The aim of this study is to develop a coagulation algorithm based on Quantra POCT for the treatment of coagulopathic cardiac surgery patients.
In order to perform a targeted coagulation therapy during intra- and postoperative care of cardiosurgical patients, it is necessary to know the hemostatic potential. After blood samples have been taken for coagulation diagnosis, they are usually sent to the central laboratory. After analysis and validation, the results are transmitted electronically. The loss of time due to sample transport, analysis and provision of the results prolongs the time required to derive therapeutic measures. In recent years, point of care testing (POCT) devices for the diagnosis of coagulopathic patients have become increasingly important. In our clinic, POCT devices have been routinely used for intra- and postoperative targeted coagulation therapy for years. These include the ROTEM delta and Multiplate. For analysis, a whole blood sample is pipetted together with test reagents. Depending on the selected reagent, different parts of the coagulation cascade can be evaluated and, depending on this, an appropriate therapy can be derived. A coagulation algorithm developed in our clinic is based on these measurement results and has been used successfully for years for perioperative coagulation management. This algorithm requires additional information on the platelet function, which is also carried out as standard on the bed side using multi-plate analysis as POCT. A new system for whole blood analysis has recently become available on the market. The Quantra from HemoSonics also allows the analysis of a whole blood sample on the bed side. Due to the cassette structure, the time-consuming and potentially error-prone pipetting of a whole blood sample is no longer necessary. The aim of this study is to develop a coagulation algorithm based on Quantra POCT for the treatment of coagulopathic cardiac surgery patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
20
Hemotherapy based on Quantra-Algorithm
Hemotherapy based on Basic-Algorithm
University Hospital Frankfurt
Frankfurt am Main, Hesse, Germany
Bloodloss
Cumulative bloodloss directly after surgery for 24h Determined by cumulative volume of all drains in millilitres
Time frame: From finishing operation until 24 hours postoperative
Correlations of parameters between POCT and laboratory parameters.
Quick
Time frame: During operation within 24 hours postoperative
Correlations of parameters between POCT and laboratory parameters.
prothrombine time
Time frame: During operation within 24 hours postoperative
Correlations of parameters between POCT and laboratory parameters.
activated partial thromboplastin time
Time frame: During operation within 24 hours postoperative
Correlations of parameters between POCT and laboratory parameters.
Firbinogen
Time frame: During operation within 24 hours postoperative
Correlations of parameters between POCT and laboratory parameters.
platelet count
Time frame: During operation within 24h postoperative
Multiplate results
Determin platelet function with TRAP test
Time frame: During operation within 24 hours postoperative
Multiplate results
Determin platelet function with ASPI test
Time frame: During operation within 24 hours postoperative
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Multiplate results
Determin platelet function with ADP test
Time frame: During operation within 24 hours postoperative
Time saving by using a cassette
Influence of a cassette structure in comparison to pipetting with regard to the temporal availability of the measurement results
Time frame: During operation within 24 hours postoperative
Use of blood products
Cumulative volume of administered fresh frozen plasma, platelet infusion and packed red blood cells in mililitres
Time frame: During operation within 24 hours postoperative
Coagulationfactos and procoagulant drugs
Cumulative usage of prothrombin complexe concentrate measured in international units, fibrinogen measured in gramm, tranexamic acid measured in gramm, desmopressin measured in microgramm, Calcium measured in gramm, activated factor VII measured in international units
Time frame: During operation within 24 hours postoperative
Thromboembolic complications
Thromboembolic complications
Time frame: During operation within 24h postoperative
Comorbidities
Comorbidities
Time frame: 15 years before operation