Evaluation of hemostatic analytes after use of hypertonic saline solution combined with colloids for resuscitation of dogs with hypovolemia

Debra L. Zoran From the Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, (Zoran, Jergens, Riedesel, Martin), the Department of Pathology, College of Veterinary Medicine, University of Missouri-Columbia, Columbia, MO 65211 (Johnson), and the Department of Statistics College of Sciences and Humanities, Iowa State University, Ames, IA 500ll (Bailey).

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Albert E. Jergens From the Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, (Zoran, Jergens, Riedesel, Martin), the Department of Pathology, College of Veterinary Medicine, University of Missouri-Columbia, Columbia, MO 65211 (Johnson), and the Department of Statistics College of Sciences and Humanities, Iowa State University, Ames, IA 500ll (Bailey).

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Dean H. Riedesel From the Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, (Zoran, Jergens, Riedesel, Martin), the Department of Pathology, College of Veterinary Medicine, University of Missouri-Columbia, Columbia, MO 65211 (Johnson), and the Department of Statistics College of Sciences and Humanities, Iowa State University, Ames, IA 500ll (Bailey).

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Gary S. Johnson From the Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, (Zoran, Jergens, Riedesel, Martin), the Department of Pathology, College of Veterinary Medicine, University of Missouri-Columbia, Columbia, MO 65211 (Johnson), and the Department of Statistics College of Sciences and Humanities, Iowa State University, Ames, IA 500ll (Bailey).

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Theodore B. Bailey From the Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, (Zoran, Jergens, Riedesel, Martin), the Department of Pathology, College of Veterinary Medicine, University of Missouri-Columbia, Columbia, MO 65211 (Johnson), and the Department of Statistics College of Sciences and Humanities, Iowa State University, Ames, IA 500ll (Bailey).

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Stephen D. Martin From the Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, (Zoran, Jergens, Riedesel, Martin), the Department of Pathology, College of Veterinary Medicine, University of Missouri-Columbia, Columbia, MO 65211 (Johnson), and the Department of Statistics College of Sciences and Humanities, Iowa State University, Ames, IA 500ll (Bailey).

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SUMMARY

The effects of hypertonic saline solution (htss) combined with colloids on hemostatic analytes were studied in 15 dogs. The analytes evaluated included platelet counts, one-stage prothrombin time, activated partial thromboplastin time, von Willebrand's factor antigen (vWf:Ag), and buccal mucosa bleeding times. The dogs were anesthetized, and jugular phlebotomy was used to induce hypovolemia (mean arterial blood pressure = 50 mm of Hg). Treatment dogs (n = 12) were resuscitated by infusion (6 ml/kg of body weight) of 1 of 3 solutions: htss combined with 6% dextran 70, 6% hetastarch, or 10% pentastarch. The control dogs (n = 3) were autotransfused. Hemostatic analytes were evaluated prior to induction of hypovolemia (baseline) and then after resuscitation (after 30 minutes of sustained hypovolemia) at 0.25, 0.5, 1, 6 and 24 hours.

All treatment dogs responded rapidly and dramatically to resuscitation with hypertonic solutions. Clinically apparent hemostatic defects (epistaxis, petechiae, hematoma were not observed in any dog. All coagulation variables evaluated, with the exception of vWf:Ag, remained within reference ranges over the 24-hour period. The vWf:Ag values were not statistically different than values from control dogs, and actual values were only slightly lower than reference ranges. Significant (P ≤ 0.04) differences were detected for one-stage prothrombin time, but did not exceed reference ranges. The results of this study suggested that small volume htss/colloid solutions do not cause significant alterations in hemostatic analytes and should be considered for initial treatment of hypovolemic or hemorrhagic shock.

SUMMARY

The effects of hypertonic saline solution (htss) combined with colloids on hemostatic analytes were studied in 15 dogs. The analytes evaluated included platelet counts, one-stage prothrombin time, activated partial thromboplastin time, von Willebrand's factor antigen (vWf:Ag), and buccal mucosa bleeding times. The dogs were anesthetized, and jugular phlebotomy was used to induce hypovolemia (mean arterial blood pressure = 50 mm of Hg). Treatment dogs (n = 12) were resuscitated by infusion (6 ml/kg of body weight) of 1 of 3 solutions: htss combined with 6% dextran 70, 6% hetastarch, or 10% pentastarch. The control dogs (n = 3) were autotransfused. Hemostatic analytes were evaluated prior to induction of hypovolemia (baseline) and then after resuscitation (after 30 minutes of sustained hypovolemia) at 0.25, 0.5, 1, 6 and 24 hours.

All treatment dogs responded rapidly and dramatically to resuscitation with hypertonic solutions. Clinically apparent hemostatic defects (epistaxis, petechiae, hematoma were not observed in any dog. All coagulation variables evaluated, with the exception of vWf:Ag, remained within reference ranges over the 24-hour period. The vWf:Ag values were not statistically different than values from control dogs, and actual values were only slightly lower than reference ranges. Significant (P ≤ 0.04) differences were detected for one-stage prothrombin time, but did not exceed reference ranges. The results of this study suggested that small volume htss/colloid solutions do not cause significant alterations in hemostatic analytes and should be considered for initial treatment of hypovolemic or hemorrhagic shock.

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