A comparison between the TEG 6s and TEG 5000 analyzers to assess coagulation in trauma patients

Autor: Robert D. Winfield, Akpofure Peter Ekeh, Michael L. Foreman, Ernest E. Moore, Lucy Z. Kornblith, Mark Walsh, Lawrence Lottenberg, David Milia, Matthew D. Neal, Jan Hartmann, Hardean E. Achneck, Susan L. Evans, Noelle Saillant, Michael D. Goodman, Scott Thomas, Rachael A. Callcut, Carl R. Freeman, Adam J. Singer, Martin A Schreiber
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Adult
Male
Adolescent
Point-of-Care Systems
Clinical Sciences
and over
Nursing
Cardiorespiratory Medicine and Haematology
Critical Care and Intensive Care Medicine
03 medical and health sciences
Young Adult
0302 clinical medicine
Clinical Research
Thromboelastography
medicine
80 and over
Trauma team
Humans
Aged
Aged
80 and over
Severe injury
medicine.diagnostic_test
business.industry
030208 emergency & critical care medicine
Original Articles
TEG 5000
TEG 6s
Blood Coagulation Disorders
Middle Aged
trauma-induced coagulopathy
Emergency & Critical Care Medicine
Thrombelastography
Clot lysis
Good Health and Well Being
Method comparison
ComputingMethodologies_DOCUMENTANDTEXTPROCESSING
Wounds and Injuries
Surgery
Female
Level ii
viscoelastic testing
Linear correlation
Nuclear medicine
business
Maximum amplitude
Zdroj: The Journal of Trauma and Acute Care Surgery
The journal of trauma and acute care surgery, vol 88, iss 2
ISSN: 2163-0763
2163-0755
Popis: Supplemental digital content is available in the text.
BACKGROUND Trauma-induced coagulopathy is a major driver of mortality following severe injury. Viscoelastic goal-directed resuscitation can reduce mortality after injury. The TEG 5000 system is widely used for viscoelastic testing. However, the TEG 6s system incorporates newer technology, with encouraging results in cardiovascular interventions. The purpose of this study was to validate the TEG 6s system for use in trauma patients. METHODS Multicenter noninvasive observational study for method comparison conducted at 12 US Levels I and II trauma centers. Agreement between the TEG 6s and TEG 5000 systems was examined using citrated kaolin reaction time (CK.R), citrated functional fibrinogen maximum amplitude (CFF.MA), citrated kaolin percent clot lysis at 30 minutes (CK.LY30), citrated RapidTEG maximum amplitude (CRT.MA), and citrated kaolin maximum amplitude (CK.MA) parameters in adults meeting full or limited trauma team criteria. Blood was drawn ≤1 hour after admission. Assays were repeated in duplicate. Reliability (TEG 5000 vs. TEG 6s analyzers) and repeatability (interdevice comparison) was quantified. Linear regression was used to define the relationship between TEG 6s and TEG 5000 devices. RESULTS A total of 475 patients were enrolled. The cohort was predominantly male (68.6%) with a median age of 49 years. Regression line slope estimates (ß) and linear correlation estimates (p) were as follows: CK.R (ß = 1.05, ρ = 0.9), CFF.MA (ß = 0.99, ρ = 0.95), CK.LY30 (ß = 1.01, ρ = 0.91), CRT.MA (TEG 6s) versus CK.MA (TEG 5000) (ß = 1.06, ρ = 0.86) as well as versus CRT.MA (TEG 5000) (ß = 0.93, ρ = 0.93), indicating strong reliability between the devices. Overall, within-device repeatability was better for TEG 6s versus TEG 5000, particularly for CFF.MA and CK.LY30. CONCLUSION The TEG 6s device appears to be highly reliable for use in trauma patients, with close correlation to the TEG 5000 device and equivalent/improved within-device reliability. Given the potential advantages of using the TEG 6s device at the site of care, confirmation of agreement between the devices represents an important advance in diagnostic testing. LEVEL OF EVIDENCE Diagnostic test, level II.
Databáze: OpenAIRE
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