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Comparison of two viscoelastic testing devices in a porcine model of surgery, hemorrhage and resuscitation.
Gruneberg, Daniel; Dietrich, Maximilian; Studier-Fischer, Alexander; Petersen, Clara; von der Forst, Maik; Özdemir, Berkin; Schöchl, Herbert; Nickel, Felix; Weigand, Markus A; Schmitt, Felix C F.
Afiliación
  • Gruneberg D; Department of Anesthesiology, Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany.
  • Dietrich M; Department of Anesthesiology, Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany.
  • Studier-Fischer A; Department of General, Visceral, and Trasplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany.
  • Petersen C; Department of Anesthesiology, Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany.
  • von der Forst M; Department of Anesthesiology, Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany.
  • Özdemir B; Department of General, Visceral, and Trasplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany.
  • Schöchl H; Ludwig Boltzmann Institute for Traumatology, The Research Center in Cooperation with AUVA, Vienna, Austria.
  • Nickel F; Department of General, Visceral, and Trasplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany.
  • Weigand MA; Department of Anesthesiology, Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany.
  • Schmitt FCF; Department of Anesthesiology, Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany.
Front Bioeng Biotechnol ; 12: 1417847, 2024.
Article en En | MEDLINE | ID: mdl-39193228
ABSTRACT

Introduction:

Viscoelastic hemostatic assays (VHA) are integral in contemporary hemostatic resuscitation, offering insights into clot formation, firmness, and lysis for rapid diagnosis and targeted therapy. Large animal models, particularly swine, provide anatomical and physiological analogies for coagulation research. Despite the growing use of VHAs, the ClotPro® device's applicability in porcine models remains unexplored. This study investigates ClotPro® in a porcine model of abdominal surgery, severe hemorrhage, and resuscitation, comparing it with the established ROTEM® delta system.

Methods:

Twenty-seven healthy pigs underwent abdominal surgery, hemorrhage and resuscitation. ClotPro® and ROTEM® were used to assess viscoelastic hemostatic properties at baseline, after surgery, 60 min after shock induction, 60 and 120 min after resuscitation.

Results:

Clotting times in extrinsically and intrinsically stimulated assays exhibited fair to moderate correlation. Clot firmness in extrinsically stimulated tests could be used interchangeably while fibrin polymerization assays revealed significant differences between the devices. Fibrin polymerization assays in ClotPro® consistently yielded higher values than ROTEM®. Furthermore, the study evaluated the ClotPro® TPA-test's applicability in porcine blood, revealing failure of lysis induction in porcine blood samples.

Conclusion:

This research contributes valuable insights into the use of ClotPro® in porcine models of hemorrhage and coagulopathy, highlighting both its applicability and limitations in comparison to ROTEM® delta. The observed differences, especially in fibrin polymerization assays, emphasize the importance of understanding device-specific characteristics when interpreting results. Due to its inapplicability, TPA-test should not be used in porcine blood to evaluate fibrinolytic potential. The study provides a foundation for future investigations into the use of different viscoelastic hemostatic assays in porcine animal models.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Front Bioeng Biotechnol Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Front Bioeng Biotechnol Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Suiza