Assessment of method reliability and determination of reference intervals for rotational thromboelastometry in horses.
Abstract: To assess the measurement reliability of rotational thromboelastometry (ROTEM) measurements in horses, establish reference intervals for healthy horses, and evaluate the relationship between ROTEM variables, hematologic variables, and standard coagulation tests. Methods: Prospective observational study. Methods: University teaching hospital. Methods: Fifty healthy and 10 diseased adult horses. Methods: None. Results: Blood was sampled from 10 healthy and 10 diseased horses and samples were repeatedly analyzed to evaluate measurement reliability of various ROTEM variables. Four different ROTEM assays (ie, EXTEM, INTEM, FIBTEM, and APTEM) were run simultaneously under standardized conditions. The device-related, operator-related, and day-to-day variability for the majority of ROTEM variables was very low to low, as indicated by a coefficient of variation (CV) of < 15%. Most of test-retest variability of ROTEM variables appeared to be device-related. Blood samples from 50 clinically healthy horses were used to establish reference intervals for ROTEM variables. Multiple stepwise regression analyses identified associations of different ROTEM variables with hematocrit, total protein concentration, fibrinogen concentration, platelet count, prothrombin time, activated partial thromboplastin time, and thrombin time. Conclusions: ROTEM is a feasible method to evaluate coagulation in horses. Its measurement reliability is acceptable, but device-related measurement variability has to be considered. Reference intervals are presented, but the influence of hematocrit, platelet count, and fibrinogen concentration may need to be taken into account when interpreting individual test results.
© Veterinary Emergency and Critical Care Society 2016.
Publication Date: 2016-09-06 PubMed ID: 27599160DOI: 10.1111/vec.12515Google Scholar: Lookup
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- Journal Article
- Validation Study
Summary
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The study assesses the reliability of rotational thromboelastometry (ROTEM) in horses, determines reference intervals, and examines its relation to hematologic variables and standard coagulation tests. The researchers found ROTEM to be a viable method for evaluating blood coagulation in horses. While its reliability is adequate, device-related measurement variability needs to be accounted for.
Research Methodology
- The study was a prospective observational one, conducted at a university teaching hospital.
- Fifty healthy and ten diseased adult horses were involved in the study.
- Blood samples were taken from both healthy and diseased horses, and were repeatedly analyzed to assess the measurement reliability of various ROTEM variables.
- Four different ROTEM assays (EXTEM, INTEM, FIBTEM, and APTEM) were run all at once under standardized conditions.
Findings and Results
- The variability associated with the device, the operator, and day-to-day conditions for the majority of ROTEM variables was very low to low, represented by a coefficient of variation (CV) of less than 15%.
- The majority of the test-retest variability of ROTEM variables appeared to be device-related.
- The blood samples from the fifty clinically healthy horses were used to determine reference intervals for ROTEM variables.
- Multiple stepwise regression analyses disclosed associations of different ROTEM variables with hematocrit, total protein concentration, fibrinogen concentration, platelet count, prothrombin time, activated partial thromboplastin time, and thrombin time.
Conclusion and Recommendations
- Rotational thromboelastometry (ROTEM) is a feasible method to evaluate coagulation in horses, and its measurement reliability is acceptable.
- However, device-related measurement variability has to be taken into consideration.
- The study provides reference intervals, but aspects like hematocrit, platelet count, and fibrinogen concentration should be factored in when interpreting individual test results.
Cite This Article
APA
Junge HK, Ringer SK, Mayer N, Schwarzwald CC.
(2016).
Assessment of method reliability and determination of reference intervals for rotational thromboelastometry in horses.
J Vet Emerg Crit Care (San Antonio), 26(5), 691-703.
https://doi.org/10.1111/vec.12515 Publication
Researcher Affiliations
- Clinic for Equine Internal Medicine, University of Zurich, Zurich, Switzerland.
- Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
- Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
- Clinic for Equine Internal Medicine, University of Zurich, Zurich, Switzerland. cschwarzwald@vetclinics.uzh.ch.
MeSH Terms
- Animals
- Blood Coagulation
- Blood Coagulation Tests / methods
- Blood Coagulation Tests / veterinary
- Female
- Fibrinogen / metabolism
- Hemorrhage / diagnosis
- Hemorrhage / veterinary
- Horse Diseases / blood
- Horse Diseases / diagnosis
- Horses
- Male
- Partial Thromboplastin Time
- Platelet Count
- Prospective Studies
- Prothrombin Time
- Reference Values
- Reproducibility of Results
- Thrombelastography / methods
- Thrombelastography / veterinary
Citations
This article has been cited 1 times.- Vuille-Dit-Bille J, Weingand N, Jud Schefer R, Stirn M, Adamik KN, Rathmann JMK, Sigrist NE. Comparison of Jugular vs. Saphenous Blood Samples, Intrarater and In-Between Device Reliability of Clinically Used ROTEM S Parameters in Dogs. Animals (Basel) 2022 Aug 17;12(16).
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