Assessment of method reliability and determination of reference intervals for rotational thromboelastometry in horses

Junge, H.; Ringer, Simone K; Mayer, Nathalie; Schwarzwald, Colin C.

doi:10.1111/vec.12515

Cited by 8 publications

(9 citation statements)

References 54 publications

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“…The judgment of the variability depends on the classification of the CoV, for which we followed the approach of previous studies [ 7 , 30 , 31 ]. With Ex-TEM and Fib-TEM S tests, the parameters CT, CFT and ML should be interpreted with caution.…”

Section: Discussionmentioning

confidence: 99%

“…The statistical significance of the differences between the respective first and second measurement was estimated using paired t -tests. Following the approach by Junge et al [ 7 ], we classified the CoV as follows: <5%, very low variability; 5–15%, low variability; 15–25%, moderate variability; >25%, high variability. Additionally, the interclass correlation coefficients to estimate the reliability of the measurements was calculated.…”

Section: Methodsmentioning

confidence: 99%

“…In veterinary medicine, TEG/ROTEM have been validated for use in horses [ 6 , 7 ], dogs [ 8 , 9 ] and cats [ 10 , 11 ]. Although, theoretically, there are many advantages of viscoelastic tests compared to traditional coagulation testing in plasma, it is important to note that multiple preanalytical and analytical factors can influence test results [ 4 , 12 , 13 ], including sample collection technique (size of chosen vessel, amount of vessel occlusion, venipuncture technique, use of vacutainers, use of syringes), sample handling (storage time before initiation of the test, storage temperature), and the analysis itself (variability of ROTEM devices, operator variability).…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Jugular vs. Saphenous Blood Samples, Intrarater and In-Between Device Reliability of Clinically Used ROTEM S Parameters in Dogs

Vuille-dit-Bille

Weingand

Schefer

et al. 2022

Animals

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Rotational Thromboelastometry (ROTEM) allows for the global assessment of hemostasis in whole blood samples. Preanalytical and analytical factors may influence test results, and data about the reliability and reproducibility of lyophilized ROTEM tests are scarce. Therefore, the objective of this study was to evaluate the influence of blood collection site on ROTEM S parameters and to assess intrarater and in-between device variability. A total of thirty, healthy, staff-owned dogs were included. Blood collection and ROTEM analysis were performed by trained staff according to a standardized protocol. Extrinsically activated (tissue factor; Ex-TEM S), with the addition of cytochalasin for platelet inhibition (Fib-TEM S), and intrinsically activated (In-TEM) analyses were performed. Analysis of our data showed significant variability for various Ex-TEM S and Fib-TEM S parameters from different collection sites and intrarater and in-between device measurements. We conclude that serial monitoring with ROTEM should be performed on the same device, with blood always taken from the same collection site using a standardized blood sampling technique. While In-TEM S, apart from maximum lysis, showed very stable and reliable results, we suggest interpreting especially clotting and clot formation parameters from Ex-TEM S and Fib-TEM S tests with caution and using duplicate measurements to detect outliers and to prevent initiation of incorrect therapies.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of Jugular vs. Saphenous Blood Samples, Intrarater and In-Between Device Reliability of Clinically Used ROTEM S Parameters in Dogs

Vuille-dit-Bille

Weingand

Schefer

et al. 2022

Animals

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“…Variability between individual viscoelastic devices has been evaluated in veterinary and human populations with both TEG and ROTEM using different methods 17,18,19,20,21 . Devices located at different institutions possessed the highest coefficients of variation when plasma samples were assessed 19,20 .…”

Section: Discussionmentioning

confidence: 99%

Establishment of normal reference intervals in dogs using a viscoelastic point‐of‐care coagulation monitor and its comparison with thromboelastography

Buriko

Drobatz

Silverstein

2020

Veterinary Clinical Pathol

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BackgroundViscoelastic coagulation devices are a useful adjunct to the evaluation of hemostasis in veterinary patients. VCM Vet is a point‐of‐care device that is simple in operation and could be used to diagnose and trend hemostatic abnormalities in sick patients. VCM Vet does not use activators.ObjectivesWe aimed to establish reference intervals (RIs) for VCM Vet in a healthy adult canine population and concurrently perform thromboelastographic (TEG) analysis on these samples with and without tissue factor (TF) activation for RI comparisons.MethodsDuplicate VCM Vet tests were performed immediately upon sample collection. Two concurrent TEG tests were performed on the remaining blood, one citrated, untreated (CU), and one activated with TF at a 1:3600 dilution.ResultsFifty‐two dogs were enrolled in the study. The following RIs were generated for VCM Vet machine 1 and 2, respectively: clot time (CT) (seconds) 163‐480 and 172‐457; clot formation time (CFT) (seconds) 104‐288 and 94‐252, α‐angle (degrees) 41‐65 and 44‐66, and maximum clot firmness (MCF) (no units) 27‐43 and 30‐46. Moderate to good correlations were observed between the two machines with Lin’s concordance correlation coefficients of 0.51‐0.9 and a P < 0.002. TEG RIs were similar to previously reported values.ConclusionsVCM Vet RIs were generated. Each VCM Vet device should have a unique RI established due to inter‐device variability. Direct correlations of VCM Vet values with TEG parameters were not performed due to the narrow range of the normal values and the need to evaluate patients with a wide range of hemostatic abnormalities.

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“…Entsprechend erlaubt sie unter anderem die Feststellung von hyperfibrinolytischen Zuständen (Johansson et al 2009). Vor Kurzem wurden für diese Analyse Referenzwerte für Pferde definiert (Junge et al 2016). Die ROTEM-Analyse lieferte jedoch bei keinem der Patienten Hinweise auf einen Solchen.…”

Section: Statistische Analysenunclassified

Haemothorax in the horse: a retrospective study

Rickli¹,

Birkmann²,

Hilbe³

et al. 2018

PHK

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In dieser Studie wurden die Krankengeschichten von 13 Pferden ausgewertet, bei welchen in den Jahren 2005 bis 2017 an der Klinik für Pferdemedizin der Vetsuisse-Fakultät der Universität Zürich die Diagnose Hämothorax gestellt wurde. Es handelte sich um vier Stuten und neun Wallache. Sowohl die Befunde der klinischen Untersuchung, der Blutuntersuchung, der röntgenologischen, ultrasonographischen sowie der zytologischen Untersuchung des Thoraxpunktates als auch die durchgeführte Behandlung der Pferde wurden analysiert. Die folgenden Fallzahlen beziehen sich jeweils auf die Anzahl Pferde, bei denen die beschriebene Untersuchung durchgeführt wurde, da nicht bei allen jeder Befund vorliegt. Die häufigsten Symptome bei Vorstellung waren Tachypnoe, abnorme Lungenauskultationsbefunde, verändertes Verhalten, angestrengte Atmung oder Dyspnoe, Tachykardie, feuchte Körperoberfläche, beidseitige Epistaxis und verlängerte kapilläre Füllungszeit. Die Blutuntersuchung zeigte Leukozytose, Thrombozytopenie, Hyperglykämie sowie eine Hypocalcämie. Die arterielle Blutgasanalyse zeigte einen erniedrigten pO 2. In der radiologischen Untersuchung waren eine weichteildichte Verschattung unterschiedlichen Ausmaßes ventral im Thorax sowie verschiedene Lungenmuster sichtbar. Die sonographische Untersuchung zeigte freie Flüssigkeit im Pleuralraum mit hypo-bis hyperechogenem, korpuskulärem Charakter. Die zytologische Untersuchung der per Thorakozentese gewonnenen Flüssigkeit bestätigte die Diagnose Hämothorax. Die Behandlung erfolgte mittels Infusionen, antibiotischen und analgetischen Medikamenten, Tranexamsäure, Formalin und Furosemid. Bei einzelnen Pferden wurden Blut-und Plasmatransfusionen durchgeführt. Je nach klinischen Symptomen wurde eine Thoraxdrainage gelegt. Die Aufenthaltsdauer an der Klinik betrug im Mittel 5 (0-9) Tage. Die Kurzzeitüberlebensrate (Anteil der Pferde, welche die Klinik lebend verliessen) lag bei 38 %, die Langzeitüberlebensrate (Stand Juli 2016, 6 Monate bis 10 Jahre und 11 Monate nach Klinikaustritt) bei 75 %. Als Ursachen für den Hämothorax bei den überlebenden Patienten wurden idiopathische Ätiologie sowie Blutung nach einer Lungenbiopsie, starker Anstrengung oder Trauma vermutet. Die pathologischen Diagnosen der euthanasierten Pferde lauteten Lungenriss, Lungenblutung, multiple Lungenlazerationen aufgrund von Rippenfrakturen, mesenchymale Neoplasie und Zwerchfellhernie. Ein euthanasiertes Pferd wurde nicht seziert, hier lautete die Verdachtsdiagnose Blutung aufgrund einer Lungenverletzung.

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Assessment of method reliability and determination of reference intervals for rotational thromboelastometry in horses

Cited by 8 publications

References 54 publications

Comparison of Jugular vs. Saphenous Blood Samples, Intrarater and In-Between Device Reliability of Clinically Used ROTEM S Parameters in Dogs

Comparison of Jugular vs. Saphenous Blood Samples, Intrarater and In-Between Device Reliability of Clinically Used ROTEM S Parameters in Dogs

Establishment of normal reference intervals in dogs using a viscoelastic point‐of‐care coagulation monitor and its comparison with thromboelastography

Haemothorax in the horse: a retrospective study

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