Dataset Information

Rapid measurement of fibrinogen concentration in whole blood using a steel ball coagulometer.

ABSTRACT:

Background

Fibrinogen plays a key role in hemostasis and is the first coagulation factor to reach critical levels in bleeding patients. Current European guidelines on the management of traumatic or perioperative bleeding recommend fibrinogen supplementation at specific threshold levels. Whole blood viscoelastic tests provide fast evaluation of fibrin deficits. Fast measurement of plasma fibrinogen concentration is not yet available. We investigated a method to rapidly determine whole blood fibrinogen concentration using standard Clauss assays and a steel ball coagulometer and provide an estimate of the "plasma-equivalent" fibrinogen concentration within minutes by adjustment of the measured whole blood fibrinogen concentration with a quickly measureable hemoglobin-derived hematocrit.

Methods

The feasibility of this approach was tested with a Clauss assay using multiple porcine fresh blood samples obtained during in vivo bleeding, hemodilution, and after treatment with hemostatic therapy. Two different Clauss assays were then tested using multiple human volunteers' blood samples diluted in vitro and supplemented with fibrinogen concentrate. Comparative measurements with fibrin-based thromboelastometry tests were performed.

Results

Regression and Bland-Altman analyses of derived "plasma-equivalent" fibrinogen and measured plasma fibrinogen concentration was excellent in porcine and human blood samples, especially in the ranges relevant to traumatic or perioperative bleeding.

Conclusion

Fast whole blood fibrinogen measurements could be considered as an alternative to plasma fibrinogen measurement for acute bleeding management in trauma and perioperative care settings. Further studies are needed to prove this concept and determine the turnaround times for its clinical application in emergency departments and operating theaters.

SUBMITTER: Schlimp CJ

PROVIDER: S-EPMC4888927 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Elderly people need activities that will positively contribute to a satisfactory process of getting older. Vibration training uses mechanical stimulus of a vibrational character that, similarly to other forms of physical activity, affects metabolic processes and conditions of health. The aim of this work was to assess the influence of thirty vibration treatments on body fatness, hematologic and rheologic indexes of blood, and proteinogram and fibrinogen concentration in elderly men's blood. The study included twenty-one males, aged 60-70 years (mean age 65.3 ± 2.7), who were randomly assigned into a vibrotherapy group (VG) and took part in interventions on mattresses generating oscillatory-cycloid vibrations, and a control group (CG), without interventions. In all patients the following assessments were performed twice: an assessment of body fatness using the bioimpedance method, a complete blood count with a hematology analyzer, and erythrocyte aggregation by a laser-optical rotational cell analyzer; whereas, total plasma protein and fibrinogen values were established, respectively, by biuret and spectrophotometric methods. In order to compare the impact of vibrotherapy on changes in the analyzed variables, analysis of variance (ANOVA) or the Wilcoxon test were used. After applying thirty vibration treatments in the VG, a significant decrease in body fatness parameters was confirmed: BM (∆BM: -2.7 ± 2.0; p = 0.002), BMI (∆BMI: -0.9 ± 0.7; p = 0.002), BF (∆BF: -2.5 ± 2.5; p = 0.013), and %BF (∆%BF: -2.0 ± 2.7; p = 0.041), as well as in RBC (∆RBC: -0.1 ± 0.1; p = 0.035). However, changes in erythrocyte aggregation and proteinogram were not confirmed. It was found that after thirty treatments with VG, a significant decrease of fibrinogen level took place (∆ = -0.3 ± 0.3, p = 0.005). Application of thirty vibrotherapy treatments positively affected body fatness parameters and fibrinogen concentrations in the examined. However, further research should include a greater number of participants.