Comparison of the New Viscoelastic Coagulation Analyzer ClotPro® With ROTEM® Delta and Conventional Coagulation Tests in Critically Ill Patients With COVID-19.
Comparison of the New Viscoelastic Coagulation Analyzer ClotPro® With ROTEM® Delta and Conventional Coagulation Tests in Critically Ill Patients With COVID-19.
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DOI：
10.3389/fmed.2021.777145
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发表时间：
2021
影响因子：
3.9
通讯作者：
Gratz J
中科院分区：
文献类型：
--
作者：
Infanger L;Dibiasi C;Schaden E;Ulbing S;Wiegele M;Lacom C;Gratz J
背景：粘弹性凝血试验被建议用来帮助治疗新冠肺炎危重患者的凝血障碍。然而，不同粘弹性装置的结果并不容易比较。ClotPro®是一款新型的血栓弹性分析仪，可提供更广泛的商业分析。方法：我们将CLotPro检测结果与成熟的Rotem®Delta设备检测结果以及新冠肺炎危重患者的常规凝血试验结果进行比较。结果：粘弹性参数显示大多数患者存在潜在的高凝状态。在多达95对测量中，我们发现了临床上常规使用的几个参数之间的强相关性：(I)EX测试与EXTEMCT、A5、A10、MCF，(Ii)IN测试与INTEMA5、A10、MCF，以及(Iii)FIB测试与FIBTEMA5、A10、MCF(所有R&>；0.7和P<；0.001)。相反，INTEMCT和INTEMCT只显示出中等的相关性(R=0.53p<；0.001)。两种设备的凝血强度参数与血小板计数和纤维蛋白原水平显示出很强的相关性(均为R>；0.7和P<；0.001)。内源性激活试验与aPTT和抗Xa因子活性的相关性明显不同。关于测试结果的绝对差异，两种设备的CT、CFT和凝血强度参数(均为P<；0.001)都有相当大的差异。结论：ClotPro获得的多个参数与Rotem Delta有很强的相关性。由于内在激活的凝血时间的弱相关性和许多参数的相当大的绝对差异，我们的发现强调了在该患者队列中使用特定于设备的算法的必要性。
Background: Viscoelastic coagulation testing has been suggested to help manage coagulopathy in critically ill patients with COVID-19. However, results from different viscoelastic devices are not readily comparable. ClotPro® is a novel thromboelastometry analyzer offering a wider range of commercially available assays. Methods: We compared the results from ClotPro with results from the well-established ROTEM® Delta device and conventional coagulation tests in critically ill patients with COVID-19. Results: Viscoelastic parameters indicated the presence of a potentially hypercoagulable state in the majority of patients. In up to 95 paired measurements, we found strong correlations between several parameters routinely used in clinical practice: (i) EX test vs. EXTEM CT, A5, A10, MCF, (ii) IN test vs. INTEM A5, A10, MCF, and (iii) FIB test vs. FIBTEM A5, A10, MCF (all R > 0.7 and p < 0.001). In contrast, IN test CT vs. INTEM CT showed only a moderate correlation (R = 0.53 and p < 0.001). Clot strength parameters of both devices exhibited strong correlations with platelet counts and fibrinogen levels (all R > 0.7 and p < 0.001). Divergent correlations of intrinsically activated assays with aPTT and anti-factor Xa activity were visible. Regarding absolute differences of test results, considerable delta occurred in CT, CFT, and clot strength parameters (all p < 0.001) between both devices. Conclusions: Several parameters obtained by ClotPro show strong correlations with ROTEM Delta. Due to weak correlations of intrinsically activated clotting times and considerable absolute differences in a number of parameters, our findings underline the need for device-specific algorithms in this patient cohort.
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DOI：
10.1097/shk.0000000000001635
发表时间：
2021-03-01
期刊：
Shock (Augusta, Ga.)
影响因子：
--
作者：
Creel-Bulos C;Auld SC;Caridi-Scheible M;Barker NA;Friend S;Gaddh M;Kempton CL;Maier CL;Nahab F;Sniecinski R
通讯作者：
Sniecinski R
影响因子：
1.1
作者：
Lang, T;Bauters, A;Lakner, M
通讯作者：
Lakner, M
影响因子：
6.5
作者：
Curry, Nicola S.;Davenport, Ross;Laffan, Mike
通讯作者：
Laffan, Mike
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.
影响因子：
8.8
作者：
Maatman, Thomas K.;Jalali, Farid;Meagher, Ashley D.
通讯作者：
Meagher, Ashley D.