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Equine veterinary journal2024; doi: 10.1111/evj.14413

Increased packed cell volume alters point of care viscoelastic clotting parameters in horses.

Abstract: Polycythaemia and coagulopathy are identified risk factors for non-survival in critically ill horses. Assessment of coagulation is recommended for critical care monitoring but may be affected by concurrent polycythaemia. Objective: To evaluate the effects of induced polycythaemia on coagulation parameters as measured by a point-of-care viscoelastic coagulation device (VCM Vet™). Methods: Prospective interventional study. Methods: Healthy adult horses (n = 7) were given 6 mcg/kg of phenylephrine IV over 15 min to induce transient polycythaemia. Samples for packed cell volume (PCV), total solids (TS), complete blood count (CBC), activated partial thromboplastin time (PTT), prothrombin (PT) and VCM Vet™ viscoelastic testing were collected at baseline (T0), 5 min (T1) and 2 h (T2) post-phenylephrine infusion. Splenic volume was measured by transabdominal ultrasonography. VCM Vet™ and plasma-based coagulation parameters, splenic volume and haematologic values were compared within and between time points. Results: Splenic volume decreased from T0 (11.5 ± 4.8 L) to T1 (6.1 ± 2 L, p = 0.04) and returned to baseline volume by T2 (12.1 ± 3.9 L, p = 0.8), consistent with phenylephrine-induced splenic contraction. PCV increased from T0 (37% ± 4%) to T1 (56.3% ± 5.3%; p < 0.001) and returned to baseline at T2 (41.6% ± 3.6%; p = 0.1). A10 and A20 (amplitude at 10 and 20 min, VCM units) were decreased from T0 (12.6 ± 1.6, 18.9 ± 5) to T1 (5.4 ± 1.9, 7.6 ± 2.4; both p < 0.001) and remained lower than baseline at T2 (9.3 ± 2.1, 12.7 ± 3; both p = 0.01). PT and PTT remained within reference ranges with no significant difference over time (p = 0.5 and 0.09, respectively). PCV was negatively correlated with CFT (R = -0.61, p = 0.003), A10 (R = -0.9, p < 0.001) and A20 (R = -0.87, p < 0.001). Conclusions: Small sample size, limited to healthy mares. Conclusions: Phenylephrine-induced polycythaemia was associated with hypocoagulable viscoelastic traces using the VCM Vet™ device without effect on plasma-based coagulation assessments or platelet number. Further investigation of viscoelastic testing is needed in horses with increased PCV due to clinical illness. Unassigned: Polyzythämie und Koagulopathie sind bekannte Risikofaktoren für Nicht‐Überleben bei schwererkrankten Pferden. Die Beurteilung der Blutgerinnung wird für die Überwachung auf der Intensivstation empfohlen, kann aber durch gleichzeitige Polyzythämie beeinträchtigt werden. ZIEL: Bewertung der Auswirkungen einer induzierten Polyzythämie auf die Gerinnungsparameter, die mit einem viskoelastischen Point‐of‐Care‐ (“Patientennahe Sofortdiagnostik”)‐Koagulationsgerät (VCM Vet™) gemessen warden. Methods: Prospektive Interventionsstudie. Methods: Gesunden erwachsenen Pferden (n = 7) wurden 6 mcg/kg Phenylephrin intravenös über 15 Minuten verabreicht, um eine vorübergehende Polyzythämie auszulösen. Proben für PCV, Gesamtfeststoffe (TS), vollständiges Blutbild (CBC), aktivierte partielle Thromboplastinzeit (PTT), Prothrombin (PT) und VCM Vet™ viskoelastische Tests wurden zu Beginn (T0), 5 Minuten (T1) und 2 Stunden (T2) nach der Phenylephrin‐Infusion entnommen. Das Milzvolumen wurde mittels transabdominaler Ultraschalluntersuchung gemessen. VCM Vet™ und plasmabasierte Gerinnungsparameter, Milzvolumen und hämatologische Werte wurden innerhalb und zwischen den Zeitpunkten verglichen. Unassigned: Das Milzvolumen verringerte sich von T0 (11,5 ± 4,8 L) auf T1 (6,1 ± 2 L, p = 0,04) und kehrte bis T2 (12,1 ± 3,9 L, p = 0,8) zum Ausgangsvolumen zurück, was mit der durch Phenylephrin induzierten Milzkontraktion übereinstimmt. Das PCV stieg von T0 (37 ± 4%) auf T1 (56,3 ± 5,3%; p < 0,001) und kehrte bei T2 zum Ausgangswert zurück (41,6 ± 3,6%; p = 0,1). A10 und A20 (Amplitude nach 10 und 20 Minuten, VCM‐Einheiten) waren von T0 (12,6 ± 1,6, 18,9 ± 5) zu T1 (5,4 ± 1,9, 7,6 ± 2,4; beide p < 0,001) verringert und blieben bei T2 (9,3 ± 2,1, 12,7 ± 3; beide p = 0,01) niedriger als der Ausgangswert. PT und PTT blieben innerhalb der Referenzbereiche und wiesen im Laufe der Zeit keine signifikanten Unterschiede auf (p = 0,5 bzw. 0,09). PCV war negativ korreliert mit CFT (R = ‐0,61, p = 0,003), A10 (R = ‐0,9, p < 0,001) und A20 (R = ‐0,87, p < 0,001). Unassigned: Kleine Stichprobengröße, beschränkt auf gesunde Stuten. Unassigned: Phenylephrin‐induzierte Polyzythämie war mit hypokoagulierbaren viskoelastischen Spuren unter Verwendung des VCM Vet™‐Geräts verbunden, ohne Auswirkungen auf plasmabasierte Gerinnungsmessungen oder die Thrombozytenzahl. Weitere Untersuchungen von viskoelastischen Tests sind bei Pferden mit erhöhtem PCV aufgrund einer klinischen Erkrankung erforderlich.
© 2024 The Author(s). Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
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Publication Date: 2024-09-03 PubMed ID: 39228098DOI: 10.1111/evj.14413Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research article examines the effects of induced polycythaemia (an increase in the number of red blood cells) on the coagulation parameters of horses, using the point-of-care viscoelastic coagulation device, VCM Vet™. The study suggests that polycythaemia results in hypocoagulable readings without affecting plasma-based coagulation assessments or platelet number.

Objective of the Study

  • The primary goal of the study was to understand the influence of induced polycythaemia on the coagulation parameters of horses. This assessment was conducted using a point-of-care viscoelastic coagulation monitoring device named VCM Vet™.

Methods Used in The Study

  • This study was carried out using healthy adult horses, all of which were given Phenylephrine intravenously to induce temporary polycythaemia.
  • Several parameters were measured at different times, starting from the induction of polycythaemia (T0) to 5 minutes (T1) and 2 hours (T2) post-phenylephrine infusion. These parameters include packed cell volume (PCV), total solids (TS), complete blood count (CBC), activated partial thromboplastin time (PTT), prothrombin (PT) and VCM Vet™ viscoelastic testing.
  • The splenic volume of the horses was also assessed using transabdominal ultrasonography. This provided information about the impact of polycythaemia and the infusion of Phenylephrine on the spleen of the horses.

Results of the Study

  • Findings from the study indicated that splenic volume decreased at T1 but returned to its normal level by T2. This reduction and subsequent increase can be linked to the infusion of Phenylephrine, which contributes to splenic contraction.
  • The PCV increased dramatically at T1 but returned to baseline levels by T2. This was an expected result as Phenylephrine is known to induce polycythaemia.
  • The A10 and A20 values reduced significantly at T1 and remained lower than the baseline values at T2. The reduction in these values indicates an effect on the coagulation parameters of the horses.
  • No significant anomalies were found in the PT and PTT values, suggesting that polycythaemia has no effect on plasma-based coagulation assessment or the number of platelets.

Conclusion of the Study

  • Though the sample size was small and restricted to healthy mares, it was concluded that polycythaemia (induced by Phenylephrine) was associated with hypocoagulable readings using the VCM Vet™ device, without effect on plasma-based coagulation assessments or platelet count.
  • The research recommends further investigation of viscoelastic testing in horses with increased PCV due to clinical illness. This is important for understanding the implications of polycythaemia in disease conditions.

Cite This Article

APA
Bishop RC, Jonk KM, Migliorisi A, Austin SM, Mullins EC, Wilkins PA. (2024). Increased packed cell volume alters point of care viscoelastic clotting parameters in horses. Equine Vet J. https://doi.org/10.1111/evj.14413

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English

Researcher Affiliations

Bishop, Rebecca C
  • Department of Veterinary Clinical Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois, USA.
Jonk, Kaitlyn M
  • Department of Veterinary Clinical Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois, USA.
Migliorisi, Alessandro
  • Department of Veterinary Clinical Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois, USA.
Austin, Scott M
  • Department of Veterinary Clinical Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois, USA.
Mullins, Emma C
  • Department of Veterinary Clinical Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois, USA.
Wilkins, Pamela A
  • Department of Veterinary Clinical Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois, USA.

Grant Funding

  • VM622 / University of Illinois College of Veterinary Medicine Student Research Course

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Citations

This article has been cited 2 times.
  1. de la Cuesta-Torrado M, Vitale V, Velloso Alvarez A, Neira-Egea P, Diss C, Cuervo-Arango J. The Effect of Vaccination Status on Total Lymphocyte Count in Horses Affected by Equine Herpes Virus-1 Myeloencephalopathy. Animals (Basel) 2025 Apr 1;15(7).
    doi: 10.3390/ani15071019pubmed: 40218411google scholar: lookup
  2. Mersich I, Bishop RC, Diaz Yucupicio S, Nobrega AD, Austin SM, Barger AM, Fick ME, Wilkins PA. Decreased Circulating Red Cell Mass Induced by Intravenous Acepromazine Administration Alters Viscoelastic and Traditional Plasma Coagulation Testing Results in Healthy Horses. Animals (Basel) 2024 Oct 28;14(21).
    doi: 10.3390/ani14213102pubmed: 39518825google scholar: lookup
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