Sato Tomoe, Edanaga Mitsutaka, Yamakage Michiaki, Harada Ryo, Kawaharada Nobuyoshi
Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, JPN.
Department of Cardiovascular Surgery, Shin-Sapporo Cardiology Hospital, Sapporo, JPN.
Cureus. 2023 Nov 20;15(11):e49131. doi: 10.7759/cureus.49131. eCollection 2023 Nov.
Introduction The point-of-care test (POCT) is useful for blood coagulation management during cardiovascular surgery. Although thromboelastography (TEG6s) has been reported to have targeted benefits for blood transfusion in cardiac surgery, Sonoclot analysis has not yet been fully validated. In this study, we evaluated the accuracy of Sonoclot, especially platelet function (PF) as a platelet concentrate (PC) transfusion parameter, compared to TEG6s in cardiovascular surgery. Methods This single-center, prospective, randomised trial was conducted at a university hospital. Forty-two adult patients who underwent elective cardiac surgery requiring cardiopulmonary bypass were included in this study between 2017 and 2021. The participants were randomly assigned to the Sonoclot (S) or Sonoclot and TEG6s (ST) groups. The amount of intraoperative PC was determined according to the POCT parameter values at the time of protamine administration. In addition, we investigated the correlation between PF parameters of POCT and platelet count at the end of surgery. Results There was no statistically significant difference in the intraoperative PC volume between the two groups. The Sonoclot PF parameter, PF, was moderately correlated with platelet count at the end of surgery (r=0.5449, p=0.009), and the TEG6s PF parameter showed a strong correlation with platelet count at the end of surgery (r=0.7744, p<0.001). Conclusion There was no statistically significant difference in platelet transfusion volume between the Sonoclot and TEG6s in this study. The correlation between the PF of the Sonoclot and platelet count was moderate. This study suggests that PF of Sonoclot may be a potentiating indicator of PF.
引言
即时检验(POCT)在心血管手术期间的凝血管理中很有用。尽管有报道称血栓弹力图(TEG6s)在心脏手术中对输血有针对性的益处,但Sonoclot分析尚未得到充分验证。在本研究中,我们评估了Sonoclot的准确性,特别是作为血小板浓缩物(PC)输血参数的血小板功能(PF),并与心血管手术中的TEG6s进行了比较。
方法
这项单中心、前瞻性、随机试验在一家大学医院进行。2017年至2021年期间,42例接受需要体外循环的择期心脏手术的成年患者纳入本研究。参与者被随机分配到Sonoclot(S)组或Sonoclot和TEG6s(ST)组。术中PC的用量根据鱼精蛋白给药时的POCT参数值确定。此外,我们还研究了手术结束时POCT的PF参数与血小板计数之间的相关性。
结果
两组术中PC用量无统计学显著差异。Sonoclot的PF参数PF与手术结束时的血小板计数中度相关(r=0.5449,p=0.009),而TEG6s的PF参数与手术结束时的血小板计数高度相关(r=0.7744,p<0.001)。
结论
本研究中,Sonoclot和TEG6s在血小板输血量方面无统计学显著差异。Sonoclot的PF与血小板计数之间的相关性为中度。本研究表明,Sonoclot的PF可能是PF的一个增强指标。