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Comparison of Two Viscoelastic Testing Devices in a Parturient Population
Daniel Gruneberg1, Stefan Hofer2, Herbert Schöchl3
1Department of Anesthesiology, Medical Faculty Heidelberg, Heidelberg University, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany.
Journal of Clinical Medicine
|February 10, 2024
Summary
Viscoelastic hemostatic assays (VHAs) like ClotPro® and ROTEM® delta show significant variability in parturient women. Device-specific algorithms are crucial for accurate interpretation and effective hemostatic therapy.
Area of Science:
- Anesthesiology
- Obstetrics
- Hematology
Background:
- Viscoelastic hemostatic assays (VHAs) are vital for personalized hemostatic resuscitation.
- Assessing device interchangeability is crucial for reliable clinical application.
Purpose of the Study:
- To evaluate the interchangeability of ClotPro® and ROTEM® delta in parturient women.
- To compare VHA parameters with standard laboratory coagulation tests.
Main Methods:
- Analysis of 631 blood samples from 217 parturient women at three timepoints.
- Comparison of clotting times and clot firmness (A5, A10, MCF) using extrinsic, intrinsic, and fibrin polymerization assays.
- Regression and Bland-Altman plots for device comparison; ROC analysis for cutoff determination.
Main Results:
- Significant differences observed in clotting times between ClotPro® and ROTEM® delta.
- Clot firmness parameters (extrinsic, intrinsic) showed interchangeability.
- ClotPro® yielded higher fibrinogen values; VHA parameters had high predictive value but low specificity for coagulopathy.
Conclusions:
- ROTEM® and ClotPro® parameters exhibit significant variability in the obstetric setting.
- Device- and indication-specific transfusion algorithms are essential for accurate interpretation.
- Tailored algorithms ensure adequate hemostatic therapy in parturient women.
