Posted in Transfusion Medicine
Initial requirements for patient stabilisation depend on the rapidity of onset, type and underlying cause of the anaemia. Collapsed cats require more intensive and aggressive stabilisation than cats with chronic anaemia who frequently appear cardiovascularly stable (based on heart rate, pulse quality, respiratory rate and systolic blood pressure and general demeanour) despite a low PCV.
Patients with blood loss or hypovolaemia will benefit from immediate intravenous fluid therapy to ensure organ perfusion. Initially this can be administered as crystalloid therapy (40-60 ml/kg) although crystalloids will redistribute rapidly (within 30 minutes). Hypotensive resuscitation maybe useful in patients with marked haemorrhage as aggressive fluid therapy may worsen bleeding. This technique requires invasive monitoring methods (e.g. arterial blood pressure) which are rarely available in general practice.
Synthetic colloids (doses ranging from 2-7 ml/kg in cats) may hold fluid within the vascular space for longer than crystalloid fluids depending on the health of the vascular endothelium. They may be used in combination with crystalloids to maintain adequate plasma volume expansion. Caution should be used when administering these products to patients with a coagulopathy as their effect on coagulation is unpredictable in critically ill patients...
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