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SARS-CoV-2 Pandemic
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| Name | Class |
|---|---|
| HemoSonics LLC | INDUSTRY |
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The aim of this study is to develop a coagulation algorithm based on Quantra POCT for the treatment of coagulopathic cardiac surgery patients.
In order to perform a targeted coagulation therapy during intra- and postoperative care of cardiosurgical patients, it is necessary to know the hemostatic potential. After blood samples have been taken for coagulation diagnosis, they are usually sent to the central laboratory. After analysis and validation, the results are transmitted electronically. The loss of time due to sample transport, analysis and provision of the results prolongs the time required to derive therapeutic measures.
In recent years, point of care testing (POCT) devices for the diagnosis of coagulopathic patients have become increasingly important. In our clinic, POCT devices have been routinely used for intra- and postoperative targeted coagulation therapy for years. These include the ROTEM delta and Multiplate. For analysis, a whole blood sample is pipetted together with test reagents. Depending on the selected reagent, different parts of the coagulation cascade can be evaluated and, depending on this, an appropriate therapy can be derived. A coagulation algorithm developed in our clinic is based on these measurement results and has been used successfully for years for perioperative coagulation management. This algorithm requires additional information on the platelet function, which is also carried out as standard on the bed side using multi-plate analysis as POCT.
A new system for whole blood analysis has recently become available on the market. The Quantra from HemoSonics also allows the analysis of a whole blood sample on the bed side. Due to the cassette structure, the time-consuming and potentially error-prone pipetting of a whole blood sample is no longer necessary. The aim of this study is to develop a coagulation algorithm based on Quantra POCT for the treatment of coagulopathic cardiac surgery patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Quantra | Experimental | Evaluation of bloodsamples using the Quantra and Multiplate device |
|
| Control | Active Comparator | Evaluation of bloodsamples using the ROTEM and Multiplate device |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Quantra-Algorithm | Other | Hemotherapy based on Quantra-Algorithm |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Bloodloss | Cumulative bloodloss directly after surgery for 24h Determined by cumulative volume of all drains in millilitres | From finishing operation until 24 hours postoperative |
| Measure | Description | Time Frame |
|---|---|---|
| Correlations of parameters between POCT and laboratory parameters. | Quick | During operation within 24 hours postoperative |
| Correlations of parameters between POCT and laboratory parameters. | prothrombine time |
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Inclusion Criteria:
>18 years elective operation with cardiac bypass
Exclusion Criteria:
participation on another study
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| Name | Affiliation | Role |
|---|---|---|
| Florian J Raimann, Dr. med. | Goethe University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospital Frankfurt | Frankfurt am Main | Hesse | 60590 | Germany |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23793973 | Result | Weber CF, Zacharowski K, Brun K, Volk T, Martin EO, Hofer S, Kreuer S. [Basic algorithm for Point-of-Care based hemotherapy: perioperative treatment of coagulopathic patients]. Anaesthesist. 2013 Jun;62(6):464-72. doi: 10.1007/s00101-013-2184-8. German. | |
| 27224934 | Result | Ferrante EA, Blasier KR, Givens TB, Lloyd CA, Fischer TJ, Viola F. A Novel Device for the Evaluation of Hemostatic Function in Critical Care Settings. Anesth Analg. 2016 Dec;123(6):1372-1379. doi: 10.1213/ANE.0000000000001413. |
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| ID | Term |
|---|---|
| D006470 | Hemorrhage |
| ID | Term |
|---|---|
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ROTEM-Algorithm |
| Other |
Hemotherapy based on Basic-Algorithm |
|
| During operation within 24 hours postoperative |
| Correlations of parameters between POCT and laboratory parameters. | activated partial thromboplastin time | During operation within 24 hours postoperative |
| Correlations of parameters between POCT and laboratory parameters. | Firbinogen | During operation within 24 hours postoperative |
| Correlations of parameters between POCT and laboratory parameters. | platelet count | During operation within 24h postoperative |
| Multiplate results | Determin platelet function with TRAP test | During operation within 24 hours postoperative |
| Multiplate results | Determin platelet function with ASPI test | During operation within 24 hours postoperative |
| Multiplate results | Determin platelet function with ADP test | During operation within 24 hours postoperative |
| Time saving by using a cassette | Influence of a cassette structure in comparison to pipetting with regard to the temporal availability of the measurement results | During operation within 24 hours postoperative |
| Use of blood products | Cumulative volume of administered fresh frozen plasma, platelet infusion and packed red blood cells in mililitres | During operation within 24 hours postoperative |
| Coagulationfactos and procoagulant drugs | Cumulative usage of prothrombin complexe concentrate measured in international units, fibrinogen measured in gramm, tranexamic acid measured in gramm, desmopressin measured in microgramm, Calcium measured in gramm, activated factor VII measured in international units | During operation within 24 hours postoperative |
| Thromboembolic complications | Thromboembolic complications | During operation within 24h postoperative |
| Comorbidities | Comorbidities | 15 years before operation |
| 26688324 | Result | Viola F, Lin-Schmidt X, Bhamidipati C, Haverstick DM, Walker WF, Ailawadi G, Lawrence MB. Sonorheometry assessment of platelet function in cardiopulmonary bypass patients: Correlation of blood clot stiffness with platelet integrin alphaIIbbeta3 activity, aspirin usage, and transfusion risk. Thromb Res. 2016 Feb;138:96-102. doi: 10.1016/j.thromres.2015.11.036. Epub 2015 Nov 26. |
| 27749339 | Result | Huffmyer JL, Fernandez LG, Haghighian C, Terkawi AS, Groves DS. Comparison of SEER Sonorheometry With Rotational Thromboelastometry and Laboratory Parameters in Cardiac Surgery. Anesth Analg. 2016 Dec;123(6):1390-1399. doi: 10.1213/ANE.0000000000001507. |
| 27159065 | Result | Reynolds PS, Middleton P, McCarthy H, Spiess BD. A Comparison of a New Ultrasound-Based Whole Blood Viscoelastic Test (SEER Sonorheometry) Versus Thromboelastography in Cardiac Surgery. Anesth Analg. 2016 Dec;123(6):1400-1407. doi: 10.1213/ANE.0000000000001362. |
| 32314972 | Derived | Michel S, Piekarski F, Fischer JH, Hettler V, Adam EH, Holzer L, Lotz G, Walther T, Zacharowski K, Raimann FJ. Hemostatis Analyzer-Supported Hemotherapy Algorithm in Cardiac Surgery: Protocol for a Randomized Controlled Monocentric Trial. JMIR Res Protoc. 2020 Apr 21;9(4):e17206. doi: 10.2196/17206. |