Emergency and Critical Care Center, Hokkaido University Hospital, Sapporo, Japan.
Semin Thromb Hemost. 2015 Apr;41(3):267-71. doi: 10.1055/s-0035-1547372. Epub 2015 Apr 3.
Rapid evaluation of fibrinogen (Fbg) levels is essential for maintaining homeostasis in patients with massive bleeding during severe trauma and major surgery. This study evaluated the accuracy of fibrinogen levels measured by the CG02N whole blood coagulation analyzer (A&T Corporation, Kanagawa, Japan) using heparinized blood drawn for blood gas analysis (whole blood-Fbg). A total of 100 matched pairs of heparinized blood samples and citrated blood samples were simultaneously collected from patients in the intensive care unit. Whole blood-Fbg results were compared with those of citrated plasma (standard-Fbg). The whole blood coagulation analyzer measured fibrinogen levels within 2 minutes. Strong correlations between standard-Fbg and whole blood-Fbg were observed (ρ = 0.91, p < 0.001). Error grid analysis showed that 88% of the values were clinically acceptable, and 12% were in a range with possible effects on clinical decision-making; none were in a clinically dangerous range without appropriate treatment. Using a fibrinogen cutoff value of 1.5 g/L for standard-Fbg, the area under the receiver operating characteristic curve of whole blood-Fbg was 0.980 (95% confidence interval 0.951-1.000, p < 0.001). The whole blood coagulation analyzer can rapidly measure fibrinogen levels in heparinized blood and could be useful in critical care settings where excessive bleeding is a concern.
快速评估纤维蛋白原（Fbg）水平对于维持严重创伤和大手术期间大出血患者的体内平衡至关重要。本研究评估了肝素化全血凝血分析仪（日本神奈川县 A&T 公司的 CG02N）测量纤维蛋白原水平的准确性，所用肝素化全血采自血气分析（全血-Fbg）。共从重症监护病房的患者中同时采集了 100 对肝素化全血和枸橼酸盐血浆样本。将全血-Fbg 结果与枸橼酸盐血浆（标准-Fbg）进行比较。全血凝血分析仪在 2 分钟内测量纤维蛋白原水平。标准-Fbg 和全血-Fbg 之间存在很强的相关性（ρ=0.91，p<0.001）。误差网格分析显示 88%的数值在临床可接受范围内，12%的数值在可能影响临床决策的范围内；没有在没有适当治疗的情况下处于临床危险范围内的数值。使用标准-Fbg 的纤维蛋白原截断值为 1.5 g/L，全血-Fbg 的受试者工作特征曲线下面积为 0.980（95%置信区间 0.951-1.000，p<0.001）。肝素化全血凝血分析仪可以快速测量纤维蛋白原水平，在关注过度出血的重症监护环境中可能有用。
