PDF(Pubmed)
Abstract：
UNASSIGNED: Viscoelastic assays have widely been used for evaluating coagulopathies but lack the addition of shear stress important to in vivo clot formation. Stasys technology subjects whole blood to shear forces over factor-coated surfaces. Microclot formation is analyzed to determine clot area (CA) and platelet contractile forces (PCFs). We hypothesize the CA and PCF from this novel assay will provide information that correlates with trauma-induced coagulopathy and transfusion requirements.
UNASSIGNED: Blood samples were collected on adult trauma patients from a single-institution prospective cohort study of high-level activations. Patient and injury characteristics, transfusion data, and outcomes were collected. Thromboelastography, coagulation studies, and Stasys assays were run on paired samples collected at admission. Stasys CA and PCFs were quantified as area under the curve calculations and maximum values. Normal ranges for Stasys assays were determined using healthy donors. Data were compared using Kruskal-Wallis tests and simple linear regression.
UNASSIGNED: From March 2021 to January 2023, 108 samples were obtained. Median age was 37.5 (IQR 27.5-52) years; patients were 77% male. 71% suffered blunt trauma, 26% had an Injury Severity Score of ≥25. An elevated international normalized ratio significantly correlated with decreased cumulative PCF (p=0.05), maximum PCF (p=0.05) and CA (p=0.02). Lower cumulative PCF significantly correlated with transfusion of any products at 6 and 24 hours (p=0.04 and p=0.05) as well as packed red blood cells (pRBCs) at 6 and 24 hours (p=0.04 and p=0.03). A decreased maximum PCF showed significant correlation with receiving any transfusion at 6 (p=0.04) and 24 hours (p=0.02) as well as transfusion of pRBCs, fresh frozen plasma, and platelets in the first 6 hours (p=0.03, p=0.03, p=0.03, respectively).
UNASSIGNED: Assessing coagulopathy in real time remains challenging in trauma patients. In this pilot study, we demonstrated that microfluidic approaches incorporating shear stress could predict transfusion requirements at time of admission as well as requirements in the first 24 hours.
UNASSIGNED: Level II.
UNASSIGNED: Blood samples were collected on adult trauma patients from a single-institution prospective cohort study of high-level activations. Patient and injury characteristics, transfusion data, and outcomes were collected. Thromboelastography, coagulation studies, and Stasys assays were run on paired samples collected at admission. Stasys CA and PCFs were quantified as area under the curve calculations and maximum values. Normal ranges for Stasys assays were determined using healthy donors. Data were compared using Kruskal-Wallis tests and simple linear regression.
UNASSIGNED: From March 2021 to January 2023, 108 samples were obtained. Median age was 37.5 (IQR 27.5-52) years; patients were 77% male. 71% suffered blunt trauma, 26% had an Injury Severity Score of ≥25. An elevated international normalized ratio significantly correlated with decreased cumulative PCF (p=0.05), maximum PCF (p=0.05) and CA (p=0.02). Lower cumulative PCF significantly correlated with transfusion of any products at 6 and 24 hours (p=0.04 and p=0.05) as well as packed red blood cells (pRBCs) at 6 and 24 hours (p=0.04 and p=0.03). A decreased maximum PCF showed significant correlation with receiving any transfusion at 6 (p=0.04) and 24 hours (p=0.02) as well as transfusion of pRBCs, fresh frozen plasma, and platelets in the first 6 hours (p=0.03, p=0.03, p=0.03, respectively).
UNASSIGNED: Assessing coagulopathy in real time remains challenging in trauma patients. In this pilot study, we demonstrated that microfluidic approaches incorporating shear stress could predict transfusion requirements at time of admission as well as requirements in the first 24 hours.
UNASSIGNED: Level II.
摘要：
粘弹性测定已广泛用于评估凝血病,但缺乏对体内凝块形成重要的剪切应力的添加。Stasys技术使全血在因子涂层表面上受到剪切力。分析微凝块形成以确定凝块面积(CA)和血小板收缩力(PCF)。我们假设CA和PCF从这个新的测定将提供与创伤诱导的凝血病和输血要求相关的信息。
■从一项单机构前瞻性队列研究中收集成人创伤患者的血液样本。患者和损伤特征，输血数据,并收集结果。血栓弹力图,凝血研究，和Stasys测定在入院时收集的配对样品上进行。将StasysCA和PCF定量为曲线计算下的面积和最大值。使用健康供体确定Stasys测定的正常范围。使用Kruskal-Wallis检验和简单线性回归比较数据。
■从2021年3月到2023年1月，获得了108个样品。中位年龄为37.5（IQR27.5-52）岁；77％的患者为男性。71%遭受钝性创伤,26%的人受伤严重程度评分≥25分。国际标准化比率升高与累积PCF降低显著相关(p=0.05)，最大PCF(p=0.05)和CA(p=0.02)。较低的累积PCF与在6和24小时输注任何产品（p=0.04和p=0.05）以及在6和24小时（p=0.04和p=0.03）浓缩的红细胞（pRBC）显着相关。最大PCF降低与在6小时（p=0.04）和24小时（p=0.02）接受任何输血以及pRBC的输血显着相关，新鲜冷冻血浆，和前6小时的血小板（分别为p=0.03，p=0.03，p=0.03）。
■在创伤患者中实时评估凝血功能障碍仍然具有挑战性。在这项试点研究中，我们证明,加入剪切应力的微流体方法可以预测入院时的输血需求以及前24小时的输血需求.
■二级。
■从一项单机构前瞻性队列研究中收集成人创伤患者的血液样本。患者和损伤特征，输血数据,并收集结果。血栓弹力图,凝血研究，和Stasys测定在入院时收集的配对样品上进行。将StasysCA和PCF定量为曲线计算下的面积和最大值。使用健康供体确定Stasys测定的正常范围。使用Kruskal-Wallis检验和简单线性回归比较数据。
■从2021年3月到2023年1月，获得了108个样品。中位年龄为37.5（IQR27.5-52）岁；77％的患者为男性。71%遭受钝性创伤,26%的人受伤严重程度评分≥25分。国际标准化比率升高与累积PCF降低显著相关(p=0.05)，最大PCF(p=0.05)和CA(p=0.02)。较低的累积PCF与在6和24小时输注任何产品（p=0.04和p=0.05）以及在6和24小时（p=0.04和p=0.03）浓缩的红细胞（pRBC）显着相关。最大PCF降低与在6小时（p=0.04）和24小时（p=0.02）接受任何输血以及pRBC的输血显着相关，新鲜冷冻血浆，和前6小时的血小板（分别为p=0.03，p=0.03，p=0.03）。
■在创伤患者中实时评估凝血功能障碍仍然具有挑战性。在这项试点研究中，我们证明,加入剪切应力的微流体方法可以预测入院时的输血需求以及前24小时的输血需求.
■二级。
