29 Resonant acoustic rheometry predicts transfusion requirements and correlates to clauss fibrinogen and thromboelastography results
Recommended Citation
Bunch CM, Li W, Zackariya S, Nehme J, Condon S, Chien C, Tuttle JE, Haidar S, Lin K, Walsh M, Cook B, Lopez-Plaza I, Hayward J, Kwaan H, Miller J, Walsh M, Hall T, Stegemann J, Deng C. 29 Resonant acoustic rheometry predicts transfusion requirements and correlates to clauss fibrinogen and thromboelastography results. Acad Emerg Med 2024; 31(S1):21.
Document Type
Conference Proceeding
Publication Date
5-13-2024
Publication Title
Acad Emerg Med
Abstract
Background and Objectives: Disordered hemostasis associated with life-threatening hemorrhage commonly afflicts patients in the emergency room, critical care unit, and perioperative settings. Clinicians in these arenas are seeking a point-of-care global hemostasis test to rapidly diagnose coagulopathies and guide blood components and hemostatic adjuncts to reverse aberrant coagulofibrinolysis. Resonant acoustic rheometry (RAR) is an ultrasound-based viscoelastic biomaterial characterization technique which offers key advantages over current shear rheometric assays in terms of speed, throughput, reduced sample volume, and increased information content. Methods: Here, a convenience sample of pathologic plasma samples from 38 patients were tested under nine unique reagent conditions with RAR to compare with concomitant clinical Clauss fibrinogen, conventional coagulation assays, whole blood TEG® 6s results, patient demographics, and transfusion requirements. About half of the patients were admitted for major surgery, the most common cases being cardiac surgery (n?=?5, 13.2%), general surgery (n?=?5, 13.2%), and organ transplantation (n?=?7, 18.4%). Other reasons for hospitalization included traumatic injury (n?=?5, 13.2%), decompensated cirrhosis (n?=?10, 26.3%), septic shock (n?=?1, 2.6%), post-cardiac arrest syndrome (n?=?1, 2.6%), cardiogenic shock requiring peripheral venoarterial extracorporeal membrane oxygenation (n?=?2, 5.3%), and non-cirrhotic gastrointestinal bleeding (n?=?2, 5.3%). Results: The RAR parameter Final Resonant Frequency (FRF) demonstrated agreement with the Clauss fibrinogen and TEG functional fibrinogen. RAR parameters Start Time and Duration demonstrated agreement with the TEG reaction time. Significantly, RAR FRF correlated to the clinical need for cryoprecipitate across all nine RAR reagent conditions. Additionally, plasma administration correlated to the RAR parameters when kaolin and Tissue Factor were used as coagulation activators. Conclusion: These results lay the foundation for future study with whole blood to further elucidate RAR's bedside potential for sensitivity to fibrinogen content and fibrinolysis in bleeding patients.
Volume
31
Issue
S1
First Page
21
