Performance Evaluation of a New Point of Care Viscoelastic Coagulation Monitoring System in Major Abdominal, Orthopaedic and Vascular Surgery

Abstract

Viscoelastic Coagulation Testing (VCT), or Thromboelastography has the potential to improve the cost and clinical effectiveness of surgical and medical care by preventing unnecessary treatment and by improving treatment for bleeding, via targeted transfusion strategies. Recently a new viscoelastic coagulation monitoring system, the VCM System, has been developed, which has several advantages over existing systems. The VCM system is a small, portable device, that is designed to be simple to operate and can be used to reliably perform viscoelastic testing at the patient's bedside. The aim of this study was to evaluate the performance of the VCM system by comparing it to that of the ROTEM® delta. The CT, CFT, alpha angle, A10, A20, MCF and lysis results obtained from blood samples run in parallel on the VCM System and the ROTEM® NATEM test were compared for 86 patients undergoing planned abdominal, major orthopedic or vascular surgery. There was good correlation between the VCM and ROTEM® NATEM tests results for CT, A10, A20 and MCF, with Spearman Rank values of 0.70, 0.80, 0.80 and 0.73 respectively. The correlation between the two systems for CFT and alpha was moderate (Spearman Rank values of 0.68 and 0.51). There was also good agreement between the lysis parameters for the two systems. No problems with the usability of the VCM system, or difficulties with training on the system were reported by any of the clinical staff involved in the study. The VCM system is capable of making viscoelastic measurements of the hemostasis of blood samples within a rapid timeframe and addresses the accessibility, robustness and training issues associated with the larger traditional systems.

Keywords: Thromboelastography; VCM system; Viscoelastic testing; hemostasis.