Abstract Number: PB0476
Meeting: ISTH 2022 Congress
Theme: Acquired Bleeding Disorders » Coagulopathy of Major Bleeding (Trauma, PPH, Vascular/surgical, ECMO, GI bleeding, etc.)
Background: T-TAS has gained popularity as a diagnostic tool to monitor antiplatelet therapy and predict bleeding risks. Its applicability to monitor trauma induced coagulopathy has not yet been assessed. The T-TAS AR chip evaluates fibrin-rich thrombus progression during arterial shear stress using platelet and coagulation system interactions. We hypothesized that the T-TAS AR Chip measurements (T10, OT, and AUC30) would correlate with prothrombin time (PT) and thrombelastography (TEG) measurements in detecting coagulopathy.
Aims: Using PT and TEG as gold standards, we evaluated the diagnostic accuracy of T-TAS.
Methods: 16 Yorkshire swine were randomized to undergo either instrumentation only (SHAM), or an injury model (INJURY: blast brain injury, femur fractures, hemorrhagic shock) followed by resuscitation. Native TEG, PT, and T-TAS measurements were performed in tandem on citrated blood samples collected at baseline, and at 60 and 240 minutes post-injury. Coagulopathy was defined as PT>14sec ( >2 SD above baseline mean). Correlation of T-TAS values with TEG and PT findings were conducted using Pearson’s correlation test.
Results: 4 Swine were assigned to the SHAM group and 12 to the INJURY group. The INJURY group developed coagulopathy at 60min (PT=15.4±3.8sec) and 240min (PT=14.91±2.2sec), while the SHAM group did not develop any coagulopathy. At baseline, the T-TAS outcome T10 correlated strongly with TEG’s R-Time (R=0.7, p=0.002) and Angle (R=-0.67, p=0.005), and correlated weakly with PT (R=0.35. p=0.18). R-time remained highly correlated with T10 throughout the experiment for both groups. PT and Angle showed correlations with T-TAS measurements at maximum coagulopathy in the INJURY group at 60min. MA was not significantly correlated to any T-TAS measurements.
Conclusion(s): T-TAS T10 appears to be a sensitive marker for detecting hypocoagulability postinjury, with strong correlations to the TEG R-Time. Other T-TAS measurements only correlated with PT and Angle during PT-detected hypocoagulability.
Table 1.
Table 1. Baseline correlations of T-TAS measurements with PT and TEG results.
Table
Table 2. Correlations at 60min and 240min post injury per each group for T-TAS measurements with PT and TEG results.
To cite this abstract in AMA style:
Cralley A, Moore E, DeBot M, Schaid T, Fox C, Ghasabyan A, Mitra S, Hom P, Hansen K, Cohen M, Silliman C, Sauaia A. Total Thrombus Formation Analysis System (T-TAS) Detects Poor Clot Formation in a Swine Model of Polytrauma and Hemorrhagic Shock [abstract]. https://abstracts.isth.org/abstract/total-thrombus-formation-analysis-system-t-tas-detects-poor-clot-formation-in-a-swine-model-of-polytrauma-and-hemorrhagic-shock/. Accessed October 2, 2023.« Back to ISTH 2022 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/total-thrombus-formation-analysis-system-t-tas-detects-poor-clot-formation-in-a-swine-model-of-polytrauma-and-hemorrhagic-shock/