Comparison of citrated and fresh whole blood for viscoelastic coagulation testing during elective neurosurgery

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift

Abstract

Background Previous viscoelastic haemostatic tests studies have often indicated a hypercoagulative test signal with citrated blood, which could influence clinical decision makings. Purpose The aim of this study was to compare fresh and citrated whole blood using two non-automated viscoelastic ROTEM and Sonoclot tests. Our hypothesis was that citrated blood would demonstrate a hypercoagulative response in this setting, not tested before. Methods Perioperative viscoelastic coagulation changes were evaluated with a ROTEM and Sonoclot in 38 patients undergoing elective brain tumor surgery. The citrated samples were recalcified with CaCl2. Wilcoxon nonparametric-paired tests and Bland-Altman plots were performed to compare the fresh and citrated blood analyses. Results The citrated blood showed a hypercoagulative response in ROTEM NATEM-clot formation time and α-angle, Sonoclot-clot rate and platelet function, as compared to fresh blood (p < 0.0001). Conclusions Fresh whole blood may theoretically reflect in vivo haemostasis more closely than citrated analyses, which indicated a hypercoagulative response as compared to the fresh whole blood analyses Bland-Altman plots also indicated that ROTEM reference ranges in patients undergoing brain surgery should be redefined. Future studies must establish the correlation between viscoelastic test results using fresh or citrate anticoagulated blood and clinical outcomes, such as bleeding, transfusion or reoperation for postoperative haematoma.

Detaljer

Författare
Enheter & grupper
Externa organisationer
  • Skåne University Hospital
  • Lund University
  • Paracelsus Private Medical University of Salzburg
  • Octapharma AG
Forskningsområden

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Anestesi och intensivvård
  • Hematologi

Nyckelord

Originalspråkengelska
Sidor (från-till)73-79
Antal sidor7
TidskriftThrombosis Research
Volym156
StatusPublished - 2017 aug 1
PublikationskategoriForskning
Peer review utfördJa

Related projects

Ulf Schött

1990/05/012019/03/31

Projekt: Forskning

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