Comparison of two viscoelastic testing devices in a parturient population
Background: Viscoelastic hemostatic assays (VHAs) have become an integral diagnostic tool in guiding hemostatic therapy, offering new opportunities in personalized hemostatic resuscitation. This study aims to assess the interchangeability of ClotPro® and ROTEM® delta in the unique context of parturi...
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| Hauptverfasser: | , , , , , , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
25 Januar 2024
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| In: |
Journal of Clinical Medicine
Year: 2024, Jahrgang: 13, Heft: 3, Pages: 1-13 |
| ISSN: | 2077-0383 |
| DOI: | 10.3390/jcm13030692 |
| Online-Zugang: | Verlag, kostenfrei, Volltext: https://doi.org/10.3390/jcm13030692 Verlag, kostenfrei, Volltext: https://www.mdpi.com/2077-0383/13/3/692 
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| Verfasserangaben: | Daniel Gruneberg, Stefan Hofer, Herbert Schöchl, Johannes Zipperle, Daniel Oberladstätter, Sebastian O. Decker, Maik Von der Forst, Kevin Michel Tourelle, Maximilian Dietrich, Markus A. Weigand and Felix C.F. Schmitt |
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| 245 | 1 | 0 | |a Comparison of two viscoelastic testing devices in a parturient population |c Daniel Gruneberg, Stefan Hofer, Herbert Schöchl, Johannes Zipperle, Daniel Oberladstätter, Sebastian O. Decker, Maik Von der Forst, Kevin Michel Tourelle, Maximilian Dietrich, Markus A. Weigand and Felix C.F. Schmitt |
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| 520 | |a Background: Viscoelastic hemostatic assays (VHAs) have become an integral diagnostic tool in guiding hemostatic therapy, offering new opportunities in personalized hemostatic resuscitation. This study aims to assess the interchangeability of ClotPro® and ROTEM® delta in the unique context of parturient women. Methods: Blood samples from 217 parturient women were collected at three timepoints. A total of 631 data sets were eligible for our final analysis. The clotting times were analyzed via extrinsic and intrinsic assays, and the clot firmness parameters A5, A10, and MCF were analyzed via extrinsic, intrinsic, and fibrin polymerization assays. In parallel, the standard laboratory coagulation statuses were obtained. Device comparison was assessed using regression and Bland-Altman plots. The best cutoff calculations were used to determine the VHA values corresponding to the established standard laboratory cutoffs. Results: The clotting times in the extrinsic and intrinsic assays showed notable differences between the devices, while the extrinsic and intrinsic clot firmness results demonstrated interchangeability. The fibrinogen assays revealed higher values in ClotPro® compared to ROTEM®. An ROC analysis identified VHA parameters with high predictive values for coagulopathy exclusion and yet low specificity. Conclusions: In the obstetric setting, the ROTEM® and ClotPro® parameters demonstrate a significant variability. Device- and indication-specific transfusion algorithms are essential for the accurate interpretation of measurements and adequate hemostatic therapy. | ||
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