Comparison of arterial versus venous parameters of Rotational thromboelastometry and multiple platelet function analyzer: results of a pilot study.

Author(s): Oswald E, Finsterwalder T, Innerhofer N, Haas T, Mittermayr M, Strohmaier S, Innerhofer P

Publication: Scand J Clin Lab Invest, 2013, Vol. 73, Page 538-45

PubMed ID: 24007593 PubMed Review Paper? No

Purpose of Paper

Conclusion of Paper

Studies

1. Study Purpose

   The purpose of this study was to determine the effects of collection time with respect to surgery and using arterial versus venous blood on the results of ROTEM and Multiplate clotting and impedance aggregometry assays with specimens from patients undergoing orthopedic surgery. Arterial and venous blood specimens were obtained through arterial and central venous catheters, respectively, simultaneously in citrated tubes for ROTEM analysis and hirudin tubes for Multiplate analysis. ROTEM assays were performed at bedside within 10 minutes of specimen collection, while Multiplate assays were performed after blood was held at room temperature for 30 min per manufacturer's recommendation.

   Summary of Findings:

   While the authors did not present statistical significance, at the end of surgery (T2), hemoglobin, platelet counts, and fibrinogen levels were lower, and activated partial thromboplastin time (aPTT) was longer compared to preoperative measurements (T0). The authors state that arterial and venous measurements for all ROTEM and Multiplate assays correlated significantly at T0, T1, and T2. However, a few specific significant differences were noted between arterial and venous measurements at individual time points and between arterial measurements taken at different time points relative to surgery. Importantly, none of the differences between arterial and venous measurements were clinically significant, except the Multiplate TRAP assay results at T0 where significantly more pathological results were obtained with the venous blood specimen than the arterial specimen (p=0.0455).

   Biospecimens

   • Bodily Fluid - Blood

   Preservative Types

   • None (Fresh)

   Diagnoses:

   • Other diagnoses

   Platform:

   Analyte	Technology Platform
   Cell count/volume	Hematology/ auto analyzer
   Protein	Hematology/ auto analyzer
   Morphology	Hematology/ auto analyzer
   Glycoprotein	Hematology/ auto analyzer

   Pre-analytical Factors:

   Classification	Pre-analytical Factor	Value(s)
   Hematology/ auto analyzer Specific	Technology platform	ROTEM Multiplate
   Preaquisition	Diagnosis/ patient condition	Undergoing major elective orthopedic surgery
   Biospecimen Acquisition	Time of biospecimen collection	Pre-surgery (T0) Intraoperatively (T1) At the end of surgery (T2)
   Hematology/ auto analyzer Specific	Reaction solution	INTEM EXTEM FIBTEM ASPI ADP TRAP
   Biospecimen Acquisition	Anatomical location of blood draw	Artery Vein

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