Effects of blood contamination on peritoneal D-dimer concentration in horses with colic.
Authors: Delgado M A, Monreal L, Armengou L, Segura D, Ríos J
Journal: Journal of veterinary internal medicine
Summary
# Editorial Summary: Blood Contamination and Peritoneal D-Dimer in Equine Colic Peritoneal D-dimer measurement offers clinicians a non-invasive window into peritoneal fibrinolytic activity during colic evaluation, yet the practical reality of peritoneal fluid collection carries inherent contamination risks. Delgado and colleagues addressed this concern by serially contaminating peritoneal fluid samples from 34 colicking horses and 4 healthy controls with each horse's own blood at levels of 1%, 5%, 10%, and 20%, then quantifying D-dimer concentrations using statistical modelling to assess both numerical and interpretive shifts. Whilst 20% blood contamination did produce measurable quantitative changes in D-dimer values, this effect became clinically irrelevant when using the higher diagnostic cut-off thresholds (8,000 and 16,000 ng/mL) typically employed in practice; moreover, grouping samples as either minimally contaminated (≤1%) or highly contaminated (≥5%) revealed no significant differences at any cut-off value. These findings provide reassurance that modest blood contamination during peritoneal fluid collection—the norm rather than exception in clinical practice—should not compromise diagnostic interpretation of peritoneal fibrinolytic activity in colic cases. Practitioners can therefore be confident that subclinical contamination will not alter clinical decision-making, though technicians should still attempt to minimise blood admixture where possible during sampling.
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Practical Takeaways
- •Minor blood contamination during peritoneal tap collection does not invalidate D-Dimer results in colic cases—interpret findings with confidence using standard cut-off values
- •Only severe contamination (≥20% blood) causes measurable quantitative changes, which is unlikely to occur in routine clinical practice
- •Clinical decision-making based on peritoneal D-Dimer concentration remains reliable even with imperfect fluid collection technique
Key Findings
- •Peritoneal D-Dimer concentration was only quantitatively affected at ≥20% blood contamination levels
- •Clinical interpretation of increased peritoneal fibrinolytic activity remained unaffected even with high blood contamination when using standard cut-off values (8,000 and 16,000 ng/mL)
- •Minimal contamination (≤1%) and high contamination (≥5%) showed no significant differences in D-Dimer concentration at clinically relevant cut-off values
- •Blood contamination during peritoneal fluid collection does not compromise diagnostic reliability of peritoneal D-Dimer for assessing fibrinolysis in colic cases