Comparison with other methods Anticoagulant and other drug effects
Rotational thromboelastometry ROTEM® is available as point-of-care coagulation monitoring in an increasing number of European operating theatres and emergency rooms. The Platelet Mapping™ Assay has been described as a platelet aggregation assay for thromboelastography TEG®. The aim of this experimental trial was to evaluate feasibility of the Platelet Mapping™ Assay on the ROTEM® test system. Ex vivo study Whole blood was drawn from 22 adult volunteers and patients with and with-
Platelet aggregability was determined in three whole blood assays: the
Platelet Mapping™ Assay using both activators arachidonic acid (AA) and adenosine diphoshpate (ADP) on TEG® Haemostasis Analyser 5000, its adapted version on ROTEM® gamma, and the multiple electrode impedance aggregometer Multiplate®.
Tests were performed in duplicates simultaneously on the three test devices. The Platelet Mapping™ Assay combines three ciscoelastic measurements
involving various reagents and preparation steps.
As the conventional blood volume is 360 µl in the TEG® and 300 µl in
ROTEM® we adapted to the total test volume accordingly.
Main parameter documented was the maximum amplitude (MA) in the TEG®
and the maximum clot firmness (MCF) in the ROTEM®.
Percent aggregation inhibition results were plotted in a linear regression
Sensitivity and specificity for detecting antiplatelet medication were deter-
Overall correlation were statistically with an r²=0,83 in AA-activated and an
r²=0,82 in ADP-activated Platelet Mapping™Assay.
AA-activated tests and the Multiplate® analysis identified aspirin-inhibition in
ADP-activiated tests and the Multiplate® analysis identified clopidogrel-
inhibition in 67% and 89%, respectively.
Specificity was low both in ROTEM® and TEG®. Correlation between Platelet Mapping™ Assay performed on ROTEM® and
TEG® in patients on clopidogrel and aspirin were good and highly significant.
The Platelet Mapping™ Assay can be performed on the ROTEM®.
Coagulation, platelets, platelet aggregation, point-of-care coagulation monitoring, ROTEM®, POC
Conclusions “The study demonstrates that the Platelet Mapping™Assay designed for TEG® can be run on the ROTEM®. This information on the feasibility of per- forming the Platelet Mapping™Assay on the ROTEM® is important for the many ROTEM® users who are well aware of the diagnostic gap of this viscoelastic test in terms of platelet function monitoring.” “The correlation between Platelet Mapping™Assay performed on ROTEM® and TEG® (r²=0,825) of all available values from all patien ts and volunteers ob- tained were comparable with the correlation between optic aggregometry and Multiplate® analyses before and after clopidogrel treatment (r²=0,71).” “Diagnostic accuracy of this assay for the detection of platelet inhibition treatment by clopidogrel, aspirin, and diclofenac is inadequate and inferior to multiple electrode aggregometry using Multiplate®.”
ASL della Provincia di Varese Direzione Sanitaria Dipartimento di Prevenzione Medico Servizio Medicina Preventiva nelle Comunità EVENTI PATOLOGICI IN AMBITO SCOLASTICO: GESTIONE DEGLI INTERVENTI DI EMERGENZA E DELLE TERAPIE PROGRAMMATE GESTIONE DELL’EMERGENZA IN AMBITO SCOLASTICO 1. OBBLIGHI DEL DATORE DI LAVORO IN MATERIA DI PRONTO SOCCORSO pag.2 GESTIONE
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