Clinical use of cryopoor plasma continuous rate infusion in critically ill, hypoalbuminemic dogs.

Abstract

To investigate the impact of cryopoor plasma (CPP) continuous rate infusion (CRI) on albumin concentration and colloid osmotic pressure (COP) in critically ill dogs with hypoalbuminemia. Retrospective study between 2013 and 2015 with a 90-day follow-up on survivors. University teaching hospital. Ten hypoalbuminemic dogs receiving a CPP CRI for albumin replacement or oncotic support. All patients with documented hypoalbuminemia or low COP receiving CPP administration for albumin or oncotic support during the study period were included. CRI of CPP. Mean age was 7.4±4.5 years. Mean survival prediction index score was 0.66±0.13. Seven dogs were septic, with 2 of 7 in septic shock and 5 of 7 having septic peritonitis. The mean pre- and postinfusion albumin was 15±4g/L and 21±2g/L, respectively. The median pre- and postinfusion COP was 8.6mm Hg (4.9-9.7 mm Hg) and 10.2 mm Hg (8.1-13.3 mm Hg), respectively. The median duration of CRI was 16hours (11-121 h). The mean CPP rate was 1.8±0.6mL/kg/h, the mean crystalloid rate administered concurrently was 0.8±0.9mL/kg/h, and the mean hydroxyethyl starch rate administered concurrently was 1.2±0.9mL/kg/h. The difference in pre- and postinfusion albumin was significantly correlated with CPP rate (P = 0.0004), whereas the difference in pre- and postinfusion COP was correlated with hydroxyethyl starch rate (P = 0.0128). Mean duration of hospitalization was 8.6±3.9 days. Mann-Whitney U and Fisher's exact tests were used to compare survivors and nonsurvivors. Survivors were significantly younger than nonsurvivors (3.5 vs 11.5 y, P = 0.033). No side effects were reported. Survival to discharge was 40% with identical 90-day survival. Of the nonsurvivors, 50% died naturally. There was an association between the rate of CPP and the change in albumin after CPP CRI in critically ill dogs, suggesting that CPP may be a viable option for treatment of hypoalbuminemia.