory evaluation score; transfusion-associated complications; and outcome.

Results—The dose (mL/kg) of other blood products transfused was a risk factor for transfusion-associated complications (OR, 1.03; 95% confidence interval [CI], 1.01 to 1.05). The pretransfusion PCV (OR, 1.13; 95% CI, 1.06 to 1.21) and dose of packed RBCs administered (OR, 1.04; 95% CI, 1.02 to 1.07) were risk factors for nonsurvival. Age of transfused packed RBC units was not identified as a risk factor for transfusion-associated complications or nonsurvival, but the study was statistically underpowered to detect this finding.

Conclusions and Clinical Relevance—Administration of larger doses of other non–packed RBC blood products was a risk factor for transfusion-associated complications, and a higher pretransfusion PCV and larger dose of packed RBCs administered were risk factors for nonsurvival. Prospective randomized studies are needed to determine whether conservative transfusion strategies will reduce transfusion-associated complications and improve outcome in dogs.

Abstract

Objective—To determine whether the number, volume, or age of transfused packed RBC units; volume of other blood products; or pretransfusion PCV was a risk factor for transfusion-associated complications or nonsurvival in dogs.

Design—Retrospective case series.

Animals—211 client-owned dogs receiving stored packed RBC transfusions.

Procedures—Information collected or calculated from the medical record of each dog included the total number, volume, and dose of packed RBC units; mean age of packed RBC units; number of packed RBC units > 14 days old; age of oldest packed RBC unit; volume and dose of other blood products used; pretransfusion PCV; acute patient physiologic and laboratory evaluation score; transfusion-associated complications; and outcome.

Results—The dose (mL/kg) of other blood products transfused was a risk factor for transfusion-associated complications (OR, 1.03; 95% confidence interval [CI], 1.01 to 1.05). The pretransfusion PCV (OR, 1.13; 95% CI, 1.06 to 1.21) and dose of packed RBCs administered (OR, 1.04; 95% CI, 1.02 to 1.07) were risk factors for nonsurvival. Age of transfused packed RBC units was not identified as a risk factor for transfusion-associated complications or nonsurvival, but the study was statistically underpowered to detect this finding.

Conclusions and Clinical Relevance—Administration of larger doses of other non–packed RBC blood products was a risk factor for transfusion-associated complications, and a higher pretransfusion PCV and larger dose of packed RBCs administered were risk factors for nonsurvival. Prospective randomized studies are needed to determine whether conservative transfusion strategies will reduce transfusion-associated complications and improve outcome in dogs.

Contributor Notes

Supported by the Ontario Veterinary College Research Support Services and Ontario Veterinary College Undergraduate Research Assistantship Program.

Presented in part at the Ontario Veterinary College Summer Leadership and Research Program Poster Presentation Session.

The authors thank William Sears for assistance with statistical analyses.

Address correspondence to Dr. Holowaychuk (criticalcarevet@outlook.com).