title: Quantifying platelet gel coagulation using Sonoclot and Thrombelastograph hemostasis analyzer.
abstract: Little in vitro research exists discussing platelet gel composition and the resulting strength and degradation characteristics using point-of-care technologies. There must be a quantifiable way of determining the structural integrity of the resulting formed platelet gel thrombus. The Thrombelastograph Hemostasis Analyzer (TEG) and Sonoclot measure the elasticity of a clot as it forms and subsequently degrades naturally. The objective of this study was to determine the application of TEG and Sonoclot technologies as point-of-care devices for technicians using platelet gel therapy. The collected bovine blood was anticoagulated with CPD and processed using a previously published plasma sequestration protocol, using normal saline as a wash solution. The resulting platelet-rich plasma was stored in a sequestration bag in a water bath to maintain the blood temperature at 37 degrees C. Sequestered bovine platelet-rich plasma was made into platelet gel using three different thrombin concentrations. A total of 30 experiments were performed on the platelet gel product using both the TEG and the Sonoclot. We discovered that 6 of the Sonoclot tests and 15 of the TEG tests were valid. None of the TEG clot signatures and nine of the Sonoclot signatures were discovered to be invalid. A chi2 test was performed on the resultant data. The value of the chi2 test was calculated to be 12.86, which translated into a p value of less than 0.001. Despite the vast use and growing popularity of platelet gels, a method in which to quantify platelet gels has yet to be reported. There remains a possibility that gels formed with different concentrations of components may prove useful in different areas of surgery or their uses may expand to a broader spectrum of medicine. However, technology to quantify platelet gels must first be standardized. On the basis of the data collected in this study, it was determined that the TEG and the Sonoclot are not equally capable of analyzing platelet gel clots. The TEG is a valid means for analysis, whereas the Sonoclot provided unreliable analysis based on a Chi-squared test.
authors.affiliation: Circulation Technology Division, The Ohio State University School of Allied Medical Professions, Columbus, Ohio, USA. cassidy.6500@su.edu
authors.forename: Lynsay K
authors.initials: LK
authors.lastname: Cassidy
authors.forename: Angela S
authors.initials: AS
authors.lastname: Finney
authors.forename: William Cory
authors.initials: WC
authors.lastname: Ellis
authors.forename: Allison J
authors.initials: AJ
authors.lastname: Spiwak
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Riley
mesh_terms: D000818:Animals; D001777:Blood Coagulation / Q000187:drug effects*; D001780:Blood Coagulation Tests / Q000379:methods*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001792:Blood Platelets; D002417:Cattle; D015718:Fibrin Tissue Adhesive / Q000494:pharmacology*; D005782:Gels; D006487:Hemostasis; D066298:In Vitro Techniques; D019095:Point-of-Care Systems; D013916:Thrombelastography / Q000295:instrumentation* / Q000592:standards; D014914:Whole Blood Coagulation Time
chemical_list: D015718:Fibrin Tissue Adhesive; D005782:Gels