Kaolin activation of recalcified citrated whole blood in a point-of-care viscoelastic coagulation test.

Abstract

The viscoelastic coagulation monitor (VCM) is described as a point-of-care analyzer relying on activation of fresh whole blood (FWB) via contact between 2 glass plates. Kaolin is used as an activator in thromboelastography to reduce variability and shorten clotting times. The goal of this study was to compare VCM results from kaolin-activated, recalcified citrated samples with that from FWB. The VCM testing was performed using FWB and kaolin-activated, recalcified citrated samples. The VCM results were recorded for clot time (CT; seconds), clot formation time (CFT; seconds), alpha (degree), amplitude at 10 and 20 minutes (A10 and A20; VCM units), maximum clot firmness (MCF; VCM units), and lysis index (LI; %). Values were compared using a t-test or Wilcoxon-Mann-Whitney test, with a P-value < 0.05 considered significant. Variability between samples was calculated using Levene's test. The VCM kaolin activation resulted in significantly faster CT and CFT (P < 0.0001), higher alpha angle (P < 0.001), and higher A10 and A20 (P = 0.007, P = 0.015) compared to FWB. There was no difference in MCF, LI30, or LI45. There was no difference in variability identified. The addition of kaolin to recalcified citrated whole blood VCM samples results in more rapid clotting of FWB alone and could be considered for clinical use in dogs.