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- Boer, Christa, et al.
(author)
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2017 EACTS/EACTA Guidelines on patient blood management for adult cardiac surgery.
- 2018
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In: Journal of Cardiothoracic and Vascular Anesthesia. - : Elsevier BV. - 1532-8422 .- 1053-0770. ; 32:1, s. 88-120
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Journal article (peer-reviewed)abstract
- Authors/Task Force Members: Christa Boer (EACTA Chairperson)(Netherlands), Michael I. Meesters (Netherlands), Milan Milojevic (Netherlands), Umberto Benedetto (UK), Daniel Bolliger (Switzerland), Christian von Heymann (Germany), Anders Jeppsson (Sweden), Andreas Koster (Germany), Ruben L. Osnabrugge (Netherlands), Marco Ranucci (Italy), Hanne Berg Ravn (Denmark), Alexander B.A. Vonk (Netherlands), Alexander Wahba (Norway), Domenico Pagano (EACTS Chairperson)(UK), Document Reviewers: Moritz W.V. Wyler von Ballmoos (USA), Mate Petricevic (Croatia), Arie Pieter Kappetein (Netherlands), Miguel Sousa-Uva (Portugal), Georg Trummer (Germany), Peter M. Rosseel (Netherlands), Michael Sander (Germany), Pascal Colson (France), Adrian Bauer (Germany).
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- Solomon, Cristina, et al.
(author)
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Comparison of fibrin-based clot elasticity parameters measured by free oscillation rheometry (ReoRox (R)) versus thromboelastometry (ROTEM (R))
- 2015
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In: Scandinavian Journal of Clinical & Laboratory Investigation. - : Informa UK Limited. - 1502-7686 .- 0036-5513. ; 75:3, s. 239-246
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Journal article (peer-reviewed)abstract
- Background. Whole blood viscoelastic tests such as the fibrin-based thromboelastometry (ROTEM (R)) test FIBTEM are increasingly used in the perioperative setting to quickly identify deficits in fibrin quality, and to guide hemostatic therapy. The recently developed FibScreen2 test of the ReoRox (R) method, based on free oscillation rheometry, also provides an evaluation of fibrin clot quality. To date, little information is available on the performance of this test in hemodiluted blood, by comparison to FIBTEM. Methods. Whole blood samples from eight healthy volunteers were analyzed using FIBTEM and Fibscreen2. Native and diluted (to 33% and 50% using saline, gelatin or hydroxyethyl starch [HES]) samples were analyzed. Clot strength parameters, including FIBTEM maximum clot firmness (MCF), FIBTEM maximum clot elasticity (MCE) and Fibscreen2 maximum elasticity (G'max), were measured. Results. In repeatedly measured samples from two volunteers, FIBTEM MCF and Fibscreen2 G'max revealed a coefficient of variation (CV) of 5.3 vs. 16.3% and 5.6 vs. 31.7% for each volunteer, respectively. Hemodilution decreased clot strength. Both Fibscreen2 G'max and FIBTEM parameters decreased proportionally to the dilution ratio when saline was used. The observed reductions in FIBTEM and Fibscreen2 parameters were more severe in samples diluted with gelatin and HES, compared to saline. Finally, a regression analysis between FIBTEM MCE and Fibscreen2 G'max revealed a poor goodness of fit (r(2) = 0.37, p < 0.0001). Conclusions. ReoRox (R) Fibscreen2 test has a high coefficient of variation, and its application in various hemodilution conditions showed limited comparability with the ROTEM (R) FIBTEM test.
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- Solomon, Cristina, et al.
(author)
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Fibrinogen measurement in cardiac surgery with cardiopulmonary bypass: Analysis of repeatability and agreement of Clauss method within and between six different laboratories
- 2014
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In: Thrombosis and Haemostasis. - 0340-6245. ; 112:1, s. 109-117
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Journal article (peer-reviewed)abstract
- Plasma fibrinogen concentration is important for coagulopathy assessment, and is most commonly measured using the Clauss method. Several factors, including device type and reagent, have been shown to affect results, The study objective was to evaluate performance and repeatability of the Clauss method and to assess differences between measurements performed during and after cardiopulmonary bypass (CPB), by testing plasma samples from patients undergoing cardiac surgery with CPB. Samples were collected from 30 patients before surgery, approximately 20 minutes before weaning from CPB, and 5 minutes after CPB and protamine. Fibrinogen concentration was determined using the Clauss method at six quality-controlled specialised laboratories, according to accredited standard operating procedures. Regarding within-centre agreement for Clauss measurement, mean differences between duplicate measurements were between 0.00 g/l and 0.15 g/l, with intervals for 95% limits of agreement for mean Bland-Altman differences up to 1.3 g/l. Regarding between-centre agreement, some mean differences between pairs of centres were above 0.5 g/l. Differences of up to similar to 2 g/l were observed with individual samples. Increased variability was observed between centres, with inter-class correlation values below 0.5 suggesting only fair agreement. There were no significant differences in fibrinogen concentration before weaning from CPB and after CPB for most centres and methods. In conclusion, considerable differences exist between Clauss-based plasma fibrinogen measured using different detection methods. Nevertheless, the similarity between measurements shortly before weaning from CPB and after CPB within centres suggests that on-pump measurements could provide an early estimation of fibrinogen deficit after CPB and thus guidance for haemostatic therapy.
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