重症监护环境中声流变学参数与实验室值之间的关系:一项初步回顾性研究

Journal of Trauma and Injury Pub Date : 2023-09-01 Epub Date: 2023-07-04 DOI:10.20408/jti.2023.0014
Antonio Romanelli, Renato Gammaldi, Alessandro Calicchio, Salvatore Palmese, Antonio Siglioccolo
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引用次数: 0

摘要

目的:本初步回顾性研究分析了重症监护病房(ICU)患者超声测定仪Quantra提供的参数与标准静脉血凝血值的关系。方法:我们回顾了13例ICU成人患者的病历,其中至少有一次使用Quantra进行凝血研究。采用Spearman秩相关系数(rho)分析Quantra与实验室数据之间的关系。计算95%置信区间(CI)。p值<0.05认为有统计学意义。结果:共收集28对数据。以下参数有统计学意义的中度相关性:凝块时间(CT)和活化的部分凝血活素时间(rho=0.516;95% ci, 0.123-0.904;P = 0.009;凝块刚度(CS)和国际归一化比(INR);ρ= 0.418;95% ci, 0.042-0.787;P = 0.039);INR和血小板对CS的贡献(rho=0.459;95% ci, 0.077 - 0.836;P = 0.022);血小板计数及血小板对CS的贡献;ρ= 0.498;95% ci, 0.166 - 0.825;P = 0.008);纤维蛋白原和纤维蛋白原对CS的贡献(FCS);ρ= 0.620;95% ci, 0.081 - 0.881;P = 0.001)。结论:Quantra可以提供关于凝血状态的有用信息,显示出与实验室测试参数的适度相关性。弥漫性出血时,CT和FCS值可以指导凝血因子和纤维蛋白原的正确使用。然而,INR与CS和PCS的相关性可能会引起误解。需要进一步的研究来阐明在重症监护环境中Quantra参数和实验室测试之间的关系,以及超声在指导靶向治疗和改善结果中的作用。
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Relationship between sonorheometry parameters and laboratory values in a critical care setting in Italy: a retrospective cohort study.

Purpose: This preliminary retrospective cohort study analyzed the relationship between the parameters provided by sonorheometry device Quantra and the coagulation values obtained from standard venous blood samples in patients admitted in intensive care unit (ICU).

Methods: We reviewed medical charts of 13 ICU adult patients in whom at least one coagulation study with Quantra was performed. The relationship between Quantra and laboratory data was analyzed with the Spearman rank correlation coefficient (rho). The 95% confidence interval (CI) was computed. A P-value <0.05 was considered statistically significant.

Results: We collected 28 data pairs. Statistically significant moderate correlations were found for the following parameters: clot time (CT) and activated partial thromboplastin time (rho=0.516; 95% CI, 0.123-0.904; P=0.009; clot stiffness (CS) and the international normalized ratio (INR; rho=0.418; 95% CI, 0.042-0.787; P=0.039); INR and platelet contribution to CS (rho=0.459; 95% CI, 0.077-0.836; P=0.022); platelet count and platelet contribution to CS (PCS; rho=0.498; 95% CI, 0.166-0.825; P=0.008); and fibrinogen and fibrinogen contribution to CS (FCS; rho=0.620; 95% CI, 0.081-0.881; P=0.001).

Conclusions: Quantra can provide useful information regarding coagulation status, showing modest correlations with the parameters obtained from laboratory tests. During diffuse bleeding, CT and FCS values can guide the proper administration of clotting factors and fibrinogens. However, the correlation of INR with CS and PCS can cause misinterpretation. Further studies are needed to clarify the relationship between Quantra parameters and laboratory tests in the critical care setting and the role of sonorheometry in guiding targeted therapies and improving outcomes.

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