Intensive Care Unit, Gold Coast University Hospital, Gold Coast, Queensland, Australia.
Anaesthetic Department, Gold Coast University Hospital, Gold Coast, Queensland, Australia.
Emerg Med Australas. 2020 Oct;32(5):786-792. doi: 10.1111/1742-6723.13510. Epub 2020 Apr 11.
To assess the feasibility of using rotational thromboelastometry (ROTEM®)-sigma and thromboelastography (TEG®)-6s viscoelastic point-of-care assays during rotary wing aeromedical transport, and to determine the reliability of the results obtained.
A single centre, prospective, observational, non-interventional feasibility study performed at Gold Coast University Hospital intensive care unit, and in a LifeFlight Retrieval Medicine operated Leonardo AW139 helicopter. Blood was collected from eight healthy volunteers on 18 April 2019 and all testing was performed on that day. Functions measured were ROTEM-sigma extrinsically activated thromboelastometry (EXTEM) clotting time (CT), EXTEM amplitude at 5 min after CT (A5) and fibrin-based extrinsically activated thromboelastometry (FIBTEM) A5, and TEG-6s Kaolin (CK) reaction time (R), functional fibrinogen (CFF) maximal amplitude (MA) and CFF amplitude at 10 min after R (A10). Differences between the results obtained in the helicopter and control results at Gold Coast University Hospital during flight and after flight, and also differences in control results over time up to 3 h were analysed.
During flight both the ROTEM-sigma and TEG-6s devices failed to give reliable results. Post flight, the helicopter and control samples correlated well. Repeat testing of control samples at 1 and 3 h also revealed good correlation over time.
It is feasible to reliably run tests on both the ROTEM-sigma and TEG-6s after the devices have been flown in a rotary wing aircraft. However, testing cannot be performed while in flight conditions. It is also possible to run blood samples collected up to 3 h prior and acquire results which correlate well with initial testing.
评估在旋转翼航空医疗转运过程中使用旋转血栓弹性描记术（ROTEM®-sigma）和血栓弹性描记术（TEG®）-6s 粘弹性即时检测的可行性，并确定所获得结果的可靠性。
这是一项在黄金海岸大学医院重症监护病房和莱昂纳多 AW139 直升机上进行的单中心、前瞻性、观察性、非干预性可行性研究。2019 年 4 月 18 日采集了 8 名健康志愿者的血液，当天进行了所有检测。测量的功能包括 ROTEM-sigma 外激活血栓弹性描记术（EXTEM）凝血时间（CT）、CT 后 5 分钟的 EXTEM 幅度（A5）和基于纤维蛋白的外激活血栓弹性描记术（FIBTEM）A5，以及 TEG-6s 高岭土（CK）反应时间（R）、功能性纤维蛋白原（CFF）最大幅度（MA）和 R 后 10 分钟的 CFF 幅度（A10）。分析了直升机和飞行中和飞行后黄金海岸大学医院的控制室结果之间的差异，以及控制室结果随时间的差异（长达 3 小时）。
飞行过程中 ROTEM-sigma 和 TEG-6s 两种设备均无法提供可靠结果。飞行后，直升机和控制室样本相关性良好。对控制室样本的重复检测也显示出随时间的良好相关性。
在旋转翼飞机上飞行后，可靠地运行 ROTEM-sigma 和 TEG-6s 测试是可行的。然而，飞行条件下无法进行测试。在 3 小时前采集血液样本并获得与初始测试结果相关的结果也是可行的。
