Duclos Gary, Fleury Marie, Grosdidier Charlotte, Lakbar Ines, Antonini François, Lassale Bernard, Arbelot Charlotte, Albaladejo Pierre, Zieleskiewicz Laurent, Leone Marc
Service of Anesthesia and Intensive Care, Hôpital Nord, Aix-Marseille Université, Marseille, France.
Service of Medical Biology, Hôpital Nord, Aix-Marseille Université, Marseille, France.
Res Pract Thromb Haemost. 2023 Apr 24;7(4):100163. doi: 10.1016/j.rpth.2023.100163. eCollection 2023 May.
Traumatic hemorrhage guidelines include point-of-care viscoelastic tests as a standard of care. Quantra (Hemosonics) is a device based on sonic estimation of elasticity via resonance (SEER) sonorheometry to assess whole blood clot formation.
Our study aimed to assess the ability of an early SEER evaluation to detect blood coagulation test abnormalities in trauma patients.
We conducted an observational retrospective cohort study with data collected at hospital admission of consecutive multiple trauma patients from September 2020 to February 2022 at a regional level 1 trauma center. We performed a receiving operator characteristic curve analysis to determine the ability of the SEER device to detect blood coagulation test abnormalities. Four values on the SEER device were analyzed: clot formation time, clot stiffness (CS), platelet contribution to CS, and fibrinogen contribution to CS.
A total of 156 trauma patients were analyzed. The clot formation time value predicted an activated partial thromboplastin time ratio of >1.5 with an area under the curve (AUC) of 0.93 (95% CI, 0.86-0.99). The AUC of the CS value in detecting an international normalized ratio of prothrombin time of >1.5 was 0.87 (95% CI, 0.79-0.95). The AUC of fibrinogen contribution to CS to detect a fibrinogen concentration of <1.5 g/L was 0.87 (95% CI, 0.80-0.94). The AUC of platelet contribution to CS to detect a platelet concentration of <50 G/L was 0.99 (95% CI, 0.99-1.00).
Our results suggest that the SEER device may be useful for the detection of blood coagulation test abnormalities at trauma admission.
创伤性出血指南将即时粘弹性检测作为一种护理标准。Quantra（Hemosonics）是一种基于通过共振进行弹性声波估计（SEER）的声流变学设备，用于评估全血凝块形成。
我们的研究旨在评估早期SEER评估检测创伤患者凝血试验异常的能力。
我们进行了一项观察性回顾性队列研究，收集了2020年9月至2022年2月在一家地区一级创伤中心连续收治的多发创伤患者入院时的数据。我们进行了接受者操作特征曲线分析，以确定SEER设备检测凝血试验异常的能力。分析了SEER设备上的四个值：凝块形成时间、凝块硬度（CS）、血小板对CS的贡献以及纤维蛋白原对CS的贡献。
共分析了156例创伤患者。凝块形成时间值预测活化部分凝血活酶时间比值>1.5，曲线下面积（AUC）为0.93（95%CI，0.86-0.99）。CS值检测凝血酶原时间国际标准化比值>1.5的AUC为0.87（95%CI，0.79-0.95）。纤维蛋白原对CS的贡献检测纤维蛋白原浓度<1.5 g/L的AUC为0.87（95%CI，0.80-0.94）。血小板对CS的贡献检测血小板浓度<50 G/L的AUC为0.99（95%CI，0.99-1.00）。
我们的结果表明，SEER设备可能有助于在创伤入院时检测凝血试验异常。
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