Comparison of thromboelastometry by ROTEM® Delta and ROTEM® Sigma in women with postpartum haemorrhage
Comparison of thromboelastometry by ROTEM® Delta and ROTEM® Sigma in women with postpartum haemorrhage
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DOI：
10.1080/00365513.2019.1571220
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发表时间：
2019-01-01
影响因子：
2.1
通讯作者：
de Maat, Moniek P. M.
中科院分区：
文献类型：
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作者：
Gillissen, Ada;van den Akker, Thomas;de Maat, Moniek P. M.
经历产后出血的妇女的止血治疗越来越多地基于ROTEM(R)血栓弹性测定仪等护理点设备。最近，Rotem(R)Delta设备的一种全自动继任者Rotem(R)Sigma被推出。为了确定这些设备是否提供了类似的结果，我们使用Rotem(R)Delta和Sigma设备对经历产后出血的妇女进行了Rotem(R)参数的比较。23例产后出血妇女的前瞻性观察队列研究。比较了Rotem(R)Delta和Sigma设备处理的ROTEM(R)INTEM、EXTEM、FIBTEM和APTEM测量结果。Rotem(R)FIBTEM值也与Clauss纤维蛋白原值相关。在血栓形成后5分钟(A5)、10分钟(A10)和20分钟(A20)，用EXTEM法、INTEM法和APTEM法测量的血栓硬度与Spearman‘s r(r(S))在0.76~0.95之间呈正相关，FIBTEMA5、A10和A20的相关性较差(r(S)在0.71~0.74之间)，尤其是在5分钟和10分钟后。两种装置在凝血时间(CT)方面的相关性很差。Delta值与纤维蛋白原水平的相关系数r(S)=0.70，95%可信区间(CI)：0.38~0.87；SIGMA的相关系数r(S)=0.85，95%可信区间(CI)0.65~0.94。从Rotem(R)Delta和Sigma设备获得的EXTEM、INTEM和APTEM测量的A5、A10和A20相似。两种装置的EXTEM值、FIBTM值和APTEM值无相关性。在这些设备的FIBTEM分析之间发现了很大的差异。因此，FIBTEM分析的结果应始终在设备特定参考值的背景下进行解释。Rotem(R)Sigma设备与克劳斯纤维蛋白原的相关性更好。
Haemostatic treatment in women experiencing postpartum haemorrhage is increasingly based on point-of-care devices such as ROTEM (R) thromboelastometry. Recently, a fully automated successor of the ROTEM (R) Delta device, the ROTEM (R) Sigma was introduced. To determine whether these devices provide similar results, we compared ROTEM (R) parameters using the ROTEM (R) Delta and Sigma devices in women experiencing postpartum haemorrhage. Prospective observational cohort study of 23 women experiencing postpartum haemorrhage. ROTEM (R) INTEM, EXTEM, FIBTEM and APTEM measurements handled by the ROTEM (R) Delta and Sigma devices were compared. ROTEM (R) FIBTEM values were also related to Clauss fibrinogen values. A correlation of Spearman's r (r(s)) varying between 0.76 and 0.95 was displayed between clot firmness measured in millimeters at 5 (A5), 10 (A10) and 20 (A20) minutes after start of clot formation measured by EXTEM, INTEM and APTEM assays executed on both devices; A5, A10 and A20 of FIBTEM correlated less well (r(s) between 0.71 and 0.74), especially after five and ten minutes. Correlation between both devices regarding clotting time (CT) was poor. The observed correlation between levels of Clauss fibrinogen and FIBTEM A5 was r(s) = 0.70, (95% confidence interval (CI): 0.38 to 0.87) for Delta and r(s) = 0.85, (CI 0.65 to 0.94) for Sigma. A5, A10 and A20 measured in EXTEM, INTEM and APTEM obtained from ROTEM (R) Delta and Sigma devices were similar. EXTEM, FIBTEM and APTEM CT values from both devices showed no correlation. Substantial variation was found between FIBTEM assays of the devices. Consequently, results of FIBTEM assays should always be interpreted in the context of device-specific reference values. Correlation with Clauss fibrinogen was better in the ROTEM (R) Sigma device.