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患病和健康犬中粘弹性凝血监测系统(VCM Vet)的评估及其与血栓弹力图(ROTEM)的相关性

Evaluation of a Viscoelastic Coagulation Monitoring System (VCM Vet) and Its Correlation with Thromboelastometry (ROTEM) in Diseased and Healthy Dogs.

作者信息

Hennink Imke, Peters Laureen, van Geest Geert, Adamik Katja-Nicole

机构信息

Department of Veterinary Clinical Medicine, Division of Small Animal Emergency and Critical Care, Vetsuisse Faculty, University of Bern, 3012 Bern, Switzerland.

Department of Veterinary Clinical Medicine, Clinical Laboratory, Vetsuisse Faculty, University of Bern, 3012 Bern, Switzerland.

出版信息

Animals (Basel). 2023 Jan 25;13(3):405. doi: 10.3390/ani13030405.

Abstract

Thromboelastometry provides a real-time assessment of global coagulation in whole blood. A novel bed-side viscoelastic coagulation monitor (VCM) has been developed for use in small animals. The aims of the study were to determine inter-device agreement of two VCM devices, to evaluate the correlation between VCM and rotational thromboelastometry as a reference method (ROTEM), and to determine the sensitivity and specificity of VCM to diagnose hypo-, normo-, and hypercoagulability. ROTEM (extrinsic and intrinsic activation) analysis was performed using citrated blood and VCM analysis using native blood. Twenty healthy and forty diseased dogs with and without coagulopathies were enrolled. The VCM inter-device agreement was moderate to strong for most of the parameters, depending on the grading scale. Correlation between VCM and ROTEM was moderate to strong for parameters of clotting time and clot strength. The VCM most likely detects true hypocoagulability and reliably rules out hypocoagulability. The VCM has a high sensitivity in diagnosing normocoagulability, but incorrectly classified dogs with abnormal coagulation as normocoagulable. The VCM was not able to detect hypercoagulability. ROTEM and VCM cannot be used interchangeably.

摘要

血栓弹力测定法可对全血中的整体凝血情况进行实时评估。一种新型的床旁粘弹性凝血监测仪(VCM)已被开发用于小动物。本研究的目的是确定两种VCM设备之间的仪器间一致性,评估VCM与作为参考方法的旋转血栓弹力测定法(ROTEM)之间的相关性,并确定VCM诊断低凝、正常凝血和高凝状态的敏感性和特异性。使用枸橼酸盐血进行ROTEM(外源性和内源性激活)分析,使用未处理的血进行VCM分析。纳入了20只健康犬和40只患有或未患有凝血障碍的患病犬。根据分级标准,大多数参数的VCM仪器间一致性为中度至高度。VCM与ROTEM在凝血时间和血凝块强度参数方面的相关性为中度至高度。VCM很可能检测到真正的低凝状态,并可靠地排除低凝状态。VCM在诊断正常凝血状态时具有较高的敏感性,但将凝血异常的犬错误分类为正常凝血。VCM无法检测到高凝状态。ROTEM和VCM不能互换使用。

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