S Agarwal1, R I Johnson2, M Shaw3. 1. Anaesthesia, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK. 2. Perfusion, LHCH, Liverpool, UK. 3. Clinical Analyst, LHCH, Liverpool, UK.
Abstract
INTRODUCTION: Viscoelastic methods of estimating fibrinogen measure clot formation under platelet inhibition; these methods are gaining in popularity because of their convenience and speed. The aim of this study was to compare the results of the TEG(®) functional fibrinogen (FF) assay with the Clauss fibrinogen method in a group of patients presenting for cardiac surgery and to assess whether they gave equivalent results. METHODS: As part of a larger study evaluation a transfusion algorithm for use in cardiac surgery, 320 paired samples of TEG(®) FF and Clauss fibrinogen were compared. These were taken from 160 patients undergoing cardiac surgery at two time points - prior to heparinisation and 10 min after the administration of protamine. The results of the two fibrinogen measurements were also analysed in relation to the platelet count at the time. RESULTS: There was no significant correlation between the TEG(®) FLEV and Clauss fibrinogen at baseline (R(2) = 0.106) or 10 min postprotamine (R(2) = 0.025) The TEG(®) FF maximal amplitude and the Clauss were also found to have no significant correlation (at baseline R(2) = 0.061), at 10 min postprotamine (R(2) = 0.260). Bland-Altman analysis showed no significant agreement between the two methods. CONCLUSION: The TEG(®) FF does not produce results equivalent to those of the Clauss fibrinogen regardless of platelet count.
INTRODUCTION: Viscoelastic methods of estimating fibrinogen measure clot formation under platelet inhibition; these methods are gaining in popularity because of their convenience and speed. The aim of this study was to compare the results of the TEG(®) functional fibrinogen (FF) assay with the Clauss fibrinogen method in a group of patients presenting for cardiac surgery and to assess whether they gave equivalent results. METHODS: As part of a larger study evaluation a transfusion algorithm for use in cardiac surgery, 320 paired samples of TEG(®) FF and Clauss fibrinogen were compared. These were taken from 160 patients undergoing cardiac surgery at two time points - prior to heparinisation and 10 min after the administration of protamine. The results of the two fibrinogen measurements were also analysed in relation to the platelet count at the time. RESULTS: There was no significant correlation between the TEG(®) FLEV and Clauss fibrinogen at baseline (R(2) = 0.106) or 10 min postprotamine (R(2) = 0.025) The TEG(®) FF maximal amplitude and the Clauss were also found to have no significant correlation (at baseline R(2) = 0.061), at 10 min postprotamine (R(2) = 0.260). Bland-Altman analysis showed no significant agreement between the two methods. CONCLUSION: The TEG(®) FF does not produce results equivalent to those of the Clauss fibrinogen regardless of platelet count.
Authors: Kirsty Rizzo; Kevin Vella; Daniel Zammit; Peter Gatt; Charlie Grima; Monique Borg Inguanez; Jurgen Gerada; Pierre Ellul; Mario Vassallo; Neville Azzopardi; James Pocock; Alex Gatt Journal: Blood Transfus Date: 2018-11-09 Impact factor: 3.443