Preoperative Point-of-Care Platelet Function Testing in Cardiac Surgery

Agarwal, Seema; Johnson, Robert; Shaw, Matthew

doi:10.1053/j.jvca.2014.06.025

Cited by 48 publications

(61 citation statements)

References 18 publications

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“…Four studies were excluded because of insufficient data to judge the study design. [27][28][29][30] One trial 31 used viscoelastic testing algorithms in the control group, and one 32 randomized abdominal aortic aneurysm surgeries. Two trials (NCT00772239; NCT01218074) were published only as protocols without any data available.…”

Section: Excluded Studiesmentioning

confidence: 99%

Routine use of viscoelastic blood tests for diagnosis and treatment of coagulopathic bleeding in cardiac surgery: updated systematic review and meta-analysis

Serraino

Murphy

2017

British Journal of Anaesthesia

148

122

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Viscoelastic point-of-care tests are commonly used to provide prompt diagnosis of coagulopathy and allow targeted treatments in bleeding patients. We updated existing meta-analyses that have evaluated the clinical effectiveness of viscoelastic point-of-care tests vs the current standard of care for the management of cardiac surgery patients at risk of coagulopathic bleeding. Randomized controlled trials comparing viscoelastic point-of-care diagnostic testing with standard care in cardiac surgery patients were sought. All-cause mortality, blood loss, reoperation, blood transfusion, major morbidity, and intensive care unit and hospital length of stay were analysed using random-effects modelling. Fifteen trials that randomized a total of 8737 participants were included for the analysis. None of the trials was classified as low risk of bias. The use of thromboelastography-(TEG V R ) or thromboelastometry (ROTEM V R )-guided algorithms did not reduce mortality [risk ratio (RR) 0.55, 95% confidence interval (CI) 0.28-1.10] without heterogeneity (I

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Section: Excluded Studiesmentioning

confidence: 99%

Routine use of viscoelastic blood tests for diagnosis and treatment of coagulopathic bleeding in cardiac surgery: updated systematic review and meta-analysis

Serraino

Murphy

2017

British Journal of Anaesthesia

148

122

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“…Unlike standard kaolin TEG analyses, the absence of thrombin provides sensitivity to common antiplatelet agents, such as aspirin and clopidogrel, or to acquired platelet inhibition. 2,22 The ADP and AA clot-strength measurements are compared with those from the kaolin and ActF to ascertain the response to each agonist.…”

Section: Teg Analysismentioning

confidence: 99%

“…2,3 There is, consequently, an opportunity to achieve substantial cost savings with a goal-directed TEG program with improved patient outcomes. These outcomes have prompted several organizations to recommend the clinical use of viscoelastic hemostatic testing devices, such as TEG, in various clinical areas.…”

mentioning

confidence: 99%

New-Generation Thromboelastography: Comprehensive Evaluation of Citrated and Heparinized Blood Sample Storage Effect on Clot-Forming Variables

Dias¹,

Haney²,

Mathew³

et al. 2017

Archives of Pathology &Amp; Laboratory Medicine

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Context.-Thromboelastography (TEG) is a whole blood, real-time analyzer measuring the viscoelastic properties of the hemostasis process and allowing for individualized goal-directed therapy. However, routine use of TEG requires validation of sample storage effect on clot parameters.Objectives.-To establish the minimum time required for equilibration time and the maximum time for sample storage for all commercially available TEG tests for the new-generation TEG 6s and to determine how those times compare with the older generation TEG 5000.Design.-Citrated and heparinized whole blood samples obtained from 20 healthy donors were analyzed for clot parameters at multiple time points for both the TEG 6s and the TEG 5000. Samples were activated with the citrated multichannel cartridge or the platelet-mapping cartridge in the TEG 6s or with recalcified kaolin in the TEG 5000.Results.-All blood samples yielded TEG parameter results within reference ranges and had a tendency toward hypercoagulable profiles with increased storage time. Sample storage resulted in increased platelet inhibition with significant differences at 4 hours in the plateletmapping cartridge (arachidonic acid percentage of inhibition, P ¼ .002; adenosine diphosphate percentage of inhibition, P ¼ .02).Conclusions.-For nonemergent cases or in a central laboratory setting, all tests provided reliable results for up to 4 hours in the citrated multichannel cartridge and for 3 hours for platelet function information in the plateletmapping cartridge. In emergent/urgent situations in which the sample needs to be run immediately, RapidTEG and functional fibrinogen tests may be preferred.

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“…This includes activated clotting time (Bittl, 2005), thrombelastography, rotational thromboelastometry (Mallett and Cox, 1992, Saner, 2014, Thölking et al, 2015), and platelet function (Agarwal et al, 2015, Petricevic et al, 2015). Many of the in vitro diagnostic tests attempt to extract information on certain pathways of the clotting cascade, primarily extrinsic and intrinsic pathways.…”

Section: Operating Roommentioning

confidence: 99%

Point-of-care diagnostics for niche applications

Cummins

Ligler

Walker

2016

Biotechnology Advances

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Point-of-care or point-of-use diagnostics are analytical devices that provide clinically relevant information without the need for a core clinical laboratory. In this review we define point-of-care diagnostics as portable versions of assays performed in a traditional clinical chemistry laboratory. This review discusses five areas relevant to human and animal health where increased attention could produce significant impact: veterinary medicine, space travel, sports medicine, emergency medicine, and operating room efficiency. For each of these areas, clinical need, available commercial products, and ongoing research into new devices are highlighted.

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Preoperative Point-of-Care Platelet Function Testing in Cardiac Surgery

Cited by 48 publications

References 18 publications

Routine use of viscoelastic blood tests for diagnosis and treatment of coagulopathic bleeding in cardiac surgery: updated systematic review and meta-analysis

Routine use of viscoelastic blood tests for diagnosis and treatment of coagulopathic bleeding in cardiac surgery: updated systematic review and meta-analysis

New-Generation Thromboelastography: Comprehensive Evaluation of Citrated and Heparinized Blood Sample Storage Effect on Clot-Forming Variables

Point-of-care diagnostics for niche applications

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