在冷藏全血中,依赖时间的凝血下降:旋转血栓显微镜和SEER声声计的配对体外比较
Edward Michelson1, Bradford Ray2, Susan H Watts1
1Department of Emergency Medicine, Texas Tech University Health Sciences Center.
概括
储存的全血 (WB) 在储存几天内显示出早期的静血恶化,特别是血小板功能. 旋转血栓弹性测量 (ROTEM) 和通过共振 (SEER) 声波测量 (Quantra) 声波弹性估计平台都检测到这些变化.
科学领域:
- 输血医学 输血医学
- 血液静止和血栓形成
- 生物材料科学 生物材料科学
背景情况:
- 保持储存全血 (WB) 中的静血潜力对于输血疗效至关重要.
- 有限的比较数据存在于粘性弹性和声波测量平台上,用于评估WB存储变化.
- 这项研究调查了储存期间WB凝固动态的时间依赖性变化.
研究的目的:
- 为了比较旋转血栓弹性测量 (ROTEM) 和通过共振 (SEER) 的声波弹性估计 (Quantra) 在评估存储的WB时.
- 评估WB存储期间凝血动态和静血功能在时间上的依赖性变化.
- 在存储的WB中识别出血静性恶化的早期指标.
主要方法:
- 来自8名健康捐献者的全血被储存在1-6°C的酸盐-酸盐-乳糖中.
- 样品在0,1,3,7,14和21日使用ROTEM和Quantra进行分析.
- 评估的关键参数包括凝血时间,振幅,凝血刚度以及血小板和纤维素原的贡献.
主要成果:
- 在两种平台上都观察到凝血时间的逐渐延长和凝血硬度的减少,最早从1-3天开始.
- 血小板对凝块硬度 (PCS) 的贡献显著下降,而纤维素素贡献 (FCS) 显示了适度的减少.
- ROTEM和Quantra显示出与一致偏差有很强的相关性,表明两种方法之间存在一致性.
结论:
- 储存的WB表现出稳定,依赖时间的静血性恶化,特别是在血小板功能和凝块启动方面.
- 在实验室中观察到血小板驱动的血块硬度的早期下降.
- 这些发现为进一步的实验室和临床评估储存血液质量提供了假设.
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