title: Rapid evaluation of fibrinogen levels using the CG02N whole blood coagulation analyzer.
abstract: Rapid evaluation of fibrinogen (Fbg) levels is essential for maintaining homeostasis in patients with massive bleeding during severe trauma and major surgery. This study evaluated the accuracy of fibrinogen levels measured by the CG02N whole blood coagulation analyzer (A&T Corporation, Kanagawa, Japan) using heparinized blood drawn for blood gas analysis (whole blood-Fbg). A total of 100 matched pairs of heparinized blood samples and citrated blood samples were simultaneously collected from patients in the intensive care unit. Whole blood-Fbg results were compared with those of citrated plasma (standard-Fbg). The whole blood coagulation analyzer measured fibrinogen levels within 2 minutes. Strong correlations between standard-Fbg and whole blood-Fbg were observed (ρ = 0.91, p < 0.001). Error grid analysis showed that 88% of the values were clinically acceptable, and 12% were in a range with possible effects on clinical decision-making; none were in a clinically dangerous range without appropriate treatment. Using a fibrinogen cutoff value of 1.5 g/L for standard-Fbg, the area under the receiver operating characteristic curve of whole blood-Fbg was 0.980 (95% confidence interval 0.951-1.000, p < 0.001). The whole blood coagulation analyzer can rapidly measure fibrinogen levels in heparinized blood and could be useful in critical care settings where excessive bleeding is a concern.
authors.affiliation: Emergency and Critical Care Center, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Mineji
authors.initials: M
authors.lastname: Hayakawa
authors.affiliation: Emergency and Critical Care Center, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Gando
authors.affiliation: Emergency and Critical Care Center, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ono
authors.affiliation: Emergency and Critical Care Center, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Asumi
authors.initials: A
authors.lastname: Mizugaki
authors.affiliation: Emergency and Critical Care Center, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Katabami
authors.affiliation: Emergency and Critical Care Center, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Maekawa
authors.affiliation: Emergency and Critical Care Center, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Miyamoto
authors.affiliation: Emergency and Critical Care Center, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Wada
authors.affiliation: Emergency and Critical Care Center, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Yanagida
authors.affiliation: Emergency and Critical Care Center, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sawamura
mesh_terms: D001777:Blood Coagulation; D001780:Blood Coagulation Tests / Q000295:instrumentation* / Q000379:methods*; D002021:Buffers; D004867:Equipment Design; D005340:Fibrinogen / Q000032:analysis*; D006470:Hemorrhage; D006493:Heparin / Q000737:chemistry; D006706:Homeostasis; D006801:Humans; D000067716:Point-of-Care Testing; D015203:Reproducibility of Results; D013916:Thrombelastography / Q000295:instrumentation / Q000379:methods
chemical_list: D002021:Buffers; D005340:Fibrinogen; D006493:Heparin