Resonant Acoustic Rheometry for Hemostasis Monitoring on Plasma and Whole Blood
Recommended Citation
Bunch CM, Li W, Zackariya S, Tuttle JE, Patel S, Walsh M, Kwaan H, Condon S, Zackariya S, Buchh M, Khan H, Aboukhaled M, Patel V, Ranginwala A, Kizilbash E, Ahmed S, Miller JB, Stegemann J, Deng C, Walsh M. Resonant Acoustic Rheometry for Hemostasis Monitoring on Plasma and Whole Blood. Acad Emerg Med 2025; 32(S1):208-209.
Document Type
Conference Proceeding
Publication Date
5-13-2025
Publication Title
Acad Emerg Med
Keywords
antifibrinolytic agent, fibrinogen, fibrinogen concentrate, tissue plasminogen activator, adult, bleeding, blood clotting, blood component, blood sampling, classifier, clinical article, conference abstract, controlled study, correlation coefficient, cryoprecipitate, diagnostic test accuracy study, duration, emergency ward, female, fibrinolysis, flow measurement, hemostasis, human, hypofibrinogenemia, intensive care unit, machine learning, male, middle aged, phenotype, prediction, provocation test, reaction time, thromboelastography
Abstract
Background and Objectives: Disordered hemostasis associated with life-threatening hemorrhage commonly afflicts patients in the emergency room, critical care unit, and perioperative settings. Rapid and sensitive hemostasis phenotyping is needed to guide administration of blood components and hemostatic adjuncts to reverse aberrant coagulobrinolysis. Resonant acoustic rheometry (RAR) is an ultrasound-based blood characterization technique which offers key advantages over current sheer rheometric assays in terms of throughput, reduced sample volume, and increased information content. We aim to develop a point-of- care global hemostasis test to rapidly guide fibrinogen concentrates and antifibrinolytic therapies in patients with hypofibrinogenemia and hyperfibrinolysis. Methods: Here, resonant acoustic rheometry (RAR) was applied to assess plasma and whole blood coagulation in a cohort of bleeding patients with concomitant clinical coagulation assays and whole blood thromboelastography (TEG) as part of their routine care. A convenience sample of 38 pathological plasma samples and six whole blood samples were run on the RAR. Correlation coefficients were calculated between RAR parameters and clinical test results. A quadratic classifier was used to predict transfusion requirements. Results: RAR plasma Start Time demonstrated good correlation with TEG reaction time (R = 0.644). RAR plasma Duration demonstrated strong correlation with TEG reaction time (R = 0.8498). RAR plasma Final Resonant Frequency demonstrated good correlation to TEG functional fibrinogen (R = 0.7720). The quadratic classifier predicted cryoprecipitate transfusion with an overall accuracy of 97%. Preliminary work shows that whole blood use is feasible on the RAR with high quality data. RAR is sensitive to detect fibrinolysis on whole blood, and the tissue plasminogen activator challenge test demonstrates robust tracings. Conclusion: RAR plasma parameters correlate well to TEG measurements in a small sample size. Larger samples size will improve prediction of transfusion requirements with the assistance of machine learning. Continued study with whole blood will further elucidate RAR's bedside potential for sensitivity to fibrinogen content and fibrinolysis in bleeding patients.
Volume
32
Issue
S1
First Page
208
Last Page
209
