Establishment of normal reference intervals in dogs using a viscoelastic point‐of‐care coagulation monitor and its comparison with thromboelastography

Buriko, Yekaterina; Drobatz, Kenneth J.; Silverstein, Deborah C.

doi:10.1111/vcp.12926

Cited by 28 publications

(78 citation statements)

References 24 publications

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“…At standard assay temperature of 37°C and using institutionally derived RIs, 2 12 patients had prolonged R time with none having shortened R; 6 had an increased K time with none having shortened K; 7 had a decreased alpha angle and none had an increased alpha angle; 2 had a low MA with 20 having increased MA. Comparisons between analyses at the 2 temperatures showed very high correlation for R and MA values, high correlation for alpha and K values, and moderate correlation for LY30 and LY60, with significance documented for all variables (Table 2; Figs.…”

Section: Resultsmentioning

confidence: 99%

The effect of analytical temperature on thromboelastography tracings in dogs

2021

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Viscoelastic testing methods such as thromboelastography (TEG) are becoming increasingly available to veterinarians in a clinical setting. TEG is useful in determining therapeutic transfusion needs and assessing global abnormalities of hemostasis of patients, given that it provides a more comprehensive assessment of coagulation than traditional tests. TEG is standardly performed at 37°C, which is considered a normal body temperature for human patients; however, 37°C is lower than normal body temperature for most canine patients. In an in vitro study, we investigated the potential effect that this difference in body temperature and test temperature might have on TEG results. Citrated blood samples were collected from clinically normal, as well as sick, dogs with various body temperatures. Samples were analyzed concurrently at the patient’s body temperature and at 37°C. There was very high correlation between TEG performed at body temperature and at 37°C for R (min) and MA (mm), high correlation for K (min) and alpha angle (deg), and moderate correlation for LY30 (%) and LY60 (%). For canine patients with normal to mildly abnormal body temperatures, performance of TEG at the standard 37°C is acceptable.

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Section: Resultsmentioning

confidence: 99%

The effect of analytical temperature on thromboelastography tracings in dogs

2021

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“…It is known that viscoelastic tests run on NWB and without activators are subject to more variabilities than their treated and activated counterparts. Such variabilities may include contact activation, operator-dependent factors, and other preanalytical factors ( 6 , 10 ). These variabilities may explain the differences in CT and MCF between NWB and CWB samples.…”

Section: Discussionmentioning

confidence: 99%

“…Another explanation for the present study's low within-sample variation is its use of only four analyzers, whereas the manufacturer used eight analyzers to generate their data. Previous studies involving humans and equids have shown that variability may exist between different operators conducting viscoelastic tests, thus reducing the number of operators may help to reduce within sample variation ( 5 , 6 , 17 ). Inter-operator variability has been studied using both TEG and rotational thromboelastometry, though inter-operator variability is currently not known for the VCM Vet device; however, a proposed advantage of the utilized cartridge-based viscoelastic testing system is that the cartridge system could reduce inter-operator variability.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, a new portable bedside viscoelastic coagulation monitor (VCM Vet™, Entegrion, Durham, NC) has been validated for use in veterinary species ( 6 , 7 ). This device provides a user-friendly, cartridge-based method to perform viscoelastic testing, which can significantly reduce the points of error that are typically associated with viscoelastic testing.…”

Section: Introductionmentioning

confidence: 99%

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Use of Citrated Whole Blood for Point-of-Care Viscoelastic Coagulation Testing in Dogs

2022

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BackgroundA new, portable bedside coagulation monitor (VCM Vet) has provided a user-friendly, cartridge-based method to perform viscoelastic testing. However, the use of native whole blood limits the time to analyze the sample to minutes. The objective of this study is to assess whether citrated whole blood can be utilized with the cartridge-based system and whether the results are comparable to those of native whole blood. A secondary objective is to assess the viability of citrated whole blood results after up to 4 hours of resting.MethodsThe study population consisted of 10 healthy mixed breed dogs. Whole blood samples were collected via jugular venipuncture. Blood was immediately transferred to the VCM test cartridge for native whole blood control group analysis per the manufacturer's instructions, and the remainder was used to fill two 3.2% sodium citrate vacutainer tubes. Test group analysis was performed on samples from each tube concurrently after a rest period of 30 min (baseline), 2 h, and 4 h. Citrated whole blood samples were recalcified for analysis immediately prior to introduction into the test cartridge. Data was recorded for all reported parameters. Results from the citrate groups were compared to the control group and to the citrated baseline to assess for differences. Overall results were compared using mixed ANOVA models. Where found, specific differences were evaluated using Tukey's test. Within-sample variation was investigated and reported as median (range). A p < 0.05 was considered significant.ResultsSamples were obtained for a total of 10 control runs and 20 citrated whole blood runs. Comparison of controls to the citrated test groups revealed significant differences in CT (p < 0.001) and MCF (p < 0.002). There were no significant differences between test groups compared to citrated baselines for any parameter. Selected median coefficients of variation were 6.8% (0–68.8%) for CT, 2.4% (0–19.46%) for alpha angle, 3.2% (0–27.4%) for MCF, and 0% (0–16.3%) for 45-min LY45.ConclusionCitrated whole blood samples can be used with the VCM Vet device; however, new reference intervals for use with citrated whole blood will be required. Results using citrated whole blood samples are not significantly different from baseline after up to 4 h of resting.

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“…To our knowledge, this study is the first to demonstrate use of VCM Vet TM to analyze blood coagulation properties in mice. To date, other investigators have published studies using VCM Vet TM to analyze blood from cats [7, 8], dogs [14], and bats [10]. In this study, we determined VCM Vet TM RIs for healthy mature adult C57BL/6N mice and reference value ranges needed for blood coagulation testing in experimental and preclinical studies with mice.…”

Section: Discussionmentioning

confidence: 99%

Viscoelastic Coagulation Monitor (VCMVet) Reference Intervals and Sex Differences in Mature Adult Mice

et al. 2021

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Introduction: Viscoelastic coagulation tests are useful to assess coagulation status in the clinical setting and to aid in understanding underlying pathophysiological mechanisms that affect coagulation status. Such tests also are useful for coagulation research. Because mouse models are widely used to study molecular mechanisms in fine detail, a simple viscoelastic coagulation test requiring small blood volumes would be convenient for such studies in mice. Methods: We tested viscoelastic coagulation properties of normal healthy adult mice using a novel veterinary clinical point-of-care device, Viscoelastic Coagulation Monitor (VCM Vet™; Entegrion Corp.). Fresh whole blood was collected from 63 healthy mature adult C57 black 6N mice, with ultimately 54 mice, equal numbers of male and females, used to determine reference intervals (RIs) for VCM test parameters. Results: RIs were determined for equal numbers of male and female mice: clot time: 43.0–353.0 s; clot formation time: 49.4–137.6 s; alpha angle: 54.4–62.2°; A10: 25.0–49.6 VCM units; A20: 31.0–56.5 VCM units; maximum clot firmness: 37.6–62.8 VCM units; Lysis Index 30 (Li30): 99.8–100.0%; and Li45: 99.7–100.0%. Significant differences were found between male and female subgroups, where females had higher mean A10 and A20 and median MCF values, indicating greater clot firmness in female versus male mice. Conclusion: VCM Vet is a feasible viscoelastic coagulation test device for studies with mature adult mice, including studying inherent sex differences in coagulation parameters. Inherent differences in coagulability of male and female mice warrant further investigation to determine if such differences underlie greater coagulopathic, hemorrhagic, or thromboembolic risk during trauma or other pathophysiologic conditions.

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Establishment of normal reference intervals in dogs using a viscoelastic point‐of‐care coagulation monitor and its comparison with thromboelastography

Cited by 28 publications

References 24 publications

The effect of analytical temperature on thromboelastography tracings in dogs

The effect of analytical temperature on thromboelastography tracings in dogs

Use of Citrated Whole Blood for Point-of-Care Viscoelastic Coagulation Testing in Dogs

Viscoelastic Coagulation Monitor (VCM<sup>Vet</sup>) Reference Intervals and Sex Differences in Mature Adult Mice

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