Multicenter in vitro thromboelastography and thromboelastometry standardization
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Multicenter in vitro thromboelastography and thromboelastometry standardization. / Goggs, Robert; Borrelli, Antonio; Brainard, Benjamin M.; Chan, Daniel L.; de Laforcade, Armelle; Goy-Thollot, Isabelle; Jandrey, Karl E.; Kristensen, Annemarie T.; Kutter, Annette; Marschner, Clara B.; Rannou, Benoît; Sigrist, Nadja; Wagg, Catherine.
In: Journal of Veterinary Emergency and Critical Care, Vol. 28, No. 3, 2018, p. 201-212.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Multicenter in vitro thromboelastography and thromboelastometry standardization
AU - Goggs, Robert
AU - Borrelli, Antonio
AU - Brainard, Benjamin M.
AU - Chan, Daniel L.
AU - de Laforcade, Armelle
AU - Goy-Thollot, Isabelle
AU - Jandrey, Karl E.
AU - Kristensen, Annemarie T.
AU - Kutter, Annette
AU - Marschner, Clara B.
AU - Rannou, Benoît
AU - Sigrist, Nadja
AU - Wagg, Catherine
PY - 2018
Y1 - 2018
N2 - Objective: To establish and compare the repeatability and reproducibility of activated thromboelastography (TEG) and thromboelastometry (ROTEM) assays. Design: Multicenter in vitro test standardization. Setting: Veterinary academic centers. Animals: Test samples were obtained from normal, healthy dogs. Sixty identical 5 mL aliquots of canine platelet-rich plasma collected by apheresis, frozen in 6% dimethyl sulfoxide, were tested initially. Sixty identical 6 mL aliquots of canine fresh frozen plasma with admixed cryoprecipitate were subsequently evaluated. Interventions: None. Measurements and Main Results: Frozen study samples, quality controls, reagents, and consumables were distributed to participating centers (7 TEG and 3 ROTEM). TEG centers analyzed study samples with kaolin and tissue factor activated assays; ROTEM centers ran proprietary ellagic acid activated and tissue factor activated assays. All machines underwent quality control prior to sample analysis. Within- and between-center coefficients of variation (CVs) were calculated and compared using Mann–Whitney tests and calculation of intraclass correlation coefficients. Within and between centers, individual parameters for both TEG and ROTEM assays were comparable. Both within-center and between-center CVs varied markedly (0.7–120.5% and 1.4–116.5%, respectively) with assay type, instrument, and parameter. CVs for equivalent parameters were not significantly different between the 2 platforms. Intraclass correlation coefficients suggested moderate agreement between centers. In general, individual parameter CVs for platelet-rich plasma samples were lower in TEG centers, while CVs for canine fresh frozen plasma with admixed cryoprecipitate samples were lower in ROTEM centers. Conclusions: More variation within and between centers was identified than anticipated, but some parameters such as alpha angle were repeatable and reproducible. Sample types for future multicenter standardization efforts will require further optimization and may need to be adapted separately to each platform. Individual centers using viscoelastic tests for evaluation and management of clinical patients should take steps to minimize preanalytical and analytical sources of variation.
AB - Objective: To establish and compare the repeatability and reproducibility of activated thromboelastography (TEG) and thromboelastometry (ROTEM) assays. Design: Multicenter in vitro test standardization. Setting: Veterinary academic centers. Animals: Test samples were obtained from normal, healthy dogs. Sixty identical 5 mL aliquots of canine platelet-rich plasma collected by apheresis, frozen in 6% dimethyl sulfoxide, were tested initially. Sixty identical 6 mL aliquots of canine fresh frozen plasma with admixed cryoprecipitate were subsequently evaluated. Interventions: None. Measurements and Main Results: Frozen study samples, quality controls, reagents, and consumables were distributed to participating centers (7 TEG and 3 ROTEM). TEG centers analyzed study samples with kaolin and tissue factor activated assays; ROTEM centers ran proprietary ellagic acid activated and tissue factor activated assays. All machines underwent quality control prior to sample analysis. Within- and between-center coefficients of variation (CVs) were calculated and compared using Mann–Whitney tests and calculation of intraclass correlation coefficients. Within and between centers, individual parameters for both TEG and ROTEM assays were comparable. Both within-center and between-center CVs varied markedly (0.7–120.5% and 1.4–116.5%, respectively) with assay type, instrument, and parameter. CVs for equivalent parameters were not significantly different between the 2 platforms. Intraclass correlation coefficients suggested moderate agreement between centers. In general, individual parameter CVs for platelet-rich plasma samples were lower in TEG centers, while CVs for canine fresh frozen plasma with admixed cryoprecipitate samples were lower in ROTEM centers. Conclusions: More variation within and between centers was identified than anticipated, but some parameters such as alpha angle were repeatable and reproducible. Sample types for future multicenter standardization efforts will require further optimization and may need to be adapted separately to each platform. Individual centers using viscoelastic tests for evaluation and management of clinical patients should take steps to minimize preanalytical and analytical sources of variation.
KW - canine
KW - dog
KW - repeatability
KW - reproducibility
KW - thromboelastography
KW - thromboelastometry
U2 - 10.1111/vec.12710
DO - 10.1111/vec.12710
M3 - Journal article
C2 - 29604163
AN - SCOPUS:85046399587
VL - 28
SP - 201
EP - 212
JO - Journal of Veterinary Emergency and Critical Care (Online Edition)
JF - Journal of Veterinary Emergency and Critical Care (Online Edition)
SN - 1476-4431
IS - 3
ER -
ID: 211950724