Reference intervals for thromboelastometry with the ROTEM® delta in cats

Döderlein, Elisabeth; Mischke, R.

doi:10.1016/j.rvsc.2015.03.005

Cited by 7 publications

(5 citation statements)

References 31 publications

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“…Parameter wise, we identified considerably higher variability and lower correlation for CT, CFT and ML compared to alpha angle, MCF, MCE and G. This is consistent with the findings of previous studies [ 7 , 29 ] but in contrast to other studies that report low variability <15% or good correlation in dogs [ 8 ] and cats [ 11 , 32 ]. The early phase of clot initiation reflected by CT is known to be mainly dependent on the activator and most sensitive to small differences regarding sample handling and choice of activator, which would explain the higher intrarater variability of CT and CFT.…”

Section: Discussionsupporting

confidence: 91%

“…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: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

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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“…However, reference intervals established in the present assay were based on a smaller population, and the robust method was used instead of a percentile method. Intra-assay coefficients of variation, evaluated from quadruplicate measurements, were found to be below 10 % for CT, CFT, alpha, and MCF in a previous study [ 26 ]. In another study, intra-assay CV was below 5 % in kaolin-activated thromboelastography in 30 healthy cats [ 24 ].…”

Section: Discussionmentioning

confidence: 91%

“…Recently, feline reference intervals for ROTEM using ex-tem and in-tem assays, based on 55 clinically healthy European shorthair cats, were published [ 26 ]. Reference ranges established in the present study were similar although a narrower interval was found for some of the parameters.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the effects of tetrastarch solutions on canine whole blood coagulation have been evaluated [ 15 , 18 , 20 ]. In cats, rare studies have been performed evaluating whole blood coagulation using thromboelastography [ 21 – 25 ] and recently, one study, assessing reference intervals in healthy cats using ROTEM was published [ 26 ]. To the authors’ knowledge, the effects of isotonic crystalloids or HES on feline whole blood coagulation using ROTEM have not been previously evaluated.…”

Section: Introductionmentioning

confidence: 99%

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In vitro effects of 6 % hydroxyethyl starch 130/0.42 solution on feline whole blood coagulation measured by rotational thromboelastometry

Albrecht¹,

Howard

Kovačević

et al. 2016

BMC Vet Res

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BackgroundThe artificial colloid, hydroxyethyl starch (HES), is recommended for intravascular volume expansion and colloid-osmotic pressure enhancement in dogs and cats. A well-known side effect of HES solutions in humans and dogs is coagulopathy. However, HES-associated coagulopathy has thus far not been investigated in cats. The goal of this study was to assess the in vitro effects of 6 % HES 130/0.42 on feline whole blood samples using rotational thromboelastometry (ROTEM). A further goal was to develop feline reference intervals for ROTEM at our institution. In this in vitro experimental study, blood samples of 24 adult healthy cats were collected by atraumatic jugular phlebotomy following intramuscular sedation. Baseline ROTEM analyses (using ex-tem, in-tem and fib-tem assays) were performed in duplicate. Additionally, ROTEM analyses were performed on blood samples after dilution with either Ringer’s acetate (RA) or 6 % HES 130/0.42 (HES) in a 1:6 dilution (i.e. 1 part solution and 6 parts blood).ResultsCoefficients of variation of duplicate measures were below 12 % in all ex-tem assays, 3 of 4 in-tem assays but only 1 of 3 fib-tem assays. Reference intervals were similar albeit somewhat narrower than those previously published. Dilution with both solutions lead to significantly prolonged CT (in-tem), CFT (ex-tem and in-tem), and reduced MCF (ex-tem, in-tem, and fib-tem) and alpha (ex-tem and in-tem). Compared to RA, dilution with HES caused a significant prolongation of CT in fib-tem (P = 0.016), CFT in ex-tem (P = 0.017) and in-tem (P = 0.019), as well as a reduction in MCF in in-tem (P = 0.032) and fib-tem (P = 0.020), and alpha in ex-tem (P = 0.014). However, only a single parameter (CFT in ex-tem) was outside of the established reference interval after dilution with HES.ConclusionsIn vitro hemodilution of feline blood with RA and HES causes a small but significant impairment of whole blood coagulation, with HES leading to a significantly greater effect on coagulation than RA. Further studies are necessary to evaluate the in vivo effects and the clinical significance of these findings.

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Correlation of rotational thromboelastometry (ROTEM) parameters with platelet count and their ability to predict thrombocytopenia in dogs

Turner

Kutter

Sigrist

2019

Research in Veterinary Science

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Reference intervals for thromboelastometry with the ROTEM® delta in cats

Cited by 7 publications

References 31 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

In vitro effects of 6 % hydroxyethyl starch 130/0.42 solution on feline whole blood coagulation measured by rotational thromboelastometry

Correlation of rotational thromboelastometry (ROTEM) parameters with platelet count and their ability to predict thrombocytopenia in dogs

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