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意大利重症监护环境中声流变学参数与实验室检查值之间的关系:一项回顾性队列研究。

Relationship between sonorheometry parameters and laboratory values in a critical care setting in Italy: a retrospective cohort study.

作者信息

Romanelli Antonio, Gammaldi Renato, Calicchio Alessandro, Palmese Salvatore, Siglioccolo Antonio

机构信息

Department of Anesthesia and Intensive Care Unit, Azienda Ospedaliero Universitaria San Giovanni di Dio Ruggi d'Aragona, Salerno, Italy.

Department of Anesthesia and Intensive Care, University of Naples Federico II, Naples, Italy.

出版信息

J Trauma Inj. 2023 Sep;36(3):210-216. doi: 10.20408/jti.2023.0014. Epub 2023 Jul 4.

Abstract

PURPOSE

This preliminary retrospective cohort study analyzed the relationship between the parameters provided by sonorheometry device Quantra and the coagulation values obtained from standard venous blood samples in patients admitted in intensive care unit (ICU).

METHODS

We reviewed medical charts of 13 ICU adult patients in whom at least one coagulation study with Quantra was performed. The relationship between Quantra and laboratory data was analyzed with the Spearman rank correlation coefficient (rho). The 95% confidence interval (CI) was computed. A P-value <0.05 was considered statistically significant.

RESULTS

We collected 28 data pairs. Statistically significant moderate correlations were found for the following parameters: clot time (CT) and activated partial thromboplastin time (rho=0.516; 95% CI, 0.123-0.904; P=0.009; clot stiffness (CS) and the international normalized ratio (INR; rho=0.418; 95% CI, 0.042-0.787; P=0.039); INR and platelet contribution to CS (rho=0.459; 95% CI, 0.077-0.836; P=0.022); platelet count and platelet contribution to CS (PCS; rho=0.498; 95% CI, 0.166-0.825; P=0.008); and fibrinogen and fibrinogen contribution to CS (FCS; rho=0.620; 95% CI, 0.081-0.881; P=0.001).

CONCLUSIONS

Quantra can provide useful information regarding coagulation status, showing modest correlations with the parameters obtained from laboratory tests. During diffuse bleeding, CT and FCS values can guide the proper administration of clotting factors and fibrinogens. However, the correlation of INR with CS and PCS can cause misinterpretation. Further studies are needed to clarify the relationship between Quantra parameters and laboratory tests in the critical care setting and the role of sonorheometry in guiding targeted therapies and improving outcomes.

摘要

目的

这项初步回顾性队列研究分析了重症监护病房(ICU)患者中,声流变仪设备Quantra提供的参数与标准静脉血样本凝血值之间的关系。

方法

我们回顾了13例成年ICU患者的病历,这些患者至少进行了一次Quantra凝血研究。采用Spearman等级相关系数(rho)分析Quantra与实验室数据之间的关系。计算95%置信区间(CI)。P值<0.05被认为具有统计学意义。

结果

我们收集了28对数据。发现以下参数存在具有统计学意义的中度相关性:凝血时间(CT)与活化部分凝血活酶时间(rho=0.516;95%CI,0.123-0.904;P=0.009);凝血硬度(CS)与国际标准化比值(INR;rho=0.418;95%CI,0.042-0.787;P=0.039);INR与血小板对CS的贡献(rho=0.459;95%CI,0.077-0.836;P=0.022);血小板计数与血小板对CS的贡献(PCS;rho=0.498;95%CI,0.166-0.825;P=0.008);纤维蛋白原与纤维蛋白原对CS的贡献(FCS;rho=0.620;95%CI,0.081-0.881;P=0.001)。

结论

Quantra可提供有关凝血状态的有用信息,与实验室检测获得的参数显示出适度相关性。在弥漫性出血期间,CT和FCS值可指导凝血因子和纤维蛋白原的合理使用。然而,INR与CS和PCS的相关性可能会导致误解。需要进一步研究以阐明重症监护环境中Quantra参数与实验室检测之间的关系,以及声流变仪在指导靶向治疗和改善预后方面的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9107/11309283/81d1f99e447c/jti-2023-0014f1.jpg

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