Abstract
BackgroundThrombelastography is a useful tool in assessment of hemostasis. Beside the traditional variables, the velocity curve and the variable delta have lately earned attention. The velocity curve provides knowledge about the speed of clot formation including information about thrombin generation. Delta, which only reflects enzymatic coagulation, allows the determination of the origin of hypercoagulability when compared to clot rigidity, a variable that reflects both platelet and enzymatic activity. The aim was to establish preliminary reference intervals for feline thrombelastography including the velocity curve variables and delta obtained after 60 min of storage including the assessment of coefficients of variation. Furthermore, the effect of citrate storage time (30 versus 60 min) on feline thrombelastography will be determined.ResultsProlonged storage times significantly reduced reaction (R) (P = 0.019) and clotting (K) (P = 0.008) times, split point (SP) (P = 0.019) and time to maximum rate of thrombus generation (TMRTG) (P = 0.023) values whereas maximum rate of thrombus generation (MRTG) significantly increased (P = 0.040). Preliminary reference intervals: R (min): 2.7–18.1; K (min): 0.8–3.9; alpha (°): 27.6–75.2; maximum amplitude (mm): 18.5–62.5; clot rigidity (dyn/cm2): 1.2–8.2; coagulation index: −4.6 – 2.6; SP (min): 2.4–15.4; delta (min): 0.3–3.1; thrombus generation (mm/min): 255.3–751.2; MRTG (mm/min): 4.0–19.3; TMRTG (min): 3.5–22.0; maximum rate of lysis (mm/min): 0.0–4.7 and time to maximum rate of lysis (min): 0.4–55.8.ConclusionStorage for 60 versus 30 min induces hypercoagulable tracings including the velocity curve, some of which variables (MRTG, TMRTG) might function as sensitive markers for changes in the coagulation activity. Because of the impact of citrate storage time on thrombelastography, reference intervals have to be established using a specific and constant storage time in each laboratory.
Highlights
Thrombelastography is a useful tool in assessment of hemostasis
Other variables reflecting clot formation derived from the velocity curve include the time to maximum rate of thrombus generation (TMRTG), defined as the distance on the x-axis from zero to the peak of the curve, and the thrombus generation (TG), which is calculated from the area under the curve and represents an indirect measurement of clot strength [5]
Values that can be obtained from the curve below the horizontal axis reflect fibrinolysis and include the maximum rate of lysis (MRL) represented by the negative peak of this curve and the time to maximum rate of lysis (TMRL), which is the represented on the x-axis from the start of the fibrinolysis curve to its negative peak [5]
Summary
Thrombelastography is a useful tool in assessment of hemostasis. Beside the traditional variables, the velocity curve and the variable delta have lately earned attention. The global integrity of the complex process of blood coagulation is preferably assessed by measurement of thrombin generation [4], which can be evaluated using the TEG velocity curve (VC). Variables generated from the curve of clot formation include the maximum rate of thrombus generation (MRTG) represented by the peak of this curve [5]. Other variables reflecting clot formation derived from the velocity curve include the time to maximum rate of thrombus generation (TMRTG), defined as the distance on the x-axis from zero to the peak of the curve, and the thrombus generation (TG), which is calculated from the area under the curve and represents an indirect measurement of clot strength [5]. Values that can be obtained from the curve below the horizontal axis reflect fibrinolysis and include the maximum rate of lysis (MRL) represented by the negative peak of this curve and the time to maximum rate of lysis (TMRL), which is the represented on the x-axis from the start of the fibrinolysis curve to its negative peak [5]
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