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Point of care examination of blood clotting –
current possibilities


Authors: J. Zatloukal 1;  M. Horáková 1,2;  L. Bultasová 3;  J. Pouska 1;  J. Kletečka 1;  J. Beneš 1,2
Authors‘ workplace: Klinika anesteziologie a resuscitace, Lékařská fakulta v Plzni, Univerzita Karlova a Fakultní nemocnice Plzeň 1;  Biomedicínské centrum, Lékařská fakulta v Plzni, Univerzita Karlova 2;  Ústav klinické biochemie a hematologie, Lékařská fakulta v Plzni, Univerzita Karlova a Fakultní nemocnice Plzeň 3
Published in: Anest. intenziv. Med., 32, 2021, č. 1, s. 14-24
Category: Review Articles

Overview

Determination of platelet function and function of plasma coagulation system is one of the commonly performed examina tions in anesthesiology and intensive care. The reason for the examination of blood clotting may be planned or acute surgery, spontaneous bleeding, postoperative bleeding without a clear source, monitoring the effect of treatment with anticoagu lant and antiplatelet drugs, thromboembolism, etc. Very often these are urgent situations where it is advantageous if such examination can be performed directly at the patient’s bedside. Current medicine offers us the possibility of using several so-called point of care (POCT) devices that can be used for this purpose. In our article, we provide an overview of the most common methods and devices that are used to examine blood clotting at the patient’s bedside.

Keywords:

hemostasis – Platelets – aggregation – thromboelastometry


Sources

1. Gurbel PA, Bliden KP, Butler K, Tantry US, Gesheff T, Wei C, et al. Randomized Double‑Blind Assessment of the ONSET and OFFSET of the Antiplatelet Effects of Ticagrelor Versus Clopidogrel in Patients With Stable Coronary Artery Disease. Circulation 2009; 120(25): 2577–2585.

2. Gurbel PA, Bliden KP, Butler K, Antonino MJ, Wei C, Teng R, et al. Response to Ticagrelor in Clopidogrel Nonresponders and Responders and Effect of Switching Therapies. Circulation 2010; 121(10): 1188–1199.

3. Ferraris VA, Saha SP, Oestreich JH, Song HK, Rosengart T, Reece TB, et al. 2012 Update to The Society of Thoracic Surgeons Guideline on Use of Antiplatelet Drugs in Patients Having Cardiac and Noncardiac Operations. Ann Thorac Surg. 2012; 94(5): 1761–1781.

4. Pagano D, Milojevic M, Meesters MI, Benedetto U, Bolliger D, Von Heymann C, et al. 2017 EACTS/EACTA Guidelines on patient blood management for adult cardiac surgery. European Journal of Cardio‑Thoracic Surgery 2018, 53(1): 79–111.

5. Reed GW, Kumar A, Guo J, Aranki S, Shekar P, Agnihotri A, et al. Point‑of‑Care Platelet Function Testing Predicts Bleeding in Patients Exposed to Clopidogrel Undergoing Coronary Artery Bypass Grafting: Verify Pre‑Op TIMI 45-A Pilot Study. Clin Cardiol. 2015; 38(2): 92–98.

6. Czerwińska‑Jelonkiewicz K, Witkowski A, Dąbrowski M, Piotrowski W, Hryniewiecki T, Stępińska J. The role of platelet reactivity assessment in dual antiplatelet prophylaxis after transcatheter aortic valve implantation. Arch Cardiovasc, DiS. 2018; 111(4): 233–245.

7. Marcucci R, Gori AM, Paniccia R, Giusti B, Valente S, Giglioli C, et al. Cardiovascular Death and Nonfatal Myocardial Infarction in Acute Coronary Syndrome Patients Receiving Coronary Stenting Are Predicted by Residual Platelet Reactivity to ADP Detected by a Point‑of‑Care Assay. Circulation. 2009; 119(2): 237–242.

8. Patti G, Nusca A, Mangiacapra F, Gatto L, D’Ambrosio A, Di Sciascio G. Point‑of‑Care Measurement of Clopidogrel Responsiveness Predicts Clinical Outcome in Patients Undergoing Percutaneous Coronary Intervention. Results of the ARMYDA‑PRO (Antiplatelet therapy for Reduction of MYocardial Damage during Angioplasty‑Platelet Rea. J Am Coll Cardiol. 2008; 52(14): 1128–1133.

9. Giustino G, Redfors B, Kirtane AJ, Mehran R, Dangas GD, Witzenbichler B, et al. Platelet Reactivity and Risk of Ischemic Stroke After Coronary Drug‑Eluting Stent Implantation. JACC Cardiovasc Interv. 2018; 11(13): 1277–1286.

10. Sibbing D, Braun S, Morath T, Mehilli J, Vogt W, Schömig A, et al. Platelet Reactivity After Clopidogrel Treatment Assessed With Point‑of‑Care Analysis and Early Drug‑Eluting Stent Thrombosis. J Am Coll Cardiol. 2009; 53(10): 849–856. doi: 10.1016/j.jacc.2008. 11. 030

11. Kjellberg G, Holm M, Lindvall G, Gryfelt G, van der Linden J, Wikman A. Platelet function analysed by ROTEM platelet in cardiac surgery after cardiopulmonary bypass and platelet transfusion. Transfus Med. 2020; (August 2018): 1–8.

12. Petricevic M, Konosic S, Biocina B, Dirkmann D, White A, Mihaljevic MZ, et al. Bleeding risk assessment in patients undergoing elective cardiac surgery using ROTEM® platelet and Multiplate® impedance aggregometry. Anaesthesia. 2016; 71(6): 636–647.

13. Favaloro EJ. Clinical utility of the PFA-100. Semin Thromb Hemost. 2008; 34(8): 709–733.

14. Favaloro EJ. Clinical utility of closure times using the platelet function analyzer-100/200. Am J Hematol. 2017; 92(4): 398–404.

15. Podda GM, Bucciarelli P, Lussana F, Lecchi A, Cattaneo M. Usefulness of PFA-100® testing in the diagnostic screening of patients with suspected abnormalities of hemostasis: comparison with the bleeding time. J Thromb Haemost. 2007; 5(12): 2393–2398.

16. Bartels A, Sarpong Y, Coberly J, Hughes N, Litt J, Quick J, et al. Failure of the Platelet Function Assay (PFA)-100 to detect antiplatelet agents. Surgery. 2015; 158(4): 1012–1019.

17. Orme R, Judge H, Storey R. Monitoring Antiplatelet Therapy. Semin Thromb Hemost. 2017; 43(03): 311–319.

18. Karkouti K, Callum J, Wijeysundera DN, Rao V, Crowther M, Grocott HP, et al. Point‑of‑Care Hemostatic Testing in Cardiac Surgery. Circulation. 2016; 134(16): 1152–1162.

19. Sivapalan P, Bäck AC, Ostrowski SR, Ravn HB, Johansson PI. Transfusion requirements in elective cardiopulmonary bypass surgery patients: predictive value of Multiplate and Thromboelastography (TEG) Platelet Mapping Assay. Scand J Clin Lab Invest. 2017; 77(5): 345–351.

20. Weitzel NS, Weitzel LB, Epperson LE, Karimpour‑Ford A, Tran ZV, Seres T. Platelet mapping as part of modified thromboelastography (TEG®) in patients undergoing cardiac surgery and cardiopulmonary bypass. Anaesthesia. 2012; 67(10): 1158–1165.

21. Karon BS, Tolan NV, Koch CD, Wockenfus AM, Miller RS, Lingineni RK, et al. Precision and Reliability of 5 Platelet Function Tests in Healthy Volunteers and Donors on Daily Antiplatelet Agent Therapy. Clin Chem. 2014; 60(12): 1524–1531.

22. Ranucci M, Baryshnikova E, Crapelli GB, Ranucci M, Meloni S, Pistuddi V. Electric impedance platelet aggregometry in cardiac surgery patients: A comparative study of two technologies. Platelets. 2016; 27(3): 185–190.

23. Le Quellec S, Bordet J‑C, Negrier C, Dargaud Y. Comparison of current platelet functional tests for the assessment of aspirin and clopidogrel response. A review of the literature. Thromb Haemost. 2016; 116(4): 638–650.

24. Haas T, Spielmann N, Mauch J, Madjdpour C, Speer O, Schmugge M, et al. Comparison of thromboelastometry (ROTEM®) with standard plasmatic coagulation testing in paediatric surgery. Br J Anaesth. 2012; 108(1): 36–41.

25. Deppe AC, Weber C, Zimmermann J, Kuhn EW, Slottosch I, Liakopoulos OJ, et al. Point‑of‑care thromboelastography/thromboelastometry‑based coagulation management in cardiac surgery: a meta‑analysis of 8332 patients. Journal of Surgical Research 2016; 203(2): 424–433.

26. Hartmann J, Murphy M, Dias JD. Viscoelastic Hemostatic Assays: Moving from the Laboratory to the Site of Care – A Review of Established and Emerging Technologies. Diagnostics 2020; 10(2): 118.

27. Görlinger K, Dirkmann D, Hanke AA, Kamler M, Kottenberg E, Thielmann M, et al. First‑line Therapy with Coagulation Factor Concentrates Combined with Point‑of‑Care Coagulation Testing Is Associated with Decreased Allogeneic Blood Transfusion in Cardiovascular Surgery. Anesthesiology. 2011; 115(6): 1.

28. Girdauskas E, Kempfert J, Kuntze T, Borger MA, Enders J, Fassl J, et al. Thromboelastometrically guided transfusion protocol during aortic surgery with circulatory arrest: A prospective, randomized trial. J Thorac Cardiovasc Surg. 2010; 140(5): 1117–1124.e2.

29. Schöchl H, Nienaber U, Hofer G, Voelckel W, Jambor C, Scharbert G, et al. Goal‑directed coagulation management of major trauma patients using thromboelastometry (ROTEM®)-guided administration of fibrinogen concentrate and prothrombin complex concentrate. Crit Care. 2010; 14(2): R55.

30. Schöchl H, Maegele M, Solomon C, Görlinger K, Voelckel W. Early and individualized goal‑directed therapy for trauma‑ induced coagulopathy. Scand J Trauma Resusc Emerg Med. 2012; 20(1): 15.

31. Gonzalez E, Moore EE, Moore HB, Chapman MP, Chin TL, Ghasabyan A, et al. Goal‑directed hemostatic resuscitation of trauma‑ induced coagulopathy a pragmatic randomized clinical trial comparing a viscoelastic assay to conventional coagulation assays. Ann Surg. 2016; 263(6): 1051–1059.

32. Moore HB, Moore EE, Chin TL, Gonzalez E, Chapman MP, Walker CB, et al. Activated clotting time of thrombelastography (T‑ACT) predicts early postinjury blood component transfusion beyond plasma. Surgery. 2014; 156(3): 564–569.

33. Bolliger D, Tanaka KA. Roles of Thrombelastography and Thromboelastometry for Patient Blood Management in Cardiac Surgery. Transfus Med Rev. 2013; 27(4): 213–220.

34. Nakayama Y, Nakajima Y, Tanaka KA, Sessler DI, Maeda S, Iida J, et al. Thromboelastometry‑guided intraoperative haemostatic management reduces bleeding and red cell transfusion after paediatric cardiac surgery. Br J Anaesth. 2015; 114(1): 91–102.

35. Clevenger B. Transfusion and coagulation management in liver transplantation. World J Gastroenterol. 2014; 20(20): 6146.

36. Hincker A, Feit J, Sladen RN, Wagener G. Rotational thromboelastometry predicts thromboembolic complications after major non‑cardiac surgery. Crit Care. 2014; 18(5): 549.

37. McCrath DJ, Cerboni E, Frumento RJ, Hirsh AL, Bennett‑Guerrero E. Thromboelastography Maximum Amplitude Predicts Postoperative Thrombotic Complications Including Myocardial Infarction. Anesth Analg. 2005; 100(6): 1576–1583.

38. Luckner G, Mayr VD, Fries DR, Innerhofer P, Jochberger S, Hasibeder WR, et al. Uncovering Hypercoagulability in Sepsis Using ROTEM® Thromboelastometry: A Case Series. Open Crit Care Med J. 2008; 1(1): 1–6.

39. Mallett SV, Sugavanam A, Krzanicki DA, Patel S, Broomhead RH, Davidson BR, et al. Alterations in coagulation following major liver resection. Anaesthesia. 2016; 71(6): 657–668.

40. Görlinger K, Fries D, Dirkmann D, Weber CF, Hanke AA, Schöchl H. Reduction of Fresh Frozen Plasma Requirements by Perioperative Point‑of‑Care Coagulation Management with Early Calculated Goal‑Directed Therapy. Transfus Med Hemotherapy. 2012; 39(2): 104–113.

41. Kozek‑Langenecker SA, Ahmed AB, Afshari A, Albaladejo P, Aldecoa C, Barauskas G, et al. Management of severe perioperative bleeding. Eur J Anaesthesiol. 2017; 34(6): 332–395.

42. Spahn DR, Bouillon B, Cerny V, Duranteau J, Filipescu D, Hunt BJ, et al. The European guideline on management of major bleeding and coagulopathy following trauma: fifth edition. Crit Care. 2019; 23(1): 98.

43. Bischof DB, Ganter MT, Shore‑Lesserson L, Hartnack S, Klaghofer R, Graves K, et al. Viscoelastic Blood Coagulation Measurement With Sonoclot Predicts Postoperative Bleeding in Cardiac Surgery After Heparin Reversal. J Cardiothorac Vasc Anesth. 2015; 29(3): 715–722.

44. Rajkumar V, Kumar B, Dutta V, Mishra AK, Puri GD. Utility of Sonoclot in Prediction of Postoperative Bleeding in Pediatric Patients Undergoing Cardiac Surgery for Congenital Cyanotic Heart Disease: A Prospective Observational Study. J Cardiothorac Vasc Anesth. 2017; 31(3): 901–908.

45. Espinosa A, Stenseth R, Videm V, Pleym H. Comparison of three point‑of‑ care testing devices to detect hemostatic changes in adult elective cardiac surgery: A prospective observational study. BMC Anesthesiol. 2014; 14(1): 1–7.

46. Groves DS, Welsby IJ, Naik BI, Tanaka K, Hauck JN, Greenberg CS, et al. Multicenter Evaluation of the Quantra QPlus System in Adult Patients Undergoing Major Surgical Procedures. Anesth Analg. 2020; 130(4): 899–909.

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Anaesthesiology, Resuscitation and Inten Intensive Care Medicine

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