Tolerable infusion rate of citrate based on clinical signs and the electrocardiogram in conscious dogs

Blois

Goy‐Thollot

et al. 2021

Objective To use a systematic, evidence‐based consensus process to develop definitions for transfusion reactions in dogs and cats. Design Evidence evaluation of the literature was carried out for identified transfusion reaction types in dogs and cats. Reaction definitions were generated based on synthesis of human and veterinary literature. Consensus on the definitions was achieved through Delphi‐style surveys. Draft recommendations were made available through industry specialty listservs and comments were incorporated. Results Definitions with imputability criteria were developed for 14 types of transfusion reactions. Conclusions The evidence review and consensus process resulted in definitions that can be used to facilitate future veterinary transfusion reaction research.

Section: Citrate Toxicity/hypocalcemiamentioning

confidence: 99%

Association of Veterinary Hematology and Transfusion Medicine (AVHTM) Transfusion Reaction Small Animal Consensus Statement (TRACS). Part 1: Definitions and clinical signs

Blois

Goy‐Thollot

et al. 2021

“…However, plasma citrate concentrations were not measured. Several complications with citrate toxicity have been reported, including electrolyte abnormalities, acid‐base disturbances, ECG changes, vomiting, nausea, and tremors 184–186 …”

Section: Domain 1: Prevention Strategiesmentioning

confidence: 99%

Association of Veterinary Hematology and Transfusion Medicine (AVHTM) Transfusion Reaction Small Animal Consensus Statement (TRACS) Part 2: Prevention and monitoring

Blois

Goy‐Thollot

et al. 2021

Objective To systematically review available evidence to develop guidelines for the prevention of transfusion reactions and monitoring of transfusion administration in dogs and cats. Design Evidence evaluation of the literature (identified through Medline searches through Pubmed and Google Scholar searches) was carried out for identified transfusion reaction types in dogs and cats. Evidence was evaluated using PICO (Population, Intervention, Comparison, Outcome) questions generated for each reaction type. Evidence was categorized by level of evidence (LOE) and quality (Good, Fair, or Poor). Guidelines for prevention and monitoring were generated based on the synthesis of the evidence. Consensus on the final recommendations and a proposed transfusion administration monitoring form was achieved through Delphi‐style surveys. Draft recommendations and the monitoring form were made available through veterinary specialty listservs and comments were incorporated. Results Twenty‐nine guidelines and a transfusion administration monitoring form were formulated from the evidence review with a high degree of consensus Conclusions This systematic evidence evaluation process yielded recommended prevention and monitoring guidelines and a proposed transfusion administration form. However, significant knowledge gaps were identified, demonstrating the need for additional research in veterinary transfusion medicine.

“…In people, it is recommended to supplement calcium when the ionized calcium falls below 0.9 mmol/L 97 . In an experimental study (LOE 3, good) using healthy dogs, clinical signs of hypocalcemia were observed in one dog when the ionized calcium was 0.91 ± 0.03 mmol/L 106 . If calcium supplementation is required, a second IV line should be used, and the calcium should not be administered through the same line as the anticoagulated blood product.…”

Section: Domain 4: Treatmentmentioning

confidence: 99%

“…97 In an experimental study (LOE 3, good) using healthy dogs, clinical signs of hypocalcemia were observed in one dog when the ionized calcium was 0.91 ± 0.03 mmol/L. 106 If calcium supplementation is required, a second IV line should be used, and the calcium should not be administered through the same line as the anticoagulated blood product. Depending on the volume of blood products infused, hypocalcemia can be severe and potentially life threatening.…”

Section: Agreement: 13/13 Evidence Summarymentioning

confidence: 99%

Association of Veterinary Hematology and Transfusion Medicine (AVHTM) transfusion reaction small animal consensus statement (TRACS). Part 3: Diagnosis and treatment

Odunayo

Nash²,

et al. 2021

Objective To systematically review available evidence to develop guidelines for diagnosis and treatment of transfusion‐associated reactions in dogs and cats. Design Standardized and systemic evaluation of the literature (identified through Medline via PubMed and Google Scholar searches) was carried out for identified transfusion reaction types in dogs and cats. The available evidence was evaluated using PICO (Population, Intervention, Comparison, Outcome) questions generated for each reaction type. The evidence was categorized by level of evidence (LOE) and quality (Good, Fair, or Poor). Guidelines, diagnostic, and treatment algorithms were generated based on the evaluation of the evidence. Consensus on the final guidelines was achieved through Delphi‐style surveys. Draft recommendations were disseminated through veterinary specialty listservs for review and comments, which were evaluated and integrated prior to final publication. Results Medline via PubMed and Google Scholar databases were searched. There were 14 Population Intervention Comparison Outcome questions identified and corresponding worksheets were developed focusing on the diagnosis and treatment of transfusion‐associated reactions in dogs and cats. Fourteen guidelines and four algorithms were developed with a high degree of consensus. Conclusions This systematic evidence evaluation process yielded recommended diagnostic and treatment algorithms for use in practice. However, significant knowledge gaps were identified, demonstrating the need for additional research in veterinary transfusion medicine.