凝血时间激活
部分凝血活酶时间
凝结
混凝试验
血栓弹性成像
纤维蛋白原
肝素
凝血时间
生物医学工程
医学
麻醉
材料科学
外科
内科学
作者
Mauro Panigada,Andrea Meli,Andrea Forastieri Molinari,Lorenzo Grazioli,Marco Giani,D Ceriani,Cecilia Bianchi,Maria Teresa Passarelli,Dario Consonni,Giacomo Grasselli
出处
期刊:Asaio Journal
[Ovid Technologies (Wolters Kluwer)]
日期:2023-04-05
卷期号:69 (6): e230-e239
被引量:1
标识
DOI:10.1097/mat.0000000000001932
摘要
The performance of viscoelastic coagulation monitor (VCM) compared with TEG 5000 (TEG) is unknown. In this multicenter study, the authors evaluated the agreement among VCM/TEG parameters and their relationship with standard coagulation tests in critically ill patients. Viscoelastic coagulation monitor, TEG, and laboratory samples were analyzed simultaneously. Viscoelastic coagulation monitor/TEG agreement was computed by Bland and Altman's plots, association with laboratory parameters was studied with Spearman's correlation coefficient and random-intercept linear models. One-hundred and twenty-seven patients enrolled, 320 paired observations: 210 (65.6%) under unfractioned heparin (UFH), 94 (29.4%) under low molecular weight heparin (LMWH), 16 (5.0%) no heparin. Under UFH prolonged clot formation times and reduced the amplitude of viscoelastic tracings on both devices, especially on TEG. The type of heparin affected the agreement between VCM/TEG homolog parameters. Reaction time (TEG-R) resulted 23.1 min longer than the homolog clotting time (VCM-CT) under UFH; maximum amplitude (TEG-MA) resulted 29.5 mm higher than maximum clot firmness (VCM-MCF) under LMWH. Weak correlation was observed between VCM-CT/TEG-R and activated partial thromboplastin time (aPTT)/anti-Xa; no correlation was found between VCM-alpha/TEG-angle and fibrinogen concentration. Viscoelastic coagulation monitor-MCF showed strong (LWMH) to moderate (UFH) correlation with platelet count, while TEG-MA only showed lower correlation. Viscoelastic coagulation monitor and TEG are differently affected by heparin. The platelet count is well represented by VCM-MCF even during UFH administration.
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