Sonoclot coagulation analysis

Abstract

Disseminated intravascular coagulation (DIC) contributes to high mortality. The study was performed to investigate Sonoclot as a potential predictor of 30-day survival in overt DIC. This cohort included 237 consecutive critically ill patients with overt DIC, admitted to a 15-bed multidisciplinary ICU between July 2010 and July 2013. Hemostasis was analyzed with Sonoclot, including activated clotting time (ACT), clot rate, and platelet function, as well as routine clotting test at admission to the critical care center. Sonoclot variables differed in survivors and nonsurvivors. Mean ACT was prolonged (289.9 ± 200.5 vs. 194.8 ± 126.6 s; P < 0.001) and platelet function (1.2 ± 0.9 vs. 1.6 ± 1.2; P = 0.010) was reduced in nonsurvivors. The clot rate was not different. Cox proportional-hazard model showed that ACT and platelet function correlated independently with survival (P < 0.05). Kaplan-Meier survival curve analysis suggested that patients with one pathological Sonoclot findings have better outcome (P < 0.05). After ACT and platelet function were introduced, the receiver-operating characteristic area under the curve of model achieved 0.876 (P < 0.05), with a specificity of 82.6% and a sensitivity of 80.5% in prediction of 30-day survival by multivariate analyses. Our data suggest that the Sonoclot can predict mortality in critically ill patients with overt DIC.

Multifunctional Cationic Hyperbranched Polyaminoglycosides that Target Multiple Mediators for Severe Abdominal Trauma Management

“…Furthermore, a Sonoclot assay was applied to comprehensively evaluate the whole process of blood coagulation, activated clotting time (ACT), and clot rate (CR). [ 30 ] ACT is the time a blood sample remains as a liquid until the beginning of fibrin formation. [ 30 ] When the small aggregates of fibrinogen are converted to large fibrin aggregates, the blood viscosity changes, and the clotting signal is gradually strengthened as the gel develops.…”

“…[ 30 ] ACT is the time a blood sample remains as a liquid until the beginning of fibrin formation. [ 30 ] When the small aggregates of fibrinogen are converted to large fibrin aggregates, the blood viscosity changes, and the clotting signal is gradually strengthened as the gel develops. [ 30 ] CR is the maximum slope of the Sonoclot Signature, which presents the coagulation conversion rate of fibrinogen to fibrin per unit of time.…”

“…[ 30 ] When the small aggregates of fibrinogen are converted to large fibrin aggregates, the blood viscosity changes, and the clotting signal is gradually strengthened as the gel develops. [ 30 ] CR is the maximum slope of the Sonoclot Signature, which presents the coagulation conversion rate of fibrinogen to fibrin per unit of time. [ 30 ] The results showed that DAMPs reduced the ACT of normal human whole blood from healthy volunteers from 105.3 ± 10.2 s to 24.3 ± 5.5 s and increased the CR from 23.0 ± 3.6 to 53.0 ± 13.8 sig min −1 , suggesting that DAMPs could effectively activate clotting (Figure 5D,E).…”

“…[ 30 ] CR is the maximum slope of the Sonoclot Signature, which presents the coagulation conversion rate of fibrinogen to fibrin per unit of time. [ 30 ] The results showed that DAMPs reduced the ACT of normal human whole blood from healthy volunteers from 105.3 ± 10.2 s to 24.3 ± 5.5 s and increased the CR from 23.0 ± 3.6 to 53.0 ± 13.8 sig min −1 , suggesting that DAMPs could effectively activate clotting (Figure 5D,E). Consistent with the previous results, HPT or ss‐HPT treatment increased the ACT to 45.7 ± 3.1 s or 51.4 ± 4.6 s and decreased the CR to 30.3 ± 2.1 or 23.7 ± 3.2 s, respectively (Figure 5D,E).…”

The value of Sonoclot detection technology to guide the clinical medication of the perioperative anticoagulation and antiplatelet therapy in patients with acute myocardial infarction undergoing emergent PCI

“…Sonoclot analyzer reflects on the whole process of the coagulation cascade and coagulation with intuitive signal curve as well as faster results (6). It has been successfully used in blood transfusion management in extracorporeal circulation of cardiac surgery, ICU and various tumor therapy, early diagnosis of disseminated intravascular coagulation (DIC), blood coagulation monitoring during liver transplantation and monitoring for heparin and antiplatelet drug therapy (7,8). At present, there are few studies on the effect of Sonoclot detection technology on recent thrombosis and bleeding events for using as a guide for perioperative anticoagulation and antiplatelet therapy in patients with AMI undergoing emergent PCI.…”