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Comparison of fibrin-based clot elasticity parameters measured by free oscillation rheometry (ReoRox (R)) versus thromboelastometry (ROTEM (R))

Solomon, Cristina; Schoechl, Herbert; Ranucci, Marco; Schött, Ulf LU and Schlimp, Christoph J. (2015) In Scandinavian Journal of Clinical & Laboratory Investigation 75(3). p.239-246
Abstract
Background. Whole blood viscoelastic tests such as the fibrin-based thromboelastometry (ROTEM (R)) test FIBTEM are increasingly used in the perioperative setting to quickly identify deficits in fibrin quality, and to guide hemostatic therapy. The recently developed FibScreen2 test of the ReoRox (R) method, based on free oscillation rheometry, also provides an evaluation of fibrin clot quality. To date, little information is available on the performance of this test in hemodiluted blood, by comparison to FIBTEM. Methods. Whole blood samples from eight healthy volunteers were analyzed using FIBTEM and Fibscreen2. Native and diluted (to 33% and 50% using saline, gelatin or hydroxyethyl starch [HES]) samples were analyzed. Clot strength... (More)
Background. Whole blood viscoelastic tests such as the fibrin-based thromboelastometry (ROTEM (R)) test FIBTEM are increasingly used in the perioperative setting to quickly identify deficits in fibrin quality, and to guide hemostatic therapy. The recently developed FibScreen2 test of the ReoRox (R) method, based on free oscillation rheometry, also provides an evaluation of fibrin clot quality. To date, little information is available on the performance of this test in hemodiluted blood, by comparison to FIBTEM. Methods. Whole blood samples from eight healthy volunteers were analyzed using FIBTEM and Fibscreen2. Native and diluted (to 33% and 50% using saline, gelatin or hydroxyethyl starch [HES]) samples were analyzed. Clot strength parameters, including FIBTEM maximum clot firmness (MCF), FIBTEM maximum clot elasticity (MCE) and Fibscreen2 maximum elasticity (G'max), were measured. Results. In repeatedly measured samples from two volunteers, FIBTEM MCF and Fibscreen2 G'max revealed a coefficient of variation (CV) of 5.3 vs. 16.3% and 5.6 vs. 31.7% for each volunteer, respectively. Hemodilution decreased clot strength. Both Fibscreen2 G'max and FIBTEM parameters decreased proportionally to the dilution ratio when saline was used. The observed reductions in FIBTEM and Fibscreen2 parameters were more severe in samples diluted with gelatin and HES, compared to saline. Finally, a regression analysis between FIBTEM MCE and Fibscreen2 G'max revealed a poor goodness of fit (r(2) = 0.37, p < 0.0001). Conclusions. ReoRox (R) Fibscreen2 test has a high coefficient of variation, and its application in various hemodilution conditions showed limited comparability with the ROTEM (R) FIBTEM test. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Blood coagulation, blood coagulation tests, blood viscosity, fibrin, fibrinogen, point-of-care systems
in
Scandinavian Journal of Clinical & Laboratory Investigation
volume
75
issue
3
pages
239 - 246
publisher
Informa Healthcare
external identifiers
  • wos:000350543800006
  • scopus:84929304408
ISSN
1502-7686
DOI
10.3109/00365513.2014.993698
language
English
LU publication?
yes
id
8aa60bf0-feff-451f-aba6-7853656dec8c (old id 5300354)
date added to LUP
2015-05-04 08:35:34
date last changed
2017-11-19 03:48:23
@article{8aa60bf0-feff-451f-aba6-7853656dec8c,
  abstract     = {Background. Whole blood viscoelastic tests such as the fibrin-based thromboelastometry (ROTEM (R)) test FIBTEM are increasingly used in the perioperative setting to quickly identify deficits in fibrin quality, and to guide hemostatic therapy. The recently developed FibScreen2 test of the ReoRox (R) method, based on free oscillation rheometry, also provides an evaluation of fibrin clot quality. To date, little information is available on the performance of this test in hemodiluted blood, by comparison to FIBTEM. Methods. Whole blood samples from eight healthy volunteers were analyzed using FIBTEM and Fibscreen2. Native and diluted (to 33% and 50% using saline, gelatin or hydroxyethyl starch [HES]) samples were analyzed. Clot strength parameters, including FIBTEM maximum clot firmness (MCF), FIBTEM maximum clot elasticity (MCE) and Fibscreen2 maximum elasticity (G'max), were measured. Results. In repeatedly measured samples from two volunteers, FIBTEM MCF and Fibscreen2 G'max revealed a coefficient of variation (CV) of 5.3 vs. 16.3% and 5.6 vs. 31.7% for each volunteer, respectively. Hemodilution decreased clot strength. Both Fibscreen2 G'max and FIBTEM parameters decreased proportionally to the dilution ratio when saline was used. The observed reductions in FIBTEM and Fibscreen2 parameters were more severe in samples diluted with gelatin and HES, compared to saline. Finally, a regression analysis between FIBTEM MCE and Fibscreen2 G'max revealed a poor goodness of fit (r(2) = 0.37, p &lt; 0.0001). Conclusions. ReoRox (R) Fibscreen2 test has a high coefficient of variation, and its application in various hemodilution conditions showed limited comparability with the ROTEM (R) FIBTEM test.},
  author       = {Solomon, Cristina and Schoechl, Herbert and Ranucci, Marco and Schött, Ulf and Schlimp, Christoph J.},
  issn         = {1502-7686},
  keyword      = {Blood coagulation,blood coagulation tests,blood viscosity,fibrin,fibrinogen,point-of-care systems},
  language     = {eng},
  number       = {3},
  pages        = {239--246},
  publisher    = {Informa Healthcare},
  series       = {Scandinavian Journal of Clinical & Laboratory Investigation},
  title        = {Comparison of fibrin-based clot elasticity parameters measured by free oscillation rheometry (ReoRox (R)) versus thromboelastometry (ROTEM (R))},
  url          = {http://dx.doi.org/10.3109/00365513.2014.993698},
  volume       = {75},
  year         = {2015},
}