Evaluation of the altitude impact on a point-of-care thromboelastography analyzer measurement: prerequisites for use in airborne medical evacuation courses

Purpose Hemorrhagic shock is the first cause of preventable death in combat. Evacuations of wounded by aircraft are increasingly used and severely injured patients can spend consequent time in the air, mostly during strategic evacuation. In these situations, monitoring of blood coagulation may be pi...

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Bibliographic Details
Published in:European journal of trauma and emergency surgery (Munich : 2007) 2022-02, Vol.48 (1), p.489-495
Main Authors: Boyé, Matthieu, Boissin, Jacqueline, Poyat, Chrystelle, Pasquier, Pierre, Martinaud, Christophe
Format: Article
Language:English
Subjects:
Aircraft
Altitude
Blood Transfusion
Critical Care Medicine
Emergency medical care
Emergency Medicine
Humans
Intensive
Medicine
Medicine & Public Health
Original Article
Performance evaluation
Point-of-Care Systems
Reproducibility
Reproducibility of Results
Sports Medicine
Surgery
Surgical Orthopedics
Thrombelastography
Traumatic Surgery
Viscoelasticity
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Summary:Purpose Hemorrhagic shock is the first cause of preventable death in combat. Evacuations of wounded by aircraft are increasingly used and severely injured patients can spend consequent time in the air, mostly during strategic evacuation. In these situations, monitoring of blood coagulation may be pivotal in the management of blood product transfusion. Viscoelastic-guided transfusion is relevant in these situations. However, evaluation of these devices used in aircraft is lacking, especially the impact of decreased atmospheric pressure. The aim of this study is to evaluate the performance of an easy-to-carry viscoelastic system (TEG ® 6s, Haemonetics). Methods First, TEG ® 6s repeatability, reproducibility, and correlation with chronometric methods and TEG-5000 were assessed on quality controls, healthy volunteers, and patients. Secondly, we tested the influence of vibrations and altitude on TEG ® 6s parameters (0ft vs. 8000 ft = 2428 m) and on quality control samples (normal and hypocoagulable). Results TEG ® 6s exhibited good correlation with the reference method and TEG ® 5000. Repeatability and reproducibility CVs were satisfactory. The tests performed in the hypobaric chamber revealed that performance at 0 ft and 8000 ft (2428 m) for 9 out of 13 parameters was not significantly different. However, we showed a significant increasing of CRT.Alpha ( p  = 0.049), CK.Alpha, CK.MA ( p  
ISSN:1863-9933
1863-9941
DOI:10.1007/s00068-020-01420-2