Are Viscoelastometric Assays of Old Generation Ready for Disposal? Comment on Volod et al. Viscoelastic Hemostatic Assays: A Primer on Legacy and New Generation Devices. J. Clin. Med. 2022, 11, 860.
Are Viscoelastometric Assays of Old Generation Ready for Disposal? Comment on Volod et al. Viscoelastic Hemostatic Assays: A Primer on Legacy and New Generation Devices. J. Clin. Med. 2022, 11, 860.
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DOI：
10.3390/jcm12020477
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发表时间：
2023-01-06
影响因子：
3.9
通讯作者：
中科院分区：
文献类型：
--
作者：
随着新的粘弹性止血分析(VHA)设备的出现，即用盒试剂允许没有特殊实验室技能的人使用，对VHA在严重创伤、产后出血、心脏手术和肝移植等环境中的实际临床价值的评价仍需充分验证。虽然最新的两个版本仍然基于“杯和针”系统(Rotem®Sigma、ClotPro®)，但另外两种新设备(TEG®6S、Quantra®)依赖非常不同的技术：凝血不再与探头接触，并受到其中一个组件的振荡的挑战，但通过超声波照射进行探索。系统的文献检索(包括Sonoclot®)检索到20项观察性研究(19项前瞻性研究)。大多数研究指出协议不完善，突出了设备的不可互换性。只有几项研究使用了临床结果，通常只有有限数量的患者参加。没有研究将VHA结果与通过快速测试小组获得的常规实验室分析进行比较。新的VHA的有效性的临床证据在很大程度上仍有待通过随机临床试验、临床相关结果以及与快速小组止血试验的比较来证实。新的、改进的VHA设备的可获得性提供了这样做的动力和机会。
With the advent of new viscoelastometric hemostatic assay (VHA) devices, with ready-to-use cartridge reagents allowing for their use by people without special laboratory skills, the appreciation of the actual clinical value of VHAs in settings such as severe trauma, post-partum hemorrhage, cardiac surgery and liver transplantation still needs to be fully validated. While two of the newest versions remain based on a ‘cup and pin’ system (ROTEM® sigma, ClotPro®), two other new devices (TEG® 6s, Quantra®) rely on very different technologies: clotting blood is no longer in contact with the probe and challenged by oscillation of one of the components but explored with ultrasound exposure. A systematic literature search (including Sonoclot®) retrieved 20 observational studies (19 prospective). Most studies pointed to imperfect agreements, highlighting the non-interchangeability of devices. Only a few studies, often with a limited number of patients enrolled, used a clinical outcome. No study compared VHA results with conventional laboratory assays obtained through a rapid tests panel. Clinical evidence of the utility of the new VHAs largely remains to be proven through randomized clinical trials, with clinically relevant outcomes, and compared to rapid panel hemostasis testing. The availability of new, improved VHA devices provides an impetus and an opportunity to do so.
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影响因子：
3.4
作者：
Roullet, Stephanie;Labrouche, Sylvie;Freyburger, Genevieve
通讯作者：
Freyburger, Genevieve
DOI：
10.1080/00365513.2019.1571220
发表时间：
2019-01-01
影响因子：
2.1
作者：
Gillissen, Ada;van den Akker, Thomas;de Maat, Moniek P. M.
通讯作者：
de Maat, Moniek P. M.
DOI：
10.1053/j.jvca.2019.06.030
发表时间：
2020-01-01
影响因子：
2.8
作者：
Meco, Massimo;Montisci, Andrea;Albano, Giovanni
通讯作者：
Albano, Giovanni
DOI：
10.3390/diagnostics11112140
发表时间：
2021-11-19
期刊：
Diagnostics (Basel, Switzerland)
影响因子：
--
作者：
Simurda T;Asselta R;Zolkova J;Brunclikova M;Dobrotova M;Kolkova Z;Loderer D;Skornova I;Hudecek J;Lasabova Z;Stasko J;Kubisz P
通讯作者：
Kubisz P
DOI：
10.1007/s00068-019-01165-7
发表时间：
2021-04-01
影响因子：
2.1
作者：
Bouzat, Pierre;Guerin, Romain;David, Jean-Stephane
通讯作者：
David, Jean-Stephane