Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
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Relationship between sonorheometry parameters and laboratory values in a critical care setting in Italy: a retrospective cohort study

  • Antonio Romanelli (Department of Anesthesia and Intensive Care Unit, Azienda Ospedaliero Universitaria San Giovanni di Dio Ruggi d'Aragona) ;
  • Renato Gammaldi (Department of Anesthesia and Intensive Care Unit, Azienda Ospedaliero Universitaria San Giovanni di Dio Ruggi d'Aragona) ;
  • Alessandro Calicchio (Department of Anesthesia and Intensive Care, University of Naples Federico II) ;
  • Salvatore Palmese (Department of Anesthesia and Intensive Care Unit, Azienda Ospedaliero Universitaria San Giovanni di Dio Ruggi d'Aragona) ;
  • Antonio Siglioccolo (Department of Anesthesia and Intensive Care Unit, Azienda Ospedaliero Universitaria San Giovanni di Dio Ruggi d'Aragona)
  • Received : 2023.03.21
  • Accepted : 2023.04.21
  • Published : 2023.09.30
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Abstract

Purpose: This preliminary retrospective cohort study analyzed the relationship between the parameters provided by sonorheometry device Quantra and the coagulation values obtained from standard venous blood samples in patients admitted in intensive care unit (ICU). Methods: We reviewed medical charts of 13 ICU adult patients in whom at least one coagulation study with Quantra was performed. The relationship between Quantra and laboratory data was analyzed with the Spearman rank correlation coefficient (rho). The 95% confidence interval (CI) was computed. A P-value <0.05 was considered statistically significant. Results: We collected 28 data pairs. Statistically significant moderate correlations were found for the following parameters: clot time (CT) and activated partial thromboplastin time (rho=0.516; 95% CI, 0.123-0.904; P=0.009; clot stiffness (CS) and the international normalized ratio (INR; rho=0.418; 95% CI, 0.042-0.787; P=0.039); INR and platelet contribution to CS (rho=0.459; 95% CI, 0.077-0.836; P=0.022); platelet count and platelet contribution to CS (PCS; rho=0.498; 95% CI, 0.166-0.825; P=0.008); and fibrinogen and fibrinogen contribution to CS (FCS; rho=0.620; 95% CI, 0.081-0.881; P=0.001). Conclusions: Quantra can provide useful information regarding coagulation status, showing modest correlations with the parameters obtained from laboratory tests. During diffuse bleeding, CT and FCS values can guide the proper administration of clotting factors and fibrinogens. However, the correlation of INR with CS and PCS can cause misinterpretation. Further studies are needed to clarify the relationship between Quantra parameters and laboratory tests in the critical care setting and the role of sonorheometry in guiding targeted therapies and improving outcomes.

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References

  1. Curry NS, Davenport R. Transfusion strategies for major haemorrhage in trauma. Br J Haematol 2019;184:508-23.  https://doi.org/10.1111/bjh.15737
  2. Moore EE, Moore HB, Kornblith LZ, et al. Trauma-induced coagulopathy. Nat Rev Dis Primers 2021;7:30. 
  3. Mitra S, Ling RR, Yang IX, et al. Severe COVID-19 and coagulopathy: a systematic review and meta-analysis. Ann Acad Med Singap 2021;50:325-35.  https://doi.org/10.47102/annals-acadmedsg.2020420
  4. Heubner L, Mirus M, Vicent O, et al. Point of care coagulation management in anesthesiology and critical care. Minerva Anestesiol 2022;88:615-28.  https://doi.org/10.23736/S0375-9393.22.16380-7
  5. Ganter MT, Hofer CK. Coagulation monitoring: current techniques and clinical use of viscoelastic point-of-care coagulation devices. Anesth Analg 2008;106:1366-75.  https://doi.org/10.1213/ane.0b013e318168b367
  6. Burghardt WR, Goldstick TK, Leneschmidt J, Kempka K. Nonlinear viscoelasticity and the thrombelastograph: 1. Studies on bovine plasma clots. Biorheology 1995;32:621-30.  https://doi.org/10.3233/BIR-1995-32607
  7. Corey FS, Walker WF. Sonic estimation of elasticity via resonance: a new method of assessing hemostasis. Ann Biomed Eng 2016;44:1405-24.  https://doi.org/10.1007/s10439-015-1460-y
  8. Ferrante EA, Blasier KR, Givens TB, Lloyd CA, Fischer TJ, Viola F. A novel device for the evaluation of hemostatic function in critical care settings. Anesth Analg 2016;123:1372-9.  https://doi.org/10.1213/ANE.0000000000001413
  9. Allen TW, Winegar D, Viola F. The Quantra system and SEER sonorheometry. In: Moore HB, Neal MD, Moore EE, editors. Trauma induced coagulopathy. Springer; 2021. p. 693-704. 
  10. Baryshnikova E, Di Dedda U, Ranucci M. A comparative study of SEER sonorheometry versus standard coagulation tests, rotational thromboelastometry, and multiple electrode aggregometry in cardiac surgery. J Cardiothorac Vasc Anesth 2019;33:1590-8.  https://doi.org/10.1053/j.jvca.2019.01.011
  11. Naik BI, Tanaka K, Sudhagoni RG, Viola F. Prediction of hypofibrinogenemia and thrombocytopenia at the point of care with the Quantra® QPlus® System. Thromb Res 2021;197:88-93.  https://doi.org/10.1016/j.thromres.2020.11.008
  12. Idowu O, Ifeanyi-Pillette I, Owusu-Agyemang P, et al. The Quantra hemostasis analyzer compared to thromboelastography (TEG) in the surgical oncologic population: a prospective observational trial. J Surg Oncol 2021;124:894-905.  https://doi.org/10.1002/jso.26578
  13. Baulig W, Akbas S, Schutt PK, et al. Comparison of the resonance sonorheometry based Quantra® system with rotational thromboelastometry ROTEM® sigma in cardiac surgery: a prospective observational study. BMC Anesthesiol 2021;21:260. 
  14. Zghaibe W, Scheuermann S, Munting K, et al. Clinical utility of the Quantra® point-of-care haemostasis analyser during urgent cardiac surgery. Anaesthesia 2020;75:366-73.  https://doi.org/10.1111/anae.14942
  15. Groves DS, Welsby IJ, Naik BI, et al. Multicenter evaluation of the Quantra QPlus System in adult patients undergoing major surgical procedures. Anesth Analg 2020;130:899-909.  https://doi.org/10.1213/ANE.0000000000004659
  16. Huffmyer JL, Fernandez LG, Haghighian C, Terkawi AS, Groves DS. Comparison of SEER sonorheometry with rotational thromboelastometry and laboratory parameters in cardiac surgery. Anesth Analg 2016;123:1390-9.  https://doi.org/10.1213/ANE.0000000000001507
  17. Le Gall JR, Lemeshow S, Saulnier F. A new Simplified Acute Physiology Score (SAPS II) based on a European/North American multicenter study. JAMA 1993;270:2957-63.  https://doi.org/10.1001/jama.1993.03510240069035
  18. Reith FC, Van den Brande R, Synnot A, Gruen R, Maas AI. The reliability of the Glasgow Coma Scale: a systematic review. Intensive Care Med 2016;42:3-15.  https://doi.org/10.1007/s00134-015-4124-3
  19. Mukaka MM. Statistics corner: a guide to appropriate use of correlation coefficient in medical research. Malawi Med J 2012;24:69-71.